Aa
Aa
A
A
A
Close
Avatar universal

Traumatic Mydriasis, need help

Hi everyone. I have what seems to be a traumatic mydriasis from blunt trauma to my right eye that happened back in the middle of December.

My history:
Middle of December I took a slapshot to the eye from a rigid PVC hockey ball (wasn't wearing a cage). I immediately lost vision in my right eye. I was rushed to the hospital and determined to have a hyphema. The only thing I could see was light. The next day, the doctors could not get an accurate pressure reading on my eye so they decided to perform an "exploration of the eye" surgery, and found out that I had no tears or ruptures. The day following the surgery, and this is a big part, I was checked out by the doctor and he said when he shined the light into my eyes, my pupil was reacting, so that was a great sign that my nerve was working. I was given Atropine to take 2x daily and Prodnolisone to take 4x daily. I am 25 years old, so you can gauge my healing capacity.

Since then, I was on bedrest for about 2 weeks, staying on the atropine during this time. I was seeing an opthalmologist every few days. The hyphema eventually reabsorbed and I regained vision in my eye. I d/c'd the atropine after 2 weeks of being on it, but stayed on prodnolisone for about another 2 weeks thereafter. About a month after the initial hit, now middle of December, I still had a mydriasis, probably around 8mm when compared to the chart. Bad photophobia, poor visual acuity, everything. I was prescribed Pilocarpine 1% to take 4x daily. Within the first dose of this, my pupil had constricted and I could see much more comfortably. I stayed on this for a week and upon dc'ing the pilocarpine, my pupil had gone back to full size within about 36 hours. I have been off all medication now since that time, seeing my doctor here in a week.

During the course, the doctors all thought I was still under the effects of Atropine, since there did not appear to be any tears in the iris muscle that were noticeable, and that was the best explanation for my very dilated pupil. Now that my entire history has been explained, is it POSSIBLE that since my pupil was reacting to light just 2 days after the surgery, and now doesn't react at all, that the atropine dilated the pupil beyond its normal range of travel and tore a muscle in the iris somewhere? I just don't understand how it was reacting to light initially after the trauma, but now is so unreactive and open. This has been an emotionally taxing ordeal and I'd like to understand where I go from here, or if the atropine may have caused me this permanent state of discomfort with my eye.

Thanks to anyone that can offer assistance, but if not, I hope any searchers with similar issues may be able to benefit from this post.
304 Responses
Sort by: Helpful Oldest Newest
Avatar universal
Hi John, since I got mydriasis, even using sunglasses, my injuried eye is a little bit red (let´s say it´s a eye: , the "-" chars are constantly red) and I noticed when I traveled during the night, driving for 5 hours, that it becomes too much red.

well, I´m sure it´s a result of mydriasis, but, what you think about it? there is a way to handle it ?

thanks again!
Helpful - 0
177275 tn?1511755244
best of luck
Helpful - 0
177275 tn?1511755244
No I don't do that type of surgery and its not necessary to travel so far as there are many fine ophthalmologists in Florida.  Bascom Palmer Eye Institute at U of Miami is among the best in the world.

JCH MD
Helpful - 0
1 Comments
Thank you
177275 tn?1511755244
Depending on the status of your eye and your injury it may be very difficult. Plus if the pupil is made smaller with a "purse string" incision it will not dilate and it will be hard for the doctors to see and treat the back of your eye. You need to discuss with your retina surgeon and also get several opinions from cataract surgeons.

JCHMD
Helpful - 0
1 Comments
Thank you for the quick response, the injury happened on 12/31/2015 and as of yet I have not had high eye pressure. When the time comes is it possible to have a second opinion by you? I live in Florida but am willing to travel. Thanks
Avatar universal
John,
as i had a ruptured globe due to a metal wire penetrating my eye which left me aphakic, right now i am recovering from my second surgery where the doctors removed the silicone oil. I do not know the exact size of my pupil but i do know that I can not tolerate bright lights. my opthomogist has suggested that if my vision improves with a contact lens that I may not need any more surgeries but my concern is the possibility that i may have Mydriasis. i would prefer a permanent solution like and IOL, how complicated is to suture my iris if my doctor would perform the IOL surgery.

thanks
Helpful - 0
177275 tn?1511755244
No that is not a side effect of pred forte.  And is related to your injury.  Know that after a hyphema you are at increased risk of glaucoma, cataract, retinal detachment.

JCH MD
Helpful - 0
Have an Answer?

You are reading content posted in the Eye Care Community

Top General Health Answerers
177275 tn?1511755244
Kansas City, MO
Avatar universal
Grand Prairie, TX
Avatar universal
San Diego, CA
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
Discharge often isn't normal, and could mean an infection or an STD.
In this unique and fascinating report from Missouri Medicine, world-renowned expert Dr. Raymond Moody examines what really happens when we almost die.
Think a loved one may be experiencing hearing loss? Here are five warning signs to watch for.
When it comes to your health, timing is everything
We’ve got a crash course on metabolism basics.
Learn what you can do to avoid ski injury and other common winter sports injury.