{{Infobox medical condition (new) | name = Iridodialysis | synonyms = '''Coredialysis''' | image = Iridodilaysis - Blunt trauma to the eye.jpg | caption = Iridodialysis caused by blunt trauma to the eye | pronounce = | field = | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }}
'''Iridodialysis''' is a localized separation or tearing away of the iris from its attachment to the ciliary body.<ref name="Cline">Cline D; Hofstetter HW; Griffin JR. ''Dictionary of Visual Science''. 4th ed. Butterworth-Heinemann, Boston 1997. {{ISBN|0-7506-9895-0}}</ref><ref name="Cassin">Cassin, B. and Solomon, S. ''Dictionary of Eye Terminology''. Gainesville, Florida: Triad Publishing Company, 1990.</ref> ==Symptoms and signs== Those with small iridodialyses may be asymptomatic and require no treatment, but those with larger dialyses may have corectopia or polycoria and experience monocular diplopia, glare, or photophobia.<ref name="Rappon">Rappon JM. [http://www.opt.pacificu.edu/ce/catalog/10310-SD/Triage.html "Ocular Trauma Management for the Primary Care Provider." Pacific University College of Optometry. Accessed October 12, 2006.] {{webarchive|url=https://web.archive.org/web/20060901104617/http://opt.pacificu.edu/ce/catalog/10310-SD/Triage.html |date=September 1, 2006 }}</ref><ref name="DRO2">[http://dro.hs.columbia.edu/iridialysis.htm "Cornea & External Diseases: Trauma: Traumatic Iridodialysis."] {{Webarchive|url=https://web.archive.org/web/20171018171013/http://dro.hs.columbia.edu/iridialysis.htm |date=2017-10-18 }} Digital Reference of Ophthalmology. Accessed October 11, 2006.</ref><ref>{{cite journal | last1 = Brown | first1 = SM | title = A technique for repair of iridodialysis in children | journal = Journal of AAPOS | volume = 2 | issue = 6 | pages = 380–2 | year = 1998 | pmid = 10532731 | doi = 10.1016/S1091-8531(98)90041-6 }}</ref> Iridodialyses often accompany angle recession<ref>Sullivan BR. [http://www.emedicine.com/oph/topic121.htm "Glaucoma, Angle Recession".] eMedicine.com. August 16, 2006. Accessed October 11, 2006.</ref> and may cause glaucoma<ref name="DRO1"/> or hyphema.<ref>{{cite journal | last1 = Kiel | first1 = J | last2 = Chen | first2 = S | title = Contusion injuries and their ocular effects | url = http://www.optometrists.asn.au/gui/files/ceo841019.pdf | journal = Clinical & Experimental Optometry | volume = 84 | issue = 1 | pages = 19–25 | year = 2001 | pmid = 12366340 | doi = 10.1111/j.1444-0938.2001.tb04931.x | access-date = 2006-10-11 | archive-url = https://web.archive.org/web/20060927215821/http://www.optometrists.asn.au/gui/files/ceo841019.pdf | archive-date = 2006-09-27 | url-status = dead | doi-access = free }}</ref> Hypotony may also occur.<ref>{{cite journal | doi = 10.1034/j.1600-0420.2002.800104.x | last1 = Behndig | first1 = A. | year = 2002 | title = Results with a modified method for scleral suturing of intraocular lenses | journal = Acta Ophthalmologica Scandinavica | volume = 80 | issue = 1| pages = 16–18 | pmid = 11906298 | doi-access = free }}</ref> ===Complications=== Those with traumatic iridodialyses (particularly by blunt trauma) are at high risk for angle recession, which may cause glaucoma.<ref name="Rappon"/> This is typically seen about 100 days after the injury, and as such is sometimes called "100-day glaucoma". Medical or surgical treatment to control the IOP may be required if glaucoma is present.<ref name="DRO1"/> Soft, opaque contact lenses may be used to improve cosmesis and reduce the perception of double vision.<ref name="DRO1"/><ref name="Rappon"/>
==Causes== Iridodialyses are usually caused by blunt trauma to the eye,<ref name="Cassin"/> but may also be caused by penetrating eye injuries.<ref name="DRO1">[http://dro.hs.columbia.edu/trglaucoma.htm "Glaucoma: Angle Closure: Traumatic Iridodialysis."] {{Webarchive|url=https://web.archive.org/web/20170531191507/http://dro.hs.columbia.edu/trglaucoma.htm |date=2017-05-31 }} Digital Reference of Ophthalmology. Accessed October 11, 2006.</ref> An iridodialysis may be an iatrogenic complication of any intraocular surgery<ref>[http://telemedicine.orbis.org/bins/content_page.asp?cid=1-1758-1889-1921 "Manual Small Incision Cataract Surgery: Intraoperative Complications."] {{Webarchive|url=https://web.archive.org/web/20120205213540/http://telemedicine.orbis.org/bins/content_page.asp?cid=1-1758-1889-1921 |date=2012-02-05 }} ORBIS International Inc. Accessed October 11, 2006.</ref><ref>{{cite journal | last1 = Gashau | first1 = AG | last2 = Anand | first2 = A | last3 = Chawdhary | first3 = S | title = Hydrophilic acrylic intraocular lens exchange: Five-year experience | journal = Journal of Cataract and Refractive Surgery | volume = 32 | issue = 8 | pages = 1340–4 | year = 2006 | pmid = 16863972 | doi = 10.1016/j.jcrs.2006.02.062 }}</ref><ref>{{cite journal | last1 = Walker | first1 = NJ | last2 = Foster | first2 = A | last3 = Apel | first3 = AJ | title = Traumatic expulsive iridodialysis after small-incision sutureless cataract surgery | journal = Journal of Cataract and Refractive Surgery | volume = 30 | issue = 10 | pages = 2223–4 | year = 2004 | pmid = 15474840 | doi = 10.1016/j.jcrs.2004.03.040 }}</ref> and at one time they were created intentionally as part of intracapsular cataract extraction.<ref>{{cite journal | last1 = Beetham | first1 = WP. | year = 1941 | title = Cataract Extraction with Iridodialysis | journal = Trans. Am. Ophthalmol. Soc. | volume = 39 | pages = 104–15 | pmid = 16693243 | pmc = 1315004 }}</ref> Iridodialyses have been reported to have occurred from boxing,<ref>{{cite journal | last1 = Hazar | first1 = M | last2 = Beyleroglu | first2 = M | last3 = Subasi | first3 = M | last4 = Or | first4 = M | title = Ophthalmological findings in elite amateur Turkish boxers | url = http://bjsm.bmjjournals.com/cgi/content/full/36/6/428 | journal = British Journal of Sports Medicine | volume = 36 | issue = 6 | pages = 428–30 | year = 2002 | pmid = 12453836 | pmc = 1724577 | doi=10.1136/bjsm.36.6.428}}</ref> airbag deployments,<ref>{{cite journal | last1 = Kenney | first1 = KS | last2 = Fanciullo | first2 = LM | title = Automobile air bags: friend or foe? A case of air bag-associated ocular trauma and a related literature review | journal = Optometry | volume = 76 | issue = 7 | pages = 382–6 | year = 2005 | pmid = 16038865 | doi = 10.1016/j.optm.2005.06.001 }}</ref> high-pressure water jets,<ref>{{cite journal | last1 = Gracner | first1 = B | last2 = Pahor | first2 = D | title = Bilateral eye injury caused by a high-pressure water jet from a fire hose | journal = Wiener Klinische Wochenschrift | volume = 113 Suppl 3 | pages = 62–4 | year = 2001 | pmid = 15503624 }}</ref> elastic bungee cords,<ref>{{cite journal | last1 = Viestenz | first1 = A | last2 = Küchle | first2 = M | title = Ocular contusion caused by elastic cords: a retrospective analysis using the Erlangen Ocular Contusion Registry | journal = Clinical & Experimental Ophthalmology | volume = 30 | issue = 4 | pages = 266–9 | year = 2002 | pmid = 12121366 | doi = 10.1046/j.1442-9071.2002.00529.x }}</ref><ref>{{cite journal | last1 = Chorich Lj | first1 = 3rd | last2 = Davidorf | first2 = FH | last3 = Chambers | first3 = RB | last4 = Weber | first4 = PA | title = Bungee cord-associated ocular injuries | journal = American Journal of Ophthalmology | volume = 125 | issue = 2 | pages = 270–2 | year = 1998 | pmid = 9467466 | doi = 10.1016/S0002-9394(99)80111-1 }}</ref> bottle caps opened under pressure,<ref>{{cite journal | last1 = Viestenz | first1 = A | last2 = Küchle | first2 = M | title = Eye contusions caused by a bottle cap. A retrospective study based on the Erlangen Ocular Contusion Register (EOCR) | journal = Der Ophthalmologe | volume = 99 | issue = 2 | pages = 105–8 | year = 2002 | pmid = 11871070 | doi = 10.1007/s003470100504 }}</ref> water balloons,<ref>{{cite journal | last1 = Bullock | first1 = JD | last2 = Ballal | first2 = DR | last3 = Johnson | first3 = DA | last4 = Bullock | first4 = RJ | title = Ocular and orbital trauma from water balloon slingshots. A clinical, epidemiologic, and experimental study | journal = Ophthalmology | volume = 104 | issue = 5 | pages = 878–87 | year = 1997 | pmid = 9160038 | doi=10.1016/s0161-6420(97)30218-8}}</ref> fireworks,<ref>{{cite journal|last1=Arya|first1=SK|last2=Malhotra|first2=S|last3=Dhir|first3=SP|last4=Sood|first4=S|date=September 2001|title=Ocular fireworks injuries. clinical features and visual outcome|url=http://www.ijo.in/article.asp?issn=0301-4738;year=2001;volume=49;issue=3;spage=189;epage=190;aulast=Arya|journal=Indian Journal of Ophthalmology|volume=49|issue=3|pages=189–90|pmid=15887729}}</ref><ref>{{cite journal | last1 = Sacu | first1 = S | last2 = Ségur-Eltz | first2 = N | last3 = Stenng | first3 = K | last4 = Zehetmayer | first4 = M | title = Ocular firework injuries at New Year's eve | journal = Ophthalmologica | volume = 216 | issue = 1 | pages = 55–9 | year = 2002 | pmid = 11901290 | doi = 10.1159/000048298 }}</ref> and various types of balls.<ref>{{cite journal | last1 = Purdie | first1 = AT | last2 = Whyte | first2 = IF | title = Shinty and ocular trauma in north west Scotland | url = http://bjo.bmjjournals.com/cgi/content/full/82/12/1444a | journal = British Journal of Ophthalmology | volume = 82 | issue = 12 | pages = 1445 | year = 1998 | pmid = 9930282 | pmc = 1722457 | doi = 10.1136/bjo.82.12.1444a }}</ref>
==Treatment== Iridodialysis causing an associated hyphema has to be carefully managed, and recurrent bleeds should be prevented by strict avoidance of all sporting activities. Management typically involves observation and bed rest. Red blood cells may decrease the outflow of aqueous humor, therefore the eye pressure should be kept low by giving oral acetazolamide (a diuretic given to reduce intraocular pressure). Accidental trauma during sleep should be prevented by patching with an eye shield during night time. Avoid giving aspirin, heparin/warfarin and observe daily for resolution or progression. A large hyphema may require careful anterior chamber washout. Rebleeds may require additional intervention and therapy. {{cn|date=November 2025}}
Later, surgical repair may be considered for larger avulsions causing significant double vision, cosmesis or glare symptoms.<ref name="DRO2"/> Surgical repair is usually done by 10-0 prolene suture taking the base of iris avulsion and suturing it to the scleral spur and ciliary body junction.{{cn|date=November 2025}}
==See also== * Eye injury
==References== {{reflist}}
== External links == {{Medical resources | DiseasesDB = | ICD10 = {{ICD10|H|21|5|h|15}} | ICD9 = {{ICD9|364.76}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = | eMedicineTopic = | MeshID = | SNOMED CT = 45953007 | ICD10CM = {{ICD10CM|H21.53}} }}
{{Eye pathology}}
Category:Disorders of iris and ciliary body