Eye injury while playing badminton

Hello, I am 26 years old female. I got badly hit on my left eye by a birdie(shuttle cork) while playing badminton exactly 5 weeks ago. I went to ER and also got immediate ophthalmologist care. I suffered from hyphema, inflammation, dilation of the pupil and high pressure in the eye. Thankfully, I did not have any vision loss.
Unfortunately, the eye pressure of my left eye has still been high (22-26). I have been taking medications for the increased pressure. However, to reduce the inflammation, I was taking 1% Econopred plus from a month now. The doctor told me that Econoplus is a steroid and can increase the pressure of the eye, hence I have stopped it completely. Right now, my inflammation is gone and hyphema is cured, however my pressure is still high and my pupil size is still big. From the last two days I have been experiencing floaters. Could you please let me know if there are any chances that the pupil size will reduce in future? How long can I expect for the floaters to go on and the pressure to come down? If I am having glaucoma already, is it life long or will it go away if treated?

Thanks!

[John C Hagan III, MD, FACS, FAAO]

Take home lesson for anyone reading this. In all contact and racquet sports wear proper eye protection.

1. Your pupil could be permanently injured from the direct blow. The muscle that closes the pupil is much more prone to injury then the muscle that dilates it. The problem is called traumatic mydriasis. If you used an eyedrop with a red top (atropine, homatropine, cylcogel, mydriacil) then it could be dilated from mediciations used to put your iris to rest to prevent more bleeding and inflammation. Only time will tell. Generally if you pupil is still dilated 3-6 months post injury its permanent. If it really is troublesome your ophthalmologist might prescript a very weak pilocarpine drop to make it smaller.

2. The floaters may also be permanent. Remember that by age 50 more than half of all people have floaters. If you have showers of floaters, flashes of light or any loss of peripheral vision see your Eye MD immediately as this could be a sign of a retinal detachment.

3. If your glaucoma is due to the prolonged steroids it might take several months to return to normal. If it's due to your injury it will stay up and your will require glaucoma drops to lower the pressure. You should have a test called gonioscopy done to look for damage to the filtration angle of your eye. That damage is called a recessed angle. You also need a basic glaucoma work up: visual fields, optic nerve photos, optic nerve OCT, central corneal thickness measurement and the pressure checked 3-4 times/year.

JCH III MD

[sgowri]

Thank you for a quick reply, appreciate it.

Yes, it is a very important lesson people should learn to avoid such freak accidents.

Yes I was taking the drops with red cap for 10 days after the injury, but have stopped since then. I also took steroids for a month, so I am hoping that the glaucoma will reduce after a few months. I am being monitored every two weeks by my doctor. I have been taking Betimol for the control of ocular pressure. Since its been only a month after the injury, I am really hoping my pupil size reduces eventually.

[sgowri]

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