Large pupil

[lenad77]

Hi, my 5 year old son had an eye injury, corneal laceration. He had stitches put on. After this surgery his pupil was normal size. He was put on atropine 4 times a day for 12 days and other drops. Four days later ( after the stiches surgery) he had cataract surgery but didn't t receive an iol. It has been a month now since he stopped atropine but the pupil is still  large. He has light skin and green iris. the question is, since he had normal pupil after the first surgery is there a chance that his pupil muscle could have been damaged after the cataract surgery or the atropine is still in effect or his pupil was damaged right after the trauma (if so, then why the pupil was normal after the stitches were put in) or can his pupil be large to the absence of the lense? Thank you

[lenad77]

Thank you for your answer. One more question , my son didn't receive any kind of correction to his injured eye due to his stitches on the cornea. He had half of the stitches removed a little over a month after the surgery, and the rest of them will be removed in a month from now which means he will not be using his eye for more than two months. The doctor said he doesn't want to put contact lense while the stitches still there. Will he develop bad amplyopia during these two months? And will it be hard to treat? Thank you

[Christopher C Shen, MD]

Seems unusual that the pupil is still large since the effects of Atropine typically wear off after two weeks and if there was damage to the iris from surgery, it would typically remain dilated immediately after the procedure as opposed to constricting and then subsequently dilating.  It seems like it is possible the effects of the atropine haven't worn off yet given the timing of the dilation and if the iris is still functional, perhaps the addition of a constricting drop such as pilocarpine may help if no improvement over the next few weeks.