Pupil stuck due to iritis

My son of 12, had a foam dart war with his brother and 1 accidently hit his eye. The eye was sensitive and red but looked a lot better the next day. We went through the weekend without problems and when he returned home from school on Monday, his eye was red, watery and very painful. We went to the emergency on tuesday morning where they had a look in his eye to check for damage, gave him some topical antibotic (antibiotic) around the eye and assured me that the eye would clear up within a couple of days....it did. Unfortunately this was not the end of it because a week later he was dismissed early from school and once again we were heading to the doctors office for his eye. Finally he got some eye drops 'ratio-prednisolone' to be given 3x a day. This doctor was stunned with the reply from emergency and we had to come back within 2 days. So on thursday that week we got the news from this doctor that the eye looked good, keep doing the eye drops for another 48 hours, and we should be all fine from thereon. Well it only took 24 hours without drops for his eye to act up again. Finally we received a referral for the opthamologist and now he has to take the eye drops every hour, also during the night. His pupil got stuck due to the fact that his eye has been inflamed for a long time. This tuesday we are back at the specialist office and will find out what the scoop is.
First: How can all those doctors misdiagnose his condition?
Second: He is only 12 and must spent the rest of his life with a stuck pupil.....are there options like laser surgery or....training the eye....anything?
Third: Will this condition reoccur? Even when it was caused by trauma to the eye?

We all know that kids can be cruel to each other and I fear for the years to come for him The opthamologist told me that his vision would not suffer any from this but after reading on the internet I am not so sure....please help.

Thanks, Jolanda

[Houman Vosoghi, MD]

First: You can not tell what is going on in the eye without a careful examination under magnification so the other doctor's had no chance of knowing the extent of his injuries and should have had him follow-up with an ophthalmologist within a couple of days to be sure.  Second: I do not know the extent of the scarring on the pupil, sometimes we could break the scarring up with a strong dilating drop (assuming it is stuck in a smaller position).  If it is dilated, there could be tears in his iris sphincter which are more difficult to fix.  Don't think about that right now, let his eye heal fully and then discuss options with your ophthalmologist.  Third: occasionally, iritis recurs (especially likely if there is a predisposition to autoimmune disease in the family) but in most cases once it is fully treated and gone, it stays away.  Finally, he needs to be checked a bit more frequently than the average person to make sure he does not develop a cataract or glaucoma in that eye which sometimes happens due to injury to different parts of the eye.

HV