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Traumatic Mydriasis, need help
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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.
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711220_tn?1251894727
Atropine is very long lasting cycloplegic drop.  You response to pilocarpine indicates that the constricting muscle in your eye is still working.  However the initial trauma may have partially weaken the muscle.  You may have to be on pilocarpine for the near future.  This may recover with time.   Long term this eye has to be followed closely.  In the near future you should have your retina checked for retinal tears and retinal detachment.  Long term you need to be followed for glaucoma.

Dr. O.

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Avatar_n_tn
Dr. O, thank you considerably for taking the time to respond to my issue.  That slightest bit of hope helps alleviate my other problem right now, which is obviously my everyday mood.  In the interest of keeping the initial post short, I did not mention that I had an orbital floor fracture that has been inspected and deemed to not require surgery, as well as close retinal examination since the injury, which has been reported to be in good condition.  Thank you again for the ray of hope.  Any bit helps.
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711220_tn?1251894727
I doubt the blow out fracture is a cause of the dilated pupil.

Dr. O.
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Avatar_n_tn
If you'd like a second opinion, the Cincinnatti Eye Institute in Ohio houses some of the best surgeons in the world that deal specifically with pupil function.
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Thanks, bad eyes.  For right now I'll sit tight and hope for the best, and if it looks like I've lost function I may have to give them a look.
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As an update to any using this thread as a reference, I have been on Pilocarpine for the last month.  Sometimes I use 0.5%, sometimes I use 1%.  The 1% lasts longer but it also overly constricts my pupil sometimes.  At any rate, it does bring the pupil size down but once it starts to wear off, my pupil gets larger and I have more problems focusing near, and have big problems with bright objects.  Thus, it's important for me to keep the pupil size down.  For some reason, my injured eyes sees colors more vividly than my uninjured eye, even when the pupil is very constricted.  When both pupils are the same size, for some reason my injured eye seems to see bright colors brighter than my uninjured eye, while darker colors it sees darker.  I suspect this to be an effect of the pilocarpine to explain the darker colors.  The brighter colors, so far no doctor has been able to explain to me, since the pupils are the same size and thus should be filtering the same amount of light.

I have read on another thread here that acupuncture has helped another case of traumatic mydriasis.  I am not sure if it will help me, but I am going to try, because they claim that acupuncture realigns the body and helps it heal to its fullest potential, and that's what I am hoping for, to heal.  I have found a local doctor in the area that specializes in acupuncture in the eye area.  I am hoping this will render the best results reasonable.

I am not considered an ideal patient for the iris cerclage suture procedure because my original lens is still clear without cataracts, and performing the surgery would risk damage to the lens, causing a possible cataract.  This procedure seems to be favored when performing  cataract surgery, performing both at the same time.  So as of right now, it's pilocarpine and hoping for the best.  

I would like to inform those reading that the "exploration of the eye" procedure has caused me more problems.  I have excessive redness/bloodshot on one side of my eye where the blood vessels have all come together (looks bad, everyone notices it instead of the pupil), conjunctiva that is no longer bright white, irritated eyes, and problems wearing contacts.  Thi problem cosmetically is more noticeable than my pupil when  it's full.  Everyone notices the red eye.  I understand that this surgery is done to rule out life threatening injuries that could lead to infections, but if I were in any stable state of mind and the doctors didn't just tell me "it'd heal in a day," I would've never agreed to the procedure, since they had actually gotten a pressure reading of 20 through a different means of testing.  My problems now are twofold rather than just dealing with the mydriasis itself.  Anyway, I think readers should know this, and I wish I had, when the doctors had nonchalantly suggested they should perform the surgery.  My eye has been a nightmare to look at since, and honestly a little painful at times.

I know this is not a commonly documented injury due to the limited resources I could find online, so I will be sporadically updating the events that follow.  I only hope that my misfortune and documentation of my recovery will help any of those that find themselves in a similar situation, or prevent some of those from putting themselves at risk for this type of injury.  
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Avatar_n_tn
Thanks for taking the time to do this post.  I recently got hit in the eye with a squash ball and have pretty much the same experience that you have outlined above.  I am now about one month on, and still have mydriasis in the injured eye.

This has been the most informative post I have found so far.  Understanding that at this stage the mydriasis is not considered permanent and that there are some treatments available is good news.

Due for my follow-up appointment this week, so I will post again to let you know.

Thanks again.
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Avatar_n_tn
been back to the eye doctor today and been given the all clear.  Dispite the pupil still being dilated he has told me that there is no permanent damage expected. They pupil is expected to return to normal in the next few months.  Great news for you.  I was worrying for no reason.

All the best to everyone out there - remember to put the goggles on next time you play!
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Avatar_n_tn
Toby, that sounds like a promising prognosis from the doctor.  Does your pupil have any reactivity to light?  Mine has none, even though they find no damage to the sphincter muscle of the iris.  I think they believe it to be neuronal damage.  
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Update to any readers.  I have been trying acupuncture for about the past 5 weeks, treatments 2x a week.  This involves needles in my feet, hands, eyebrow, and 3 into my orbit.  My acupuncturist is very experienced with treating eye diseases that require these special placements so although I don't have anything to compare to, he seems to know what he's doing and surprisingly can get the needles around my eye without much pain, sometimes with none at all.  This has so far yielded no results.

I have also tried homeopathic means with a naturopathic doctor, for the past week, using symphytum and arnica.  No results as of yet there, either.
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Avatar_n_tn
I had a similar injury to you. I was hit in the eye with a field hockey stick during another player's back swing. I had a fractured nose, orbital socket, a hyphema which caused total vision loss for several hours and traumatic mydriasis. My pupil was non reactive for several months after the injury and was very large. I was worried that it would never heal but after around 6-7 months it gradually got better to the stage now where is it reacting to light, just not as quickly or effectively as the other pupil. I had ordered a custom made, hand painted lens to reduce the photophobia and to improve the look of my eye. I'm hopeful that it will continue to improve. Good luck- I hope yours begins to improve also.
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Thank you for taking the time to read my post and respond.  That gives me a great amount of hope. :)  Unfortunately my hyphema led to vision loss for about 3 days so I may have had slightly more trauma within the eyeball itself but I'm glad to hear yours was just as bad and now actually responds to light.  I'll continue to get my healing treatments and hope for the best!
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I was hit in the left eye with a tennis ball towards the end of 2007.  Angle recession, trauamtic mydriasis and retinal scarring occured.  Ophthalmologists told me different things about the scarring and pupil dialation.  Some said the dialation wouldn't be permanent, others said that the scarring would not be permanent.  I have a blind spot from the retinal scar and my pupil has gradually become more responsive to light.  It has not improved completely yet.  I can't remember how long, but for the first while after being hit I had no response to light (maybe a month or two).  I am writing this post because I have decided to pursue knowledge of eye conditions and advance awareness as I  become an optometrist.  I have been researching treatments online for traumatic mydriasis (like you have I'm sure) and have found nothing promising that would bring the muscle functioning back to normal.  When I learn more or find something new I will post it.  Until then, keep your sunglasses on!
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Just another update everyone, though no real progress to update.  I'm confident to say that the grieving period has come to a close and life is resuming to a new level of "normal."  I'm back to acting like myself and accepting what happened, which honestly is a big part of the healing process.  This entire ordeal has been emotionally exhausting above all else.  Obviously my daily routine has changed with Pilocarpine drops taken about 2-3 times a day at 0.5% strength, which wear off about 3 hours after use, where the pupil start to open back up.  Also, since I've always needed corrected vision, I can no longer wear my contacts for long periods of time because they just get uncomfortable, so I wear glasses most of the time now.  It's harder to get my prescription right in the eye, since the prescription changes with how dilated the pupil is.  I have tried many types of homeopathic treatments, lots of different vitamins, and all other means listed from posts above.  Now I have just come to accept the condition and though I have not lost hope, I feel it's easier to make the best of everyday without taking progessive measures to fix the eye.  I'm out of options, other than surgery.  It's easier on the mind to not get hopes up to be let down everytime, too.

So, to anyone reading this who has recently been hit in the eye and has a mydriasis, get on vitamins asap, and if you're having a tough time dealing with the injury emotionally, consider an SSRI with your doctor just to help out with the situational anxiety or stress.  Being positive helps the body heal better, and just being honest, though I do wish my eye were healed, this isn't that bad.  I've learned to live with it and I'm sure any strong-willed person will be able to, as well.  Mornings are just a little brighter until the drop sets in.  I'll continue adding to this post if anything changes, but until then, take care of yourselves, and wear eye protection.
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Avatar_f_tn
the same thing happened to me, two weeks ago i was hit in the eye with a woofle ball bat..i had hyphema and was put on the prednisone drops..my right eye which is the injured one is still dilated, im hoping this goes away within time, my doctor said from my checkup the other day things are improving..my pupil still slighty reacts and gets a tad smaller when in the light but not as small as the uninjured one..im thinking about taking those pilocarpine drops, do they work well to make the pupil look smaller or at least somewhat similiar to the other one?
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Hi Nik.  I'm not a doctor but I will offer my personal opinion in response to your question about Pilocarpine.  I would not even consider starting to take it right now, and I assume your doctor would agree with me.  You risk a detached retina with Pilocarpine and after the trauma that your eye has sustained, it needs time to heal.  If your eye is reacting to light, you have a lot to be thankful for.  The Pilocarpine will essentially paralyze your pupil in a fixed small state, often "overshooting" the effect you're looking for, and becomes much smaller than your other pupil, looking weird.  Pilocarpine is by no means a magic medicine, it just makes the pupil smaller and has many side effects such as headaches, blurred vision, difficulty seeing in the dark, and the dreaded detachment of your retina being obviously the most severe.  So, my personal opinion is to take all your eye vitamins and take care of yourself.  Let your body heal and maybe a couple months down the road if your eye doesn't recover, talk to the doctor about Pilo.

For any others reading, a friend of mine had HIS eye struck with a hockey stick in a game about a month ago.  He had a partial hyphema and an orbital blowout.  He had a slight mydriasis afterward, but his pupil still reacts to light and is only a bit bigger than his uninjured eye, nothing near as bad as mine.  His has improved over just the last month and he's almost back to normal.  Our bodies heal themselves when we take care of them, so don't forget to do that if you find yourself in this situation.  
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thankyou so waterwings for telling me there is hope, i have a good feeling it is going to heal im just being positive..its only been two weeks and its already improving i hope you and your friend both get better!
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when i had gone to the doctors last week, my doctor said that i had a very small tear in my retina, right away he did a laser surgey to patch it up and since then i barely have floaters..will this by any chance help heal my dilated pupil? also he said that the eye pressure was perfect, great reaction to light and everything else was good, he said about 6 months for it to fully heal i really hope my pupil goes back to normal size esp. i have green eyes so to me i notice it way more, if i have all good signs, is there a good chance i just need more healing time considering its only been about 4 weeks since the incident?

i really appreciate any help or answers i can get from everyone! thanks alot
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Yeah Nik, I'd listen to your doctor.  I've heard of surgery to re-attach the retina sometimes causing pupil damage, but it sounds like you're fine.  Give the eye time to heal.  It sounds like it will.
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Hey Waterwings, I have also had a dilated pupil for coming up to 10 weeks now after blunt trauma from being hit in the eye in indoor cricket by the ball.. I am hopeful of it resolving but was wondering if you have experienced much glare/ photophobia as a result and what I could possibly do to aid this?
Cheers
GP 77
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Avatar_n_tn
Glare and photophobia, I can only assume, come from your increased pupil size, allowing in more light.  As my Pilocarpine wears off and I go outside, any colors that reflect light are difficult to look at and VERY bright.  White cars are the worst.  For me, since I wear glasses, I squint to combat it.  If you don't have corrective lenses on, the only way to combat it, without medical intervention, is sunglasses.  You're still only 10 weeks in so eat healthy and be hopeful, things could come around.  

As an update to my own case, we've been trying for awhile to find a prescription that works best for my injured eye, as the Pilo is causing my prescription needs to change throughout the day.  Just letting individuals know, if you are on Pilocarpine and need corrective lenses, the Pilo may be affecting your range of accomodation and causing problems trying to get a reliable lense.  As an example, when I put my drop in, I am pretty blurry for about the first 1.5 hours.  Midway through the medicine and when my pupil is wide open, I see pretty well.  Anyway, just a word for anyone wondering, the Pilo does cause more unexpected issues for those with higher levels of astigmatism that need corrective lenses.
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Thanks a lot for that encouragement and advice waterwings, I think this is one of those situations in life where its best to try and adjust to it and make the most of each day but at the same time hold out hope it will be corrected!
All the best with you're situation!
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Thank you for taking the time to post all this relevant information.  I am on my 8th day of trauma since being hit in the right eye with a racquetball, I've the sport twice a week for 12 years and have been side lined since the hit.  I was diagnosed with a contusion in the back of the eye and since have had traumatic mydriasis. I am a very active 34 yr old male and this so far has been a very frustrating experience.  Especially not being able to read or see the computer screen.  I am still on Atropine 3x day and Prednisolone 4x day.  After the hit I lost vision for about 4 hrs and was able to see foggy the next day.  I am trying to accept what has happened and that it can only get better....the Dr. said the pupil was "vaguely" responding when I saw him last 6 days ago and it is what he said in the ER the day of the injury.  Good luck to all of you that have this annoying condition and if and when I recover my sight I will always wear eye protection, no exceptions.  
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I recently (6 days ago) was hit in the eye by a racquetball. I have been worried sick that my dilated pupil (extremly large) will be permanent due to internet research that was vague and blunt. This site containing others' situations and experiances has been the biggest uplift thus far. I have not been to a doctor as I do not have medical insurance and also suffering financially. I have been diagnosing myself purley on internet research. With all of your posts in mind, I have come to the conclusion "And I thought my eye was messed up??" I now feel I will be fine if I just stay healthy, take vitamins, and give it time. Thank you all sooo much for the advice and hope. It means more to me and Im sure to others more than you know! ( or mabye you do )
Thanks Again!!
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Hey there and I'm glad you were able to get gain some hope from this thread.  Keep an eye out for flashes of light or what looks like a shade falling over your eye.  These are signs of a detached retina and if they show up, see a retina doctor IMMEDIATELY.  They can normally fix it if caught in time.  I think you're at most risk for this in your first month after the incident.  Otherwise, if you didn't have a hyphema, (and though there's never a substitute for proper medical care), I would expect your doctor to just tell you to give it plenty of rest.  
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I am also a case of dilated pupil and here is my story:

This happened about 6 months back when I my pupils appeared to be of different sizes when I saw in the mirror. I ignored the situation thinking that maybe light was falling unevenly in both the eyes and also, since, I was also undergoing treatment for convergence insufficiency (CI), thought it might be related it to the CI problem. When I mentioned the situation to the doctor conducting the eye exercises for treating CI, he was quite alarmed, as it was not there before.

I checked on Internet and found that dilated pupil can be caused by trauma, multiple sclerosis, tumor or some brain injury.

Other reasons could be drug abuse, certain medication or eye drops and in these cases the dilation should be temporary.

The dilated pupil affects the near range vision like reading a book, working on computer, etc. as looking at close distance requires pupils to constrict. Since, dilation allows extra light to enter into the eyes, it also causes problems in bright light situations (photophobia) like going out in a sunny day.

My pupil on one eye dilated due to simple eye trauma involving hand hitting the eye. Since, I could not remember the event, the following sequence of events ensued to do initial tests and rule out other serious possibilities.

1. Field Test - I think this tests the range of my sight at different angles.
2. VEP  (Visually Evoked Potential) – I think this was to check the response time of my optical nerve, which sends the light signal to the brain.
3. MRI (Magnetic Resonance Imaging) – I think this was to rule out the possibility of tumor in the eye region. To be doubly sure, contrast test was also done, by injecting me during the test.
4.  Next step was to see a neurologist who too could not find any problem.

As all the reports were perfectly fine and as the cause of the problem could not be located, doctor suggested to wait and watch and visit him again after a couple of months.

Recently, I happened to recollect the incident involving eye trauma and went back to the doctor with this new information and he immediately concluded that it is a case of traumatic mydriasis. The doctor recommended an OCT (sonography for the eye), to rule out any other injury within the eye and this test did not show any other problem.

So, now, no other problem has been found other than the fact that my pupil is dilated due to eye trauma which has weakened the muscles (iris) that controls the pupil, the doctor has prescribed me Pilocar 2% which reduces the size of the pupil to a small dot (can be referred to as miosis) but comes back gradually to its earlier dilated state in lets say 15-20 hours time.

Currently, I am not clear if Pilocarpine drops helps to heal or it is for temporary relief. If, it is just for temporary relief, then I would rather not use the medicine as I have got corrective lens to fix the short range problem and use sunglasses when out in the sun.  I was recommended progressive lens but currently using single vision. But that’s another story.

Although, the doctor has not given me much hope of recovery, reading posts here has given me some.

Please note that the above information is provided for the benefit of others and accurate as per my knowledge and understanding.
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Thanks for adding to the thread, eyehope.  Very informative post.  Yours doesn't seem to be that bad, so let's hope for your recovery.  I would strongly recommend trying lower doses of Pilocarpine.  Given the possibility of the detached retina, I'm just a believer to use as low a dose as is effective.  I was using 1/8 of a percent solution that I had to mix myself that my doctor showed me how to.  Of course every person's iris reacts differently to pilo so you may need a stronger dose, but still I'd recommend trying it.  You'll notice when your pupil gets real small with the 2% dose, your distance vision is poor and the shades of colors will be affected as to what the eye sees, since it's letting in minimal light.  You'll also notice your field of vision may seem smaller, as I felt claustrophobic when I used mine, and could even see my nose using the drops.  Just food for thought, you may want to try a more diluted dose of pilo to achieve more normalcy to the size of your pupil, and be safer as well.
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HI There Guys I had an accident about a month ago with a bungy chord it sprung back and hit my right eye. I did not have time to close it and had a traumatic micro hyphema and a traumatic mydriasis.  Two doctors said the same thing and confirmed that I was one of the lucky ones who had escaped blindness. I thank God I did not get any damage to my retina and holes in my eye which is said to cause blindness. I read here on this post that some of you are taking vitamins and supplements. Please let me know what those are.  I have been off of atropine for about 3 weeks and my pupils still dialated one Doctor says effects could last up to 6 weeks so I am hopeful that my pupil will return to normal.  Please get rid of your bungee chords and tell your friends they are dangerous. Like some of the other posts I found some hope in here as my vision is very blurry and I have photophobia.  Another gentleman here in the post had a similar accident and his vision almost came back to normal this is a great thing and it gives me hope that my vision will come back on my right eye.  Thanks for the posts.

Bern.
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My acupuncturist prescribed I-Caps to me, that I can buy from almost any pharmacy over the counter, but I got them from Walmart.  
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I was hit in the right eye by a golf ball on October 26 -- more than four weeks ago.  The ball hit a tree 5 or 6 feet in front of another player who hit the ball  and ricocheted directly into my eye.  I lost all sight for a while, my RGP contact was shattered and cut the cornia and I had lacerations on the lid and below the eye requiring 14 stiches.  After an ambulance, emergency room, I was taken to an eye clinic where they said I had a hyphema and was given Atropine and prodnolisone and told to stay quiet for 5 or 6 days and see the Opthmalogist once a day.  

My vision was very cloudy but gradually has recovered over a couple of weeks, but after being off the atropine for almost three weeks, the eye is still very dialated.  From this great thread I learned more about my condition than from anywhere else.  

I am very light sensitive and my near vision with either contacts or my multifocal glasses is not good.

So traumatic mydriasis is my problem now.  The opthamalogist said he did not think it likely that it would get better because the muscles in the iris appear to be damaged.  

I have some hope from reading this thread.  I am not going to ask for pilocarpine until I wait until the holidays, or another month to see if there is any improvement -- but none yet.

Thanks to those who posted
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Sorry to hear about your injury in a sport I'm pretty sure you didn't expect to be a risk for this type of injury.  Definitely glad that you were able to get the information you needed from this post, and if it gets better, please keep us updated!
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Hi was in an auto accident one month ago...scratched cornea that has healed, dilated pupil and irregular & non responsive and have developed a trauma cateract which has left me with blurry vision.

Should I wait for surgery ...I am scheduled for Jan 11, but after reading this I think it may be too soon to have surgery considering my pupil is still unresponsive.

Any thoughts? anyone with similar situation?
Thanks,
S
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Hi there.  As with all my posts, my answer is not from a medical background but only given from the research I've gotten and advice from medical professionals.  They say if your iris hasn't recovered in 3 months it's not too likely that it will, and after 6 months you'll have a hard time finding anyone that expects it to recover if it hasn't already.  If your pupil is dilated to an uncomfortable position, your doctor (with your request) may wish to perform a cerclage suture on your iris at the time of your lens replacement for your cataract surgery.  Most doctors will not perform the cerclage suture surgery at any time other than lens replacement for cataract surgery, due to the movements being very difficult to perform without scratching the original lens and causing a cataract, itself.  

So, with that knowledge, what I would personally do is try to make it through another month or two and see if your iris recovers, but your doctor may have a very good reason for the surgery taking place so soon.  Your iris may be ruined or there may be some other reason that he/she needs to get in there sooner rather than later.  If he does, though, make sure you've researched the iris cerclage suture technique for fixing the iris in a fixed state that is more comfortable for you, since that would be the prime time to have it performed, if it's the route you want to take:

http://www.osnsupersite.com/view.aspx?rid=23421
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Hi, Thank you so much for posting info on this.  I thought I was all alone with this problem but now I feel so much better that I'm not.  I have had this since 1988 from a fist from an abusive boyfriend.  They had to do emergency surgery because the pressure in my eye skyrocketed, they removed a blood clot but it has left me with one dilated pupil.  It used to bother me really, really bad because it looks so weird, so I wear a green tricolor contract to match my real green eye and you can hardly tell the difference, And finding out that David Bowie has this from a childhood accident on the playground, so I sing " I've got David Bowie eyes"  (instead of Bette David eyes" and it makes me laugh and feel better.  But I keep searching for a fix, but haven't found one yet, seems like with all the technology, there would be a way to correct it.  I should just be happy that I can see out of it, although it's very blurry.  
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Did not know David Bowie had this injury too, that's crazy.  I am very self-conscious about my eye, but really, no one ever notices.  A lot of my issues are the functionality and pain in the sunlight, and the fact that i have a LOT of trouble keeping a contact in that eye (still playing hockey).  There are more of us than we probably think, and this thread is one of the few areas that I've found online to suggest that.
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Well mine is from having ICL surgery done. It's been 2 weeks and also have been given Pilo to use. I'm also concerned about retna detachment from the use of it.
It causes me to have very blurry vision if I don't use it but I also have other problems from the surgery that is making my vision blurry, so it's like having a double wammy in that eye. Supposedly there is gel still there from the surgery or the lens hasn't totally flatened out that is causing my vision to be blurry.
Doctor said that it is supposed to go down anywhere between now and a year. :( it's hard to live life like this. I can only hope it gets better because I've been depressed for the past 2 weeks bc I can't do anything without it hindering me 24 hours a day.
When I take the pilo it takes my vision away for about 2 1/2 hours since the pupil goes down and it only lasts for a few hours. How cAn anyone live like this? It *****.  
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Hey there, well you are going through basically what I went through for about a year.  It definitely affected my quality and enjoyment of life, and it certainly still does, every day, but I've learned to embrace it for what it's worth and hold onto hope that later on I'll be able to have some form of surgery.  I was unaware that ICL surgeries could cause this, but don't be too upset just yet.  As long as your iris muscles aren't damaged, your pupil may go down.  Look on the bright side as much as you can.  The better your mood, the better your body can heal itself.  You're right though, it is a pain in the butt, any injury to our eyes.
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I have just got an injury 5 days ago, I was poked in the eye by accident from someone when playing basketball, my left pupil is dilated (not extremely dilated but more than my right) my left eye has 20/30 vision while my right eye has 20/20. These past few days I have been taking Cyclogyl 1% once a day and Tobradex 1% 3 times a day. My doctor said that I should slowly be taking Tobradex less and less over the next month until I finally stop taking it. I have another appointment with the optometrist and retina specialist in one month's time. Today, I overheard my optometrist telling his assistant that my pupil is detached from my iris or something like that. If so, am I going to heal by myself? Is there any treatment options?
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Hi Nik.  I hope a doctor on here responds to your comment.  My experience seems like it may have been a bit different from yours.  Same things apply though; eat healthy and try to stay as positive as possible.  Put your body in the best state to heal itself.  Hopefully a doctor will chime in with western medicine's take on your condition.
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Thank you for the good wishes. I have been wearing sunglasses around the house. I have also been told to stay away from physical activity because my eye might re-bleed. Anyways, how is your situation going? Did you heal?
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Nope.  My vision in my injured eye is 20/20 with corrective lenses (which I needed before the injury).  The doctors have not noticed any iris function, although some morning I'll wake up and it will be almost normal size, but still doesn't react to light.  I noticed yesterday during a long trip that in the morning it was pretty dilated, but after a 7 hour trip home and being outside, by the time I got home it had closed to a "normal" size of about 4mm.  So maybe it just reacts to light upon prolonged exposure, and not immediately.  All in all, the pupil is NOT as dilated as it was when it was first injured.  It did go down, but still poses the glare issues that I've just learned to cope with.  Like I said, try to stay positive.  It really seems like it's the best you can do right now.  Try to avoid all things that may cause a re-bleed, like heavy blowing of your nose, strained bowel movements, etc.  
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Well, at least your eye is showing signs of improvement. My stupid injury happened on my last day of school (I am 16). I have planned on doing p90x this summer but I guess I have to postpone it. I have noticed something with my eye over the past few days. My pupil used to be higher up in my iris (almost touching the top) but now it is nearly centered. The size however, has remained relatively the same. I am pretty sure these are signs of healing, it has only been eight days since the incident. Over the last couple of days I have been just sitting on my PS3 playing cod while wearing sunglasses because there's nothing else to do.  
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Esp Waterwings, thank you for starting this post.  Just reading this post has helped me with the emotional burden of going through something similar.

I had a home accident 6 days ago when the resistance band I was using snapped back at my right eye (worse, it was the ball/door attachment that hit my eye).  I immediately lost vision on that eye and had wounds around my eye.  After a few hours in the ER I started seeing light and very blurry images, except for an angle above the horizon (somewhere between 10pm and 2am if you base it on a clock's hands).

I had to undergo a CTscan and the ER paged the eye surgeon, who I saw the next day.  He shared that "you made a mess" out of my right eye, that there was some 'bleeding' at the back of my eye, and that I was lucky that my eye 'closed' as the band/ball hit it, otherwise I would have completely lost my right eye.  I don't actually remember seeing him write any diagnosis on my records other than 'blowout f' (I assume blowout fracture), but advised that the eye swelling would improve within 5 days, and that I should be able to do light computer work with my left.  Also when I asked about my vision, he shared that I should 'get most of it back'.  So far that is the only thing that I am clinging onto for hope.  He has prescribed antibiotics 3x a day and prednisolone every 2 hours 6x a day.  Since he was going on vacation he said he would see me in 3 weeks.

Right now my right eye is still bloodshot, there is still little swelling at the lower orbit, the skin around the eye is a bit jaundiced, and my vision is still the same (very blurry, I can only count my fingers, and can't see the 10am-2pm angle).  I plan on getting a second opinion this week, but I am really hoping for the best that I can still recover most if not all of my vision.  I have been really emotionally drained since my accident.

If anyone has any advice or recommendation, I would be glad to hear it.  I will also update my status once in a while in case it helps other readers.

Also, thank you for the I-Caps tip, I will get one tonight and take it religiously.

P.S.  Has anyone been advised against flying while going through this kind of problem?
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Hi Nick, I was not advised against flying but I didn't ask, either.  I cannot imagine it would be safe, so I'd definitely recommend asking that specific question before traveling.  I'd say give your a couple weeks to see how your progression is going.  After two weeks I had regained vision and after a month I think I had stabilized and had a pretty good idea how things were going.  Best wishes.
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Hi everyone, I figured I'd post an update for any of those using this thread as guidance.  I have noticed recently that my pupil tends to be smaller much more often than it used to (which was only sporadically, and never seemed to have any reason for getting smaller).  It seems that if I'm exposed to light for an extended period of time, my pupil size does get smaller, not as much as my good eye, but significantly better than before.  I also noticed that if I focus on something up close and close my good eye, in about 10 seconds my iris closes and I can focus up close.  Those with mydriasis may want to try this and see if it works for you.  Cover your good eye, and focus on small print at very close range and see if your lens can accommodate.  You SHOULD see your pupil go down if your iris isn't torn and if your lens can accommodate the close vision.

I am noticing that my vision is getting much more comfortable, and my Retina doctor thinks this is a great recovery, considering if the iris does not regain function after 6 months, it seems most doctors do not expect it to.  So it took over two years, but I'm starting to get function back in my iris, as it slowly reacts to light, and we hope it gets better with more time.  When I had finally given up hope, it started to get better.  So those who get past the 6 month mark with no improvement, don't write yourself off yet.  It may take time, but things could turn for the better.  Best of luck.
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That is great news!  About a month ago I went to see the doctor who told me that I would not heal from my injury. Now, I have noticed that my pupil is reacting to light, but not as good as my (previously it didn't react at all). However, I have also noticed that when I am outside for a prolonged period of time, when I cover my good eye that there is a tint of purple in my vision in the injured eye. I went to see the doctor this morning and he told me that it is probably consequence of the accident. He also told me I won't heal completely but I continue to be optimistic. The way I see it is that if other people can heal from various types of cancers, I am sure that I can recover from an injured eye.

Good luck healing to those who have it.    
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Everyone with mydriasis! I was looking over the other threads on this topic to gain further insight to our mutual problem and I found something that may possibly help make your iris sphincter (the muscle responsible for dilating and making your pupil smaller) regain function. You should have ginger tea once or twice a day and go for a jog for at least 20 mins a day. People on the other thread said that doing these things made their pupil much smaller than before. It appears that Ginger Tea may have some properties that we are unaware about. Best of luck recovering everyone and hope this helps!
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I am seeing that too now that you've mentioned it, Nik.  I'm going to try that and see what I find.  Thanks for posting that to our thread!
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Hi,

Due to missed communication I hit my husband on his left eye with a golf club in full front swing. He ended up at the ER with a laceration in the left eyelid and eye inflammation beyond believe. He had surgery for the eyelid and to extract fragments of glass from the sunglasses he was wearing. It's been 9 days of the accident and he is on prednisolone 4X a day for 1 week and then he goes down to 2x a day. Augmentin wich is an antibiotics to prevent infection and that is about it. He is a commercial airline pilot so we are very concerned on how will this impact our life as a family (we have a 2 year old). My husband is 37, healthy and athletic. I asked the ophthalmologist that examined him if his pupil was reacting to light and he said it was but very slowly and only if you kept the light long enough. Do you think there is hope for us? They said his vision without any lenses (he never needed them) is 20/20 and 20/30 on his injured eye. Do you think he can go back to 20/20 after inflammation is over. Do you have any other tips for us.
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hi , i have had a tramatic mydriasis  for over 20 years , and this year had a cataract removed in that eye.since the surgery , i am suffering from extreme glare at night, and now my eye dr. wants to perform the iris cercluge procedure. i am wondering now, if my new lense will be damaged during the procedure.also pupiloplasty was suggested as another possibility. this is a great sight, i just wish i'd found it sooner.
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Hi there.  It sounds like if your husband's iris is moving, it isn't torn, it's just been weakened.  Based on my experience, it would suggest there's a possibility that he could get much better with respect to the iris movement, but he might not.  I think the fact that it's moving right now is a good thing.  Same for his vision; that may get better too.  20/30 is not bad and after as much trauma just happened to his eye, I'm not surprised there's an issue right now.  Time heals these things.
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Flatsy, it sounds like you're happy with your new lens.  Do you still have close vision in that eye now or do you need reading glasses?  I heard those lenses would pretty much remove the ability to focus up close, such as reading.  The cerclage suture procedure, from what I've found, is only considered hazardous to original lenses, and could cause cataracts.  The new artificial lenses will not form cataracts if accidentally bumped or scratched during the suture procedure.  Ask your doctor about this, and I would assume he'd say the same risks as far as forming cataracts because of the maneuvers required during the procedure, are no longer a risk with your new lens.
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Waterwings, thank you for creating this site…it has really given me hope and guidance. I have mydriasis due to a rare type of glaucoma attack. 4 months ago my eye was dilated during an eye appointment and the dilation blocked the drainage ducts which caused an extreme buildup of pressure, pushing on my eye to the point that the pupil got stuck. It stayed that way for about a week until the day I had to have emergency surgery. Unfortunately the day the pupil went down, I had surgery and was then required to take atropine for a week, which caused further dilation and mydriasis. I was allowed to take Pilocarpine to try to reduce the pupil but it didn’t do much. After that I went to a hypnotherapist to help me with the visualization of the sphincter muscle closing the pupil and the pupil went down ever so slightly. Enough that my ophthalmologist even noticed. I’ve sort of plateaued but I’m currently trying out acupuncture.

One thing that’s improved for me is the night glare. The stoplights and car lights at night while driving use to be pretty rough, but even though my pupil has remained dilated, the glare is totally gone. One of my doctors said that my brain is somehow filtering the glare, so that’s been nice.

I’m glad to see that your situation is improving! Another one of my doctors said that he has seen patients with mydriasis improve after years, so wonders never cease!
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Hello,
I am a 24 yr olf female-3 weeks ago I was hit square in the left eye with a tennis ball. My sight was extremely blurry for a few hours but returned to almost normal within 1-2 days. Doc says I had a fair amount of bleeding anda blood clot beind my eye but no detached retina. I took atopine for 1 week. I have now been off atropine for 2 weeks. I was given pilocarpine (spell?) once and it constricted my eye too much and I hated it. My left pupil is still dialated mid-size and looks strange. I am so worried that it will never go down. It does not respond to light at all. What are the chances that my pupil will regain functioning?
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Hi
I have been reading this thread for a while now.  I was hit in the eye by a paintball 10 weeks ago.  I had a hyphema in one third of my eye and high pressure.  Was on bed rest and upright for 10 days and reporting to hospital every day and taking streoids, ointment for scratches, dilating drops and pressure drops.  This then reduced to every 2 days, then 2 weeks then 4 weeks.  At my last check up the pressure was high again and I had also developed a traumatic cataract.  I took the dilating drops for the first 6 weeks.  It is now 10 weeks on and my pupil is stil dilated.  Have to go another week with the steroids and another 6 weeks with the pressure drops and then if the pressure has stabilised I can go on the list to have cataract removed.  Has anyone had the cataract surgery yet and does this have any affect on the pupil size and did it stop the light/dark sensitivity?   Reassuring to read others stories.  Jane
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This thread is great.
Although self diagnosis and google can be a bit scary, seeing an ophthalmologist in combination with reading this thread has really helped.

I got hurt on the set of a commercial doing a cheerleading stunt. I took a knee straight to the eye. At the time, it hurt pretty bad. But after about a few minutes the only pain and watering associated was due to the bright sunlight. Since we were shooting outside in the middle of the day, my eye wouldn't open at all but would start to open any time I was in the shade and in the evening when the sun was down so I figured that had to be a good sign.

The next day or so it was still a bit blurry and I started noticing that my eye was reacting a lot differently to light than it should. About a week after I was in the upstairs of a brightly sunlit Apple store and a friend of mine pointed at my eye and told me that one pupil was tiny and the other was HUGE. That's when I started to worry. I also don't have insurance and workmans comp for the commercial had been shady since the day I told them things were blurry.

I just paid the money and went to see a doctor. Although money can be a factor to many, eye sight is nothing to mess around with. I'm glad I just paid the money to get a proper diagnosis. He checked my sight, my size and my pressure and told me it seems to just be a weakened muscle that could take a while to heal if at all. But other than that my eye is completely healthy.

I was SO worried before going to the doctor. Although I think about the fact that this could be permanent it has so far seemed to be getting better after a month. Not sure if the bromday prescribed has been helping as well but for now its sun g's outside. Luckily the brown eyes makes it unnoticeable unless I point it out to people.
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I was hit in the eye w a water balloon four weeks ago from a launcher. My vision was blurry and I had inflammation in my left eye. I went to the er and they said I have traumatic iristic. No permanent damage tho. This is from two specialists. I only took these red top drops the following day after the injury 3x. The doctors said that the blurry vision and dilated pupil was a result of that drop and it takes time to wear off. I thought this was weird since I only put it in my eye one day. Yesterday I went back to specialist, now being 4weeks since and the said my pupil dilation isn't normal at this point and there is prob a tear in the muscle that is microscopic that they can't see. Will this heal w time? I was given the pilocarpine drops but they made my vision terribly blurry. And surgery isn't something that I want to do. My ey feels sore still, is it still healing? It does want to constrict to light but nowhere near my other eye.
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Hi lfio10.  I feel we've covered all your concerns in the thread already, but I'll hash through them really quick anyway.  If your pupil is constricting, it is my understanding that it likely doesn't have a significant tear, or even a tear at all.  Mine has started working again, but still not to the extent that my good eye's iris functions.  Does the pilocarpine make your iris close significantly?  If it does, it suggests your muscle is working well and the damage may be nerve damage.  Give yourself 6 months to do most of your healing, but as I stated before, I saw significant progress with mine after about 3 years.  Surgery should only be for those whose iris fails to function at all and their life is severely hindered.  
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Hi Waterwings. Thank you so much for posting this information and all these updates. I have scoured the internet for 2 months looking for inforation on pupil dilation and came across nothing until now.

My husband had laser surgery for a detached retina two months ago. His pupil has remained dilated since. I feel that it has shown small improvement, that it has gone down very slightly, but my husband does not think it has. The other day he had a sneezing fit and the pupil started to constrict for the first time ever. This gave us hope that it's starting to heal. However, all the retina specialist told us when we followed up with him is that he has no idea if it will heal or not.

Has anybody experienced this? It seems from what others have posted that the improvements are very small and gradual over a long period of time. My husband is depressed and has lost hope. I don't want him to lose hope.
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Lisa's post reminded me to give an update on my status.  After having a lot of pain in my face recently and dry eye problems, which I know still remains from the trauma, I had my kinesiologist try working the muscles around my eye.  I saw an increase in tear production from my eye, as well as much less discomfort on that side of my face when smiling or moving my eye around.  Just an idea for any of those who had trauma around the eye, as well.
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Hi. Mid July i got hit with a water balloon from a launcher. I didn't have permanent damage initially but after 5 weeks and my pupil being very dilated still I was told that I have a microscopic tear in my sphincter iris muscle. It most likely won't heal but i am hoping the doctors were wrong. Did yours heal up any more than when your accident initially happened?
I was given pilo drops 1% but they make my vision terribly blurry to the point that it's hard to function.
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I just realized that you responded to a post I had already posted. So thank you for that. The pilo drops make my pupil smaller than my good eye but my vision is so blurry and I dislike using them. I'm wondering if those drops would help with my healing at all if it has any chance? I was given .1% pilo and that dose didn't do anything. Maybe I will try the .5% like you had stated you used. I just hate the blurry vision.
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It has been 10 weeks since my injury and I have not noticed any improvement with the size of my injured pupil. As I had stated before, the 1% pilo drops make life hard to function, so I was going to try a .5 dose. Do  you think that this helped your eye to heal at all? Thank you for your help!
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Pilo shouldn't help the eye heal at all; it doesn't really have that effect.  It's possible that it helps the iris' movement though.  I would say try a lower dose until you find what works for you.
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Thanks. Your forum has been so helpful to me. Did they tell you that you have a microscopic tear as well?
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Nope, no tears in the muscle from what they told me.  
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I just don't understand how a tear can't heal.. So your eye after three years has slightly improved in the aopearance?
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Last night my husband's pupil spontaneously started to constrict. All of a sudden it looked absolutely normal again and he was able to see much clearly. This lasted for approximately 10-15 minutes and then it gradually became dilated again. This morning it was back to being dilated.

It has been 3 months since the laser surgery for retinal detachment and that pupil has bee dilated this whole time. Over the last 5-6 weeks it has constricted on 4 occasions. We are still waiting to see what will happen. We have been told it generally takes about 6 months for the pupil muscles to heal and begin constricting again. Waterwings has experienced some healing even beyond that 6 month time frame.

I wanted to post this for anybody following this thread who may be going through something like this. My husband's pupil remains fixed and dilated most of the time and these random, brief episodes of constriction are the only real signs of healing we have seen.

The waiting and not knowing is excruciating.
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Lisa
Is your husband taking any drops in his eyes to help with the constricting?
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My husband's doctor is going to re-evaluate after 6 months. He had the laser surgery three months ago. The doctor doesn't want to prescribe the eye drops yet due to the side effects and the fact that my husband had a retinal detachment.

Yesterday my husband said he can now focus on very close objects, cover his good eye and his pupil will now and constrict. He says he can actually feel it constricting. This has just started this week.

His pupil is still dilated otherwise. We are cautiously optimistic. We have been told that 6 months is the time frame in which this usually heals.
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Thanks for your post. I have the same situation as you but also a cataract that will require surgery. I hope my pupil gets smaller over time. Its been 3 weeks since I stopped atropine. I am seeing doctors st johns hopkins eye center for it.
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Waterwings - Thanks for starting this thread.  I was poked hard in the eye playing basketball 3 months ago.  Suffered torn iris/pupil with detached and mangled lasik flap.  My lasik doctor re-positioned the lasik flap but my pupil is still enlarged and is "jagged" at the bottom region - the result of torn iris.  The pupil does constrict with light but not as much or as fast as my good eye.  As a result, my vision is still blurry.  Worse, the torn iris in the bottom "jagged" region allows extra light to come in and distorts my vision.  Any light source or white objects causes a severe "ghost" or "halo" effect.  If others have had similar problems with ghost or halo issues from the torn iris, I would love to hear how people deal with it.  This has been a very frustrating ordeal as my vision is poor from the moment I wake up until bedtime.
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I was hit in the eye with a paintball about 3 months ago. I had a complete hyphema for two weeks. When this cleared I could see jaggedness at the bottom of the pupil and a hole in my iris. This has now almost completely healed. I still have a dilated pupil and some issues with glare at night and lack of focus in the near ground. At the last check-up this week, I've been told that i have tears in the sphincter muscle and that it probably won't heal now due to the time passed. It does still seem to improve though from time to time and dilation isn't as bad now as it was a month ago, so I think eventually it will return to normal, but that might not be for quite some months/years.

The only treatment i've been given is steroid drops, initially dilating drops and some more drops to reduce the pressure inside the eye.
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this whole thread has been a really interesting read. I have been researching this subject recently as I had ICL surgery a few weeks back. We ended up removing the lense as it caused elevated eye pressure and the pupil never constricted around the lense. as it happens, it still hasn't constricted so I've been trying to learn more about the situation to see if this will stay this way or eventually heal. my eye doctor isn't much for over drugging the eye which I am  okay with. For that first week after the initial surgery, there were A LOT of different eye drops. interestingly, the dilated pupil isn't really affecting my near vision, it's more my distance vision. I have just been working the best I can with the situation and hope that the pupil heals...and sooner rather than later. on the down side, there really isn't any reaction to light with that pupil. not sure how bad that is to an outlook of healing. there are various things during this process that could have caused the muscles and/or nerves to be damaged. How is it going with the ICL lense now? is it just the one eye or did you  have both eyes corrected and having problems?
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Hi there.  Wait, so did you have ICL surgery in two functioning eyes?  Did you pupils function correctly before the surgery and now you're saying they don't?  I was thinking about getting ICL surgery so I'm very interested to hear if you've run into complications.
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Shortty920 - How long did it take for your "jaggedness" to resolve itself? Is your iris & pupil back to a round circular shape now? I still have the jaggedness in my lower pupil after 4 months and it distorts my vision -- everything from lights to light or white colored objects (stoplights, headlights, white cars, any white object) all have a ghost or halo effect.  My sphincter muscles also have tears and my doctors don't think it will heal itself since it's been 4 months since my injury.
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I had one doctor that insisted we do the surgeries in both eyes at the same time. I had decided right at that moment, he wasn't going to be doing my surgery...and so grateful for that decision. I was scheduled to have my two eyes done in two consecutive weeks. With the troubles after the first week, we removed the lense and I'm stuck with glasses for the rest of my life. I'm bummed about that. The procedure would have been really cool if the eye didn't have the negative reaction. Once the lense was first in, except for the glare of the dilated pupil, I really was able to see pretty clearly right off "the table". Pupil is still dilated. The doctor says the eye is still healthy. Going to get a second opinion next month just to be sure. What is the reason you are considering ICL vs. Lasik or other options? How is your pupil doing at this point? and yes, my pupils were working just fine before the surgery. Although, at times, it would take a little longer to constrict again after being dilated for glaucoma testing.  
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I have to do ICL because the amount of correction needed with my astigmatism and the size of my pupils make lasik a risky procedure.  I could get very bad halos because of the size of my pupils, even in my good eye.  I guess I just have large pupils.  My injured pupil is currently doing better.  It still isn't great, but it doesn't affect my day to day anywhere like it used to.  Now the biggest issue with my eye is seeing small print because the pupil is large (constricted pupils show small print better).  Restasis has worked wonders for the dryness, and the pupil tends to constrict outside pretty well so no big issue with glare.  I finally tried a new curvature with my contact in my bad eye that seems to stay balanced better, and not rotate all the time.  Things continue to get better.  I think the big thing that everyone reading this thread needs to remember that.  I was down and out, and 4 years later, it still gets better and it's still healing.
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I wanted to offer some advice to Waterwings and anyone else following this thread. Please, don't bother with acupuncture. You should save your time and money. It has no scientific plausibility, and no quality study has shown any real benefit (beyond "placebo effect").
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Just to update on my husband's progress in case it is helpful to anybody:

My husband had laser repair on a retinal detachment at the end of June, 2012. His pupil has been dilated ever since.

In October the pupil finally started to constrict when my husband was reading or using the computer. Since then, it has been gradually constricting more and more.

It is now 6 months since the laser procedure and his pupil remains a little bit dilated. He says that he is not bothered by the glare of the sun too much now and he is very happy that he has much more function of the eye than a few months ago.

The pupil does remain a little bit dilated when he's not looking at something up close. We are hoping that the pupil will continue to heal and improve. The progress has been slow and there is no telling how much improvement there will be, if any.

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Thanks for posting this. It's kind of hard to find any good information about this condition online. I know the only real response is "to wait and see" but as a curious person it's great to read about other people's experiences.

As for my story, I was hit by a badminton ball straight in the eye. I had an internal bleeding and very blurry vision the first few days. The pupil didn't constrict much at all to begin with but after a week it regained some of it's function. The doctor I went to was very optimistic and believed I had a good chance of recovering completely.

It's now been almost a month since the accident however and sadly it hasn't improved much the last three weeks. The doctor I visited today told me that I shouldn't expect any major improvements now since so little had happened since my last visit. Most likely the muscle fibers are somehow damaged.

I'd estimate I have about 50% of the pupil function recovered. It constricts in light but not as quick as the other and it remains larger. I get ghost images when looking at lights but I haven't noticed any major photophobia (though I guess it would be worse in the summer). I also can't focus the eye on close distances.

I don't know how much improvement I can hope for but reading this thread at least gave me some hope.
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First thanks to Waterwings. I checked english, french and german but this is BY FAR the best area to get info.

Well, my story is rather similar to you all. Got hit in the eye, the "detail" being by a hockey stick. That was in my right eye at practice and my left eye is blind since birth.

Right at the injury called up for an ambulance and was brought to the "Insel Spital" one or the best centers for eyes care in Switzerland.

I have lost full vision for 4hours and then saw light. I had high eye pressure, no
Day 1, I could see some colours but couldn't keep the eye open.
Day 2, I could start to see shapes.
Day 3, I could see body figure but not read.
Day 4, I could read the name of the hand paper dispenser from my bed. I was told a 20% view (out of 100) and had a stabilised pressure. Was let out of hospital.
Day 5, Sunday, not much to do.. so just sat around, couldn't read but watched TV. Still on drops to lower swelling (5x) drops to lower pressure (2x) and some croticoide paste at bed time.
Day 6, went to the doctors for a follow up.
I have 5 tears in the sphincter muscle, none to the Iris. Have to wait for the swelling and "microtears" to resorb.
We tested eye sight and with glasses I would be at 70%.
Pressure is low I have to stop those drops.
My lens has no pingmentation left.
Retina is ok.
Have to wait a week to see him again to find improvement.
** For the mydriasis (as this is the topic), if persistant, there is an iris implant, stitching solutions. But seems WAY to soon to discuss.
Day 7. kind of stressful, in day light I see little dots which I don't see indoors or with artificial light. I don't think it is the retina but will go and have a check up tomorrow. Most likely that the retina reacts to UV or something. Selling is pretty good.
A good note, I do see better than day 6 as I can read time on the alarm clock.
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Forgot two things. First diagnose was little chance for my eye to be safe and sound ! Seems my positive and calm attitude helped the healing till now.

I would also like to have a special mention for my girlfriend who has just been so suportive and positive.
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Hi Andy. My God! We have the same experience.

I never expect that I would be hit by a shuttlecock during a play. It's really a terrible pain because the cork hit the entire right eye. When I opened my eye, I could not see anything and I thought that I was already blind. We went directly to specialist clinic near the court but the doctor was out and we only caught one the one at the farthest. I have my eye check and ask the extent of the damage and the possibilities of the damage of my eye. I told the doctor that I could not see anything so he did further check. An eye ultra sound according to him was needed but it's not available in our area so he just applied the appropriate remedy that he could do. I have mixed feelings on my situation. I have fear that what if I lost my sight? This would be the worst thing to happen and I was really afraid. I was advised to bed rest for 3 days with my head elevated with the pillows. The doctor prescribed me Atropine and Prednisolone and ordered me to come back by Monday for check-up. I experienced headache on my first night and I wasn't able to sleep immediately because of the discomfort. I was just glad since the application of the medicine, the affected eye could see lights and images but still very blurred. I thanked God that I was not blind by the incident. I am just worried, though my eye can see, it's still very hazy and my eye reacts sensitively with light. The doctor gave me an anti-glaucoma medicine in addition with the previous two and I was again required to come back after one week which is today. There's an improvement with my vision but I am still adjusting with my eye reaction to the light. With my research to the internet of the same cases, it helps me understand the "whys" suffered from this injury. I also understand why my pupil gets bigger. Doc says that blurring will be gone by 3 weeks as well as the sensitivity to light which adding my agony. It was really an uncomfortable and hard experience for me because everything was normal after this incident. I hope that everything would come back and I hope that it is possible. After reading the posts here, it makes my feeling lighter and I feel hope that someday, I would regain what is normal with my vision. The doctor ordered me to stop the Atropine and just consumed the remaining Prednisolone. I need to continue the anti-glaucoma drops together with the other one. My next visit would be a month after. I really hope for the better because it would be very difficult to manage with impaired vision while working.
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Hi!

I never thought playing badminton could end this badly either. Such bad luck... I'll always wear eye protection when doing sports from now on.

If you were given Atropine (which dilates your pupil) and your doctor told you that your light sensitivity will go away, there's a good chance that your pupil is fine. Let's just hope for the best!

My pupil still hasn't improved any further so I guess I'll just have to accept it, which I suspect will take some time. Losing part of your eyesight is a terrible thing to have happen to you.
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Hi Andypupil,

How is it on a daily basis ? Do you just wear sunglasses for everything ? Or a contact lense?

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Yeah. I never thought of too until I was  taught by the lesson in which very too late for me now that I already have the injury.

Let's hope for the best and never lose that hope. I already told myself that whatever the outcome will be, I have to accept the reality. If this is for lifetime, then I can do nothing but to accept. As of now, nothing has change with the my pupil. The blurring has improve little by little but the lights bring terrible reaction to my eye. When I am typing this response, I just keep my left eye open.
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Hi LastEye,

It's not too bad during daylight, mostly thanks to my pupil having retained at least some of its function. I'll have to wait and see how it goes in the summer but so far I have not needed to wear sunglasses any more than I used to.

The biggest bother I have is actually in dimly lit rooms and when it's dark outside. My pupil then dilates to its fullest and I see ghost images of all lights. For every street light, I see two. This is especially a problem when watching TV since it makes the image look blurred. I'll probably try using a contact with a fixed pupil in the future to see if it helps.

Near distance vision is also worse. I'm heavily myopic so I always use glasses or contacts. Contacts seem to be a lot worse for looking at close things, mostly noticable when looking at my smartphone since it's also bright.

Finally, my vision without correction is a whole lot worse than it used to be. The injured eye is -7 and my healthy eye is at -9. When not wearing glasses I now see better with the unaffected eye and it used to be the other way around. I really stumble to find my glasses in the morning.
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Hi Andy

Thanks for yohr reply. Do you know if you had any tears in your pupil?

I think I will try the contacts with fix pupil when I am ablw too.

I am now actually at day 7 so I giess to early to know what thw final will be.

I really dream that my eye will get backt to normal. Especially ot beingy only. But I believe it safer to find ways to improove my day to day vision. I noticed that if I hide light from my eye I see close to perfect.
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Hi LastEye,

The doctors believe I have a microscopic tear in the iris sphincter, but I guess it's too small to see.

Yes, 7 days is too soon to be able to say anything about the final result. All you can do is be patient and hope for the best.
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Hey everybody, I just wanted to share my story, on Last January 3rd I got kicked in the eye playing soccer, and at first could see all red and had a small hyphema and immediately went to the emergencies (I wasn't in my country btw) the doctor that saw me just applied atropine and gave me something to get the pressure down and told me to go for a check up the next day. Long story short at the sixth day I went for a check up but my head was hurting a lot and just the side of the right eye, and when they finally checked my pressure I had 50, so they had to do an emergency procedure, I don't know how to say it in English but in Spanish is "Lavado de camara anterior" and I went home after it, I went the next day to get my pressure checked and everything was fine I had 22 pressure (the normal is between 12 and 14 but it doesn't hurt the eye till its passed 30) so they told me I could go to my country and gave me some pills to get the pressure down that I had to take 4x a day. My sight was almost normal till then I could see everything well but when I saw something bright I saw it with a glare around it. At the second day I was in my country I went to the oftalmologyst to see what I had since I didn't have the hypema anymore, they told me part of my iris sphincter was damaged and that I was now with Glaucoma, they checked my pressure and it was on 34 this time so they told me they had to make a trabeculectomy but they couldn't do it with the pressure so high so they added more drops and I had to take glycerin to make the pressure go down as much as possible, an the told me they had to check my pressure two days after that to see If I could have the surgery at the next day, and my pressure was on 22 so they told me to come the next day for the surgery, so I had the surgery the next day and I went home with some band aids covering my eye and told me to come the next day so they could take it off. So I went the next day and they took it off and Right away I noticed that I was seeing everything really really blurry, I couldn't read absolutely anything close or far, and checked the pressure and it was on 10 or 8 so they explained it was normal that I was seeing all blurry because my eye was experiencing such high pressures and all if the sudden it had dropped because of the surgery so they tol me to wait and that the sight was going to be back to normal in about a month but that I would remain with the anysocoria because of the damaged sphincter. the next day I decided to get a second opinion and went with this glaumayologyst a friend had told me about, and when he saw that I had a trabeculectomy he told me that he didnt do trabeuclectomies anymore because it was too invasive and traumatic for the eye and that there was some new type of microsurgery that he had learned last year, I just hoped they could've told me this sooner because it had all the good things the trabeculectomy has but without all the bad things, like it disnt leave a hole in my iris, They could to it in literally a minute, that I didnt have to apply any drops to my eye, and a pot more. I hope somebody reads this before having a trabeculectomy done.

So it's been almost two weeks now from the surgery and I'm still seeing a bit blurry but its getting better. About the pupil it's still dilatated and some of it reacts to light, and the doctors say that it will remain like this the rest of my life. :(

I'll be updating everything about it from now on.
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So jd. Any update for you ?
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It's been 3 weeks after my injury. To summed up my condition at present, the following are what I'm experiencing:

The medications have helped so far but the terrible reactions from daylight and any light is burdensome.

Haziness is present after taking a bath. The pupil hasn't back to normal size.

My vision on the affected part is very far. It's blurry yet. So things, images, words aren't clear to look at.

There's a dry feeling in my eye every time I wake up in the morning. Tears were there as well after applying the medicine.

When I try reading using my right eye only, there's this floating thing that I would just say a "white spot" that covers the part I was staring at so if the letter is small, I can't read it.

I have an appointment with my Doctor at the end of the month and these are part of things that I would like to ask him. I am looking forward for the full recovery of my eye. I'm working and bearing this really affected my performance at work. I hope that sooner, if full recovery is not possible, a close one would be better.
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I don't have any significant updates about my husband's eye. If there are still any improvements taking place it is very minor.

It has now been 7 1/2 months since his retinal detachment - the pupil has been dilated ever since the laser to repair the detachment.

His pupil is probably about 80% "normal" now when he is in regular light and not looking at anything close up. It seems to vary slightly. Some days I notice it might be about 85% normal or more and other days it looks a little more dilated again.

When he is looking at something close up, it immediately constricts pretty much normally. I notice that when we are in a darker lit area his pupils are pretty much equally dilated. So the only time it appears slightly "off" from the other pupil is in regular late while he's not looking at anything close up.

Over the past couple of months my husband has been spending a lot of time building an airplane model. It requires hours of close up work and we wonder if that has helped to "exercise" the pupil. Ever since he has been doing that he says he has noticed it constricts better when he needs to look at anything up close or read.

At first my husband said he could actually feel the pupil dilate! After it had been dilated for several months he said he could feel the muscles in his eye constricting. He no longer feels that anymore. We hope that over time it will gradually get better. But we are very happy with the progress. It is much, much, much better than it originally was. I doubt most people would even notice the difference in his pupils now.

I understand how traumatic and emotionally frustrating this process is. I'll update if there are more improvements.
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I'm sorry for the typo. I meant to say that at first, after several months of the pupil being dilated, he could actually feel it constrict.
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Hi Lisa, and everyone
Very useful and promising comments. My 7-year-old daughter hit her eye really bad playing with an elastic rope, and her pupil has stayed dilated ever since. By reading the posts I´ve gathered several useful tips to help her regain strength in the muscles around her pupil and iris.
Thank you for taking the time to post and for building such a wonderful online community of best practices!
Paula (Emily´s Mom)
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Update, 1 year since injury!
had my cataract surgery on 9th jan.  (traumatic cataract due to blunt trauma - paintball injury) I was not quite straight forward.  When the consultant made the incision, a quarter of the tendons had also detached from the initial injury.  Consultant had to insert a ring into the eye to keep the fluid from leaking from back of eye to front, and then inserted the new lens.  I am 6 weeks post op and have still not had the stitches removed.  I go back on 27th Feb which will be 7 weeks post op when  hopefully she will be able to remove stitches and I can resume normal activities (I was at the gym 3 times a week prior to the op but have been told not to go back until stitches are removed). My pupil is till dilated and the consultant thinks that it will remain that way.  I have just reduced the steroids to once a day and stopped the pressure drops yesterday.  This is to see if my eye can maintain a good pressure level without drops.  It was a year since the injury on 15th Feb and I have been using pressure drops ever since!!!
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Well a little update from my side. It has now been 1 month since my injury.
- Eyesight is at 20/20
- Pupil seems to constrict when I stay long in the sun or when I drive. Other than that it just stays very dilated. I really hope it will get back to normal.

Any chances it get's more healing within the next 5 months ???

I also have a traumatic cataract which seems to resorb ?!?! It seems it is less obvious now as it was three weeks ago. Seems strange.
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Hi Jane.  So are you saying you cataract surgery has caused a dilated pupil?  Does it constrict at all now?  
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Yep, this thread has stated, it's the 6 month mark that doctors seem to agree on that marks the threshold for recovery.  Doctors seem to agree that if a traumatic mydriasis has not corrected itself within 6 months, then the chance of recovery is very small.  Mine began to recover after several years, so I still contend to maintain hope.  Your current situation after 1 month is where I was after 2-3 years, so you should eat well and take care of yourself.  You have a good prognosis, I'm sure.
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Thanks for your words of comfort ! Let's keep hope it will get better.

I had an eye surgeon and opthalmologist say to me that anything is possible at this stage. Am seeing him again on the 5th of March.

By anything, he was refereing that in his carrer he has seen traumatic cataracts resorb and pupils come back.

I have seen an assistant at the hospital just to mesure eye pressure yesterday, and he said 1 month is the limit for the pupil. so I am kind of bummed by that at this moment!

I am currently wondering what is is like to have the cosmetic contact lens with a fixe pupil.

Can't wait for my girlfriend to move in with me end of the week, that will be a HUDGE support for me.
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Hi Waterwings,

Did you do the ICL surgery yet? If so, how is it working out with your large pupil? I seem to be in the same boat with contacts not working as well as they did before the injury. My biggest issues are the ghosting and reduced near vision though, both with glasses and contacts but contacts seem to be a bit worse. I'm not going to consider surgery just yet but it's nice to know if it might at least be possible.

It's been 2.5 months since my injury and there has been no more improvements. From what I understand, the general rule is that what you have after 1 month is most likely permanent. Anything after that can be considered an exception and after 6 months it's about as final as it gets. I guess you proved that last rule wrong though!
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How wide is your pupil ?

I would say mine is 12mm in the dark and arpprox 7mm in bright light.

I am wondering if I can get lower with time.
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Andy, no ICL surgery for me yet.  I have very bad astigmatism and so ICL surgery alone would not fix my eyesight, because toric ICL's have not been passed in the states, yet.  Once those pass, I will be looking very closely at having the surgery done, which I have had quoted to be about 10 grand to perform.  I am VERY interested to hear from those on this board about their experiences with ICL, because if that surgery is causing pupil problems, I know first hand that it is not worth the trade-off.  A dilated pupil is much more crippling than many would think.  
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Hi LastEye,

I haven't had it properly measured, but I tried using a ruler in front of a mirror and I'd say it's about 7-8mm in a dimly lit room. In bright lights it's probably around 2-3mm. Very hard to get an exact measure on your own though and I could be way off. It's always around twice the size of my healthy pupil. I wish my brain would "know" about the injury and just give it full power all the time (maybe Alphagan P would have that effect)

WaterWings, I think all types of eye surgery come with the risk of damaging the pupil (and other even worse things). I'm sure it's not very common though but I definitely understand where you are coming from. I would never gamble with my eyes unless there were no other options. My plan is to see if I can try other types of contacts and maybe mess around with the prescription to see if I can get the ghosting to go away, which I assume is caused by higher order aberrations.
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Hi guys,

Here is a question:
Does your traumatic mydriasis cause "blurry vision" at distance? I am asking as I also have traumatic cataract and I don't know which is causing what...Or what symptoms do you have when looking only out of ONE eye (I have only one).

For my side, Going to acupuncture today and Friday body relaxation+exploration. Only costs money, so willing to give it a try.

Hi Andy,

WOW 3mm when you are in the sun, that is really great! Mine is like double that... which cause the sky to be soo bright (when cloudy) that I actually don't see the sky.

Did you see any changes?

Hi Waterwings,

I spoke to my opthalmologists, Seems that is Switzerland we have ICL's with a fixed 4mm opening (average pupil size) which takes care of the mydriasis problem. He really isn't concerned at all about my condition, as if I was a car which only needs a change of tires.
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Hi again.  I would think your blurry vision is a result of the cataract.  Generally, the pupil relaxes to see far distances, and constricts to see closer objects.  So your relaxed pupil shouldn't be hindering you ability to see far away, unless the light that is entering your eye is causing some interference.

You're very lucky that you have a confident doctor over there.  The fixed pupil ICL sounds like a great solution if the pupil doesn't recover, but I'd really recommend giving it time to recover; it's already doing so well.
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Hi LastEye,

Yes, that is most likely caused by the cataract. I had blurry long distance vision myself the first week or so while the hyphema healed (my lens was so clouded the doctors had to use sonography to be able to see into the eye). Now I sometimes feel like I actually have better far distance vision with my injured eye, probably because the pupil is large and already set for just that while my healthy eye has to take some time to adapt.

I am very grateful that my pupil regained as much of its function as it did! It was almost completely stale the first few days after the accident so I know what it's like. I see great in daylight now, darkness is the problem.
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Little update

Well, I had three different opinions
1. I have 5 tears in the sphincter irirs (at the top). This may come back but unlikely.
2. The Iris looks fine. It may come back in a month or so.
3. I have no tears in the sphincter iris it probably is the nerves. But I do have some little defects at the top of the iris. The nerves should regenerate.

So I am kind of lost.

Only thing for sure, the bottom of the iris is moving up normally but the upper part is still not moving (I am at week 7)

By the way, I am on anti pressure drops, what about you guys?
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I have the same condition as a result of ICL surgery. My pressure spiked the night after my surgery and the 24/7 doctor just blew me off. I was told to come in at 8 am when my headache and extreme blurred vision began at 11 pm the night before. I was on pressure medication but my pressure was at 53 the following morning. God only knows how bad it was the night before. I believe it wasn't exactly because of the ICL but because of the pressure afterward. Just be careful. If you are going to do this make sure that the surgeon is experienced and that you have contact with someone who knows what they are doing in case of emergency.
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So that only tells us the short-term effects of the surgery.  How are you now?  Do your pupils work fine?
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Hi Benm311,

We would love to know more about your condition.
How long since you have this mydriasis issue?
How old are you?
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Please do not think the 6-month period is the limit to recover from traumatic mydriasis. It can take longer than that as sometimes it depends on a number of factors. I was desperate and hopeless for months and now, after 8 months of my injury, I'm not noticing a big improvement. I also have a friend who was operated due to retinal detachment and it took her a year to get her pupil back to normal.

Be hopeful !
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Please do not think the 6-month period is the limit to recover from traumatic mydriasis. It can take longer than that as sometimes it depends on a number of factors. I was desperate and hopeless for months and now, after 8 months of my injury, I'm noticing a big improvement. I also have a friend who was operated due to retinal detachment and it took her a year to get her pupil back to normal.

Be hopeful !
.
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Hi,

Would you have more about your case?
Your age, cause etc... ?

Nevertheless, you seem to be correct, my doctor told me about a case (two weeks ago) of a guy whos iris came down 15years after his car accident. He had know tears though.

I think there are a few things to consider, amongst which two:
1. Iris sphincter tears (I have 5 for one count, and 3 from aonther count). Which I don't think heal.
2. Irdoplegia, which, I may be wrong, results from damage to the nerves. This can take a long time to heal.

For my case, my iris functions but the smallest is 6mm in bright light (shall see later today if any improvement on that).
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Well, about the iris sphincter, interesting! Saw the doctor yesterday. My pupil is still 6mm but centered (we are roughly 3months). He said he can't give any prognosis at this moment. He CONFIRMED he has seen just about anything happen as Dr Hagan (spelling) has posted. He said I am young, that scaring can occur differently and unexpectedly. He has had a patient with multiple tears heal aver 1 year or so.

I am not going to the University Hospital anymore as the assistants only go by the book. Shall refer to him only. He does spend his vacation setting up Eye Hopsitals in african nations and operates "everything" (his first iris operation was 20years ago and now he uses Dr Schmidt implants). So he must be the best I am able to see.in my area.

So, it all comes up to, as Waterwing and others have stated, wait and see. Then a few operations are available (on the east side of the Atlantic) but contacts or sun glasses are best as less invasive.
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Hi "LastEyeBetterHold". I'm 34 and the cause of the damage was several punches in my eye. The ophtalmologists that followed my case for two months told me that it was very unlikely my traumatic mydriasis would ever go away despite having some little reaction to light. 3 months later I went to another doctor who told me that it should eventually go back to normal. He prescribed me a complex of vitamins B (B1-B6-B12) which apparently  are good for the peripheral nervous system, responsible for the constriction of the pupil.
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Hi Kpasa

I also have green eyes & have a large dilated pupil from a cricket accident 8 years ago. I have tried a prosthetic contact lenses but it was terrible & did not match my other eye at all. Does the green contact lense cover pupil & look OK? Where could I get one from.
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I read through a lot of the postings.  My story is this. I had surgery for a detached retina on 6/26/2013 on my left eye.  I had the gas bubble inserted and some laser done.  I took the Atropine 2x a day for 1 week and 1x for the second week.  I took the prednisolone for about four weeks.  My pupil is still dilated.  The doctor said the muscle that should make the pupil constrict is working on one side of my left eye but is paralyzed on the other side. He suggested that at some point it will just kick in and start working again.  I sure hope he is right. I asked him if exercising it by repetitively  covering the eye with my hand and then uncovering it while looking into light would help.  He suggested that I try it.  What is the best response you got from anyone that helped to reverse the effects of the drug and/or surgery?
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Hi LucyBella3508.  I'd try those vitamins that Andravies suggested (B1-B6-B12), and rely on rest to get it better.  I have exercised my pupil by focusing on objects very close to me while covering my good eye, and I can feel it constrict slowly.  Being outside in the light may help, too.  After being outside for awhile, mine will eventually constrict and stay put until I'm back inside.  Obviously, if this is too painful, it isn't good for your retinas and you may not be ready for that.  
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Hi all,

Same aa badminton lover I got hit by shuttle **** on left eye. Order bed rest in hospital for 3 days. Was on pred forte every hour 24/7 the 3 days in hospital then hourly till night after discharge.  Was on atrophine 8am, 1pm qnd 7pm  daily. As of last review blood clot (hyphema) clearing and. cornea adn retinal all intact.  However today is 2nd week of injury I could not reas short distance word or the phone or pc with glasses on. It just lump all images together.  Is it normal to have this? Will I recover and be on contact lens again?  
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Hi,

@Anyang, I don't know for the lump as I only have one eye, but for the contact lens if your cornea is fine you shouldn't have any trouble down the line in wearing one again.

@Lucy
Most doctors (young ones) told me nothing to expect once I passed the 3months cap... Suprisingly all the changes occures starting the 4month... So keep in mind what medical books teach may not be the case for you.

My "best" doctor is someone in his 50's who does a lot in africa and see this kind of case very often, he refferred to wait and that there will be changes in it till then end of my life. Why, just because the muscles change as we grow old.

Now for me,
I have been doing the usual sports (no hockey anymore) and good diet (with vitamins). Aside from that I do accupuncture & relaxation, even if it may not have any effect for this condition according to science it still is nice to do. And, according to the therapiests it does help regenerate muscle and nerves...

To this date, I am still seing changes in mine. I have 5 tears to the sphincter (and it is my only eye) that will never be fixed as iris tissue doesn't regenerate. I have some "awesome photos" of all my eye which made me better understand thos tears and their effect.

As of today my pupil has gone down to 4.5mm (vs 11 at the start, 6mm at one time, 5.6 not too long ago) so it seems it is still going down depsite what has been told.

The pupil also constricts faster, not sure of the measure, but to give you an idea something like 0.044m/s vs 0.012 two months ago.

I have somewhat accepted the fact I will never see well again. But I can still drive, travel and work. so I guess I can still enjoy living.

What I am looking into is:
1. Articial contact lense, should be ready sometime in a few weeks.

Then, at one point, I will need to have the cataract removed... in which case I would evaluate: http://www.artificial-iris.com/

Unless by that time this is a valid solution: http://www.youtube.com/watch?v=0WJXjPpZgjo + http://www.youtube.com/watch?v=DFMDN5JR5Yc research. First potential trials will be in about 4 years from now depending on fundings.

In the end, keep hope as watterwings has stated it several times.
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Hihi

What I mean is those wordings on screen just become blurry with all images like sticking together into patches. . Im going back for review tomorrow. Hopefully my blood clot are all cleared. This is my second week of medical leave.hope to be able to go back work though left eye cant read properly now.
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Hi LastEyeBetterHold

I got a traumatic Mydriasis after receiving a plastic object on the right eye the 22 of August.

At first vision was very blurred during one day. After, it improved and I noticied the mydriasis.

My pupil is still working a bit and contracting when outside in the sun.

Main problem is that at night all the illumination are very bright and I cannot see well. Morning is also very difficult due to the contrasts between the shade and light.
I saw some doctors who said there is nothing to do just wait. Rehab they say (orthoptist) is also useless. It seems the muscle of the Iris Sphincter is damaged (not the nerve).
No indication, no support for daily life (sun glasses, cap).

I had much support reading this thread thank you to Waterwings and to LastEyeBetterHold.

Any idea of what I could do to improve the healing ?
Rest of train the eye as it has been two weeks now ?

I hope we all get better with the time.

Capman



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Hope you get well soon. . I got hit on 24 aug so guess we are in same stage too.i got blank white vision the first day I got hit now improving but looking at near distance still a no

Will update more when I got doctor review tomorrow see if any exercise for eye.  
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Avatar_m_tn
Hi everyone,

Just thought I'd post an update on my eye since there are new people here. It's hard to find information about this type of injury, but I'm sure it's not as uncommon as one might think!

I'm now close to 9 months in. The healing process for me has been something like this:
Day 0: Injury happened. I had a hyphema (blood in front of the iris), elevated pressure and practically no movement at all of the pupil.
Day 2-3: Most of the blood had cleared out and pressure was normal. Still not much pupil movement. Very blurred vision.
1 week: The pupil now constricted fairly well and the doctor thought I had a good chance of making a complete recovery.
1 month: Better yet but not back to normal. New doctor said it wouldn't improve much more now.
3-4 months: About the same. Met with yet another doctor who basically said it was impossible to say anything about how an injured iris sphincter will heal. It might still get better but the chance is probably low and there's no way of saying how long it would take.
9 months: It has not changed much. I sometimes feel like it has improved a little over the last few months but it's hard to tell. Definitely better than it was at 1 month though.

Like I've mentioned before in this thread, the pupil mainly gives me two problems: reduced near sight vision and ghosting (double vision) in the dark. I luckily have no trouble at all in sunlight.

Some days it's better and some days it's worse. One day I was surprised when I looked at a candlelight and saw only one flame, and then the next day it was back to two again... On the whole I'm not nearly as concered about my situation as I used to be. Life goes on and I can still do everything I used to do. (Plus I look like a terminator on night time photos when the eyes get red, which is cool ;-)

LastEye: I'm really glad your eye is doing so much better! Let's hope it keeps improving!

Anyang: I got my injury from getting hit by a shuttlecock playing badminton too. I still play but I now use proper eye protection, and you should too! When you think about it it's pretty crazy that people are willing to play such a fast raquet sport with projectiles flying around their heads without thinking about protecting their eyes... Near distance is still blurry for me but the brain has adjusted and my other eye compensates. I don't think about it anymore. You are still early on though and have every chance of getting better!

Capman: Sounds like your situation with seeing poorly in the dark is a bit like mine. If you get symptoms like halos, starbursts or ghosting it might be caused by something called "higher order aberrations" (nothing dangerous, google it). You are also early on in the healing process. It's like your doctor said, all you can do is wait and see how it turns out (boring I know...)
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Avatar_m_tn
Hi LucyBella.

I am confident that your pupil will go back to normal, particularly if your doctor told you so. The two ophthalmologists that originally saw me for a period of over one month didn't think my pupil would recover. But from the moment I noticed there was a minimal reaction to light, I started having hope and doing some exercises with a torch for about 30 mins at nite. Natural light particularly sunny and bright days also seem to help. I took the vitamins for 30 days. My pupil seems now ok.

Also, as I mentioned above, I have a friend who was operated from retinal detachment and it took her almost one year to get her pupil back to normal. Eventually she got there so be patient, it should gradually heal itself.

Hope to read soon your pupil is ok. Keep us posted!


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Avatar_m_tn
Hi Waterwings,

I'd like to mention that reading your original post and the comments that followed helped me understand the problem better and take a more calm approach to handle the situation.

I hope you have noticed some improvement.

All the best!
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Avatar_m_tn
Hi Capman.

I'm not a doctor but I disagree 'rehab' is useless. If there is some reaction to light, you should have a lot of hope.

It's been now one year since I had my eye trauma and my pupil seems now fine. I noticed most of the improvement after the first 6 months. I invented some exercises after the first month when I noticed the reaction to light.

I'd recommendthat you stay hopeful and be patient. Good luck!



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Avatar_f_tn
Hi andypupil

Thanks for the encouragement. . I'm kinda scare that the poor short distances  blurry visions will last forever. .it's like quite depressing to not be able to read up close .

Yeah it was a sudden hit by my friend. Was playing double not sure why I turn back and the ball hit me right into the eye.


Hope to get good review today from the doctor. .
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Avatar_m_tn
Hi Andravies, Andypupil and all,

Thank you for your support it is helping as this patology seems of no interest to the medical community (no study, no data).

Andravies could you please describe the exercices you are/were doing.

To LastEyeBetterHold , how can you measure the time for the reaction of your pupil ?

Let's us be confident, we will improve with time and that we will invent the way to live our daily life the best we can.

I will keep you posted.

Capman
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Avatar_m_tn
Hello Anyang,

It happened almost at the same time but maybe quite far (I was in Grece when it happened).

Keep confidence in the recovery as we saw in this thread it can improve after 6 months and even after 2/3 years.

Take care and keep us posted. ;-)

Capman
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Avatar_m_tn
Hi again to all !

What vitamins do you suggest as my problem is more the muscle than the nerve ?

I understood B1-B6-B12 is mostly to help the nerve recovery.

Thank you for your answers.

Capman
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Avatar_m_tn
Hi Capman.

I've just read again your original post and I'm 90% sure your pupil will eventually go back to normal (or so close to norrmal you will not notice much difference in size and vision compared with your other eye).

The exercises I decided to follow are simple. In terms of tools, I thought I needed 2 things: a small/portable mirror big enough to see my eye/pupil, and a torch (also called flashlight in American English!). The torch should be relatively powerful and, if possible, allow different output levels (although this is not that important). Now the exercices:

- On sunny, bright days, I used to look towards the light (this doesn't mean looking directly at the sun, never do that!) while monitoring the reaction of my pupil using the mirror. I counted to 10 or 20 before moving my eye to an area with less light where I left it rest for around 30 secs. I repeated the process for 5-10 mins.

- At night, when arriving at home from work, I used to follow a similar process as above but with the torch/flashlight. This time looking directly at the beam of the torch (either positioning it in front of the eye on and off, or gradually using different power levels). I used to do this every day for 20 mins.

The idea behind the exercises is to get the muscle to move (constricting the pupil) by making it react to light.

The vitamins are supposed to be for the nerve but I was never told whether the problem was with the muscle or the nerve. The way I looked at it is that muscle and nerve 'help' each other. These complex of vitamins (B1-B6-B12) should not be taken longer than one month - I took one tablet a day for 30 days.

For me, the exercises are the key.
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Avatar_f_tn
Hi guys..

@ capman,I was in Asia..definitely far from you.. I'm taking lutien now as eye supplements.

Sadly my review is i got cataract developing on my injured eyes I can't really feel it cos everything is blur due to dilation. Now use uv protection eye wear to prevent.. It's too minor to risk any operation. I am only 30..

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Avatar_f_tn
Update

Fourth week of injury nothing much improve.
Consult second doctor, diagnosis as below

Bleeding in front n back of Len. Back of Len still have blood but will go away not a concern

Due to the impact, Len damaged and have post recession glaucoma risk.

Len tilted inwards as ciliary vein is broken. Will have complication if I ever need cataract surgery.

Iris damaged hence pupil will not constrict back.

I got to watch my eye myself as he video down my eye examination for me to watch. no surgery recommended as its not worth the risk. Can only observe n monitor now. Pupil dilation only sensitive to light wont have near vision issue according to him..

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Avatar_m_tn
Hello all - joining in on the discussion as a recent eye trauma sufferer and this forum has been helpful in reading other cases and having a sort of support group for each other dealing with this issue. I find that my family and friends are supportive and helpful but it only goes so far compared to others with the same problem and how they cope.  It's amazing how something we probably all took for granted but was proud of having in attractive eyes could be such an insecurity now.  So thank you in advance for starting and updating this thread!

I am 35yo active male, play Ice Hockey and Softball regularly.  Take precautions and wear safety equipment but about 7 weeks ago took a softball to the right eye / face from a teammate who threw it while I wasn't looking. Immediately went blind in the eye and had a laceration of the lid / below my brow.  Went to ER and diagnosed with a layered hyphema and after CT had fractures of the upper cheek and orbital floor bone (no displacement thank god).  Within a few hours got my sight back but with yellowish cloudiness that went away within 12 hours and hyphema treatment for 3-5 days with pred, Timolol, atropine drops and bed rest.  Pressure was elevated in ER but returned to normal next morning.  Everything seems to be back to normal except the pupil dilation. Tried Pilo 1% once and it worked but left a pretty dull ache in the region.  

No apparent tears in iris but not sure on sphincter as it's such a thin band on inside of the iris and hard to really distinguish.  Been eating very healthy, lutein rich foods, getting rest, started drinking ginger tea, flashlight and close vision exersizes, but no changes really and not a lot of movement in the dilation.  Seen a few MDs that don't really tell me anything I don't already know, and hard to get any referrals to ones that do. I know it's early but really keeping hope up as much as possible.

In meantime, anyone try THYMOXAMINE instead of Pilo?  I've read a few studies and information online that says it's less powerful and less side effects. Haven't asked my doctor but any info would be great until I do.

Thanks and hoping for a way for us all to heal!  
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Avatar_m_tn
Hi. I'm another recent eye trauma sufferer that happened on 3 November. Had been using a bungee cord attached to an anchor point in the back of my car to hold some tools down. Was putting tools away and pulled on the bungee and the anchor point came lose and the whole thing hit my left eye. Hyphens, retinal commotio, lacerations, damage to the iris, blood clot in white of eye.

Immediately put on eye dilator drops, pred forte anti inflammatory, and antibiotics. After one week was told to come off dilator drops and antibiotics. Stayed on pred forte drops. However, 1 week later eye pressure had doubled to 32mmg so put on lumigan and azopt. Pressure came down to 26 a few days later and not due to have another examination till 9 Dec. but one doctor thinks the damage to my iris may need permanent medication to keep pressure down to prevent traumatic glaucoma.

However, my pupil is still dilated more than twice the diameter of my good eye. There is some slight movement of the pupil in response to light of about 2-3mm. Vision is better to things near me but my long distance vision is just blurred. But I get jaggedness on the edges of things in near vision. Kind of like a ghosting effect. Believe this to be a symptom of too much light getting into my eye. And my blurred long distance vision could be to do with me slightly far-sighted.

The last 4 weeks have been a real emotional roller coaster. Varying opinions of the different eye doctors I've been seeing hasn't helped either. My first doctor wrote a letter for me to give to my university (I'm doing a phd) that said he expected me to make a full recovery. But two different doctors I've seen since (mainly because I had to keep changing my eye pressure drops) were much less optimistic. So I don't really know what my prognosis is.

Family, friends and university have been brilliant.

My dilated pupil is less of a concern to me right now than that I might have to medicate my eye to keep pressure down to prevent traumatic glaucoma.

It's early days I guess and finding this forum has been a real help. Thanks guys and gals...

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Avatar_n_tn
hi, waterwings
your posts are really helpful, even i am going through something what you are
but not as big as yours,, i am planning to seek second opinion with well experienced doc,, ll update u soon.
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Avatar_m_tn
How is the eye functioning now?  I am almost 10 weeks from my injury and no signficant change. Would love to know how you are doing and giving us some hope of recovery. Thanks!
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Avatar_n_tn
Hi ManofTroy59.  No significant changes for me based on my updates from before.  The pupil continues to respond better to light, to where I can't visually tell the difference between the eyes when I go outside.  In the mirror, my pupil sizes don't match perfectly but they're close, and NOBODY notices, not even the girlfriend.  The redness on my eye from the surgery has gotten better marginally, and I was able to come off Restasis for the dry eye, without any complications.  Now the eye seems to water about as normally as the healthy eye.  They can't correct my vision in the injured eye better than 20/30, but that's alright since my other eye corrects to 20/20.  Still no sign of a toric ICL in the states so no option for refractive surgery just yet.  Otherwise, the eye is a minor inconvenience in my life, anymore.  It no longer hinders my day to day and I don't live with pain.  Remember this is almost exactly 5 years after the incident, but everyone here should stay hopeful.  I'm STILL healing, and you will too.  
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Avatar_m_tn
March 2012 I was 43 and I was hit in the eye with a tool that caused a significant amount of structural damage.  Torn retina, Hyphema, Iritis, Corneal abrasions, traumatic cataract, angle recession glaucoma and traumatic mydriasis.  The glaucoma is under control with aqueous inhibiting drops, the cornea healed, the cataract was removed and a fixed IOL implanted.  Prior to my injury I was 20/20.  Post injury I was as bad as 20/200.  Once the cataract was addressed I chart 20/20 again but it is a fuzzy 20/20.  Some of that is due to the PVD and vitreous debris that is floating around but most of it is to the mydriasis.

I have iris tears and my pupil was totally non reactive to light for about 7 months.  It is showing very sluggish reactivity to light but not much.  I am closing in on the 1 year mark and am doubtful that my mydriasis is going to heal naturally.  I have contemplated Cerclage but I am concerned that it will make Retina exams more difficult in the future.  Not sure what to do.  
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Avatar_n_tn
Hi hipwr223.  I'd wait and stay healthy.  Based on my injury, I didn't see ANY movement within a year, now I'm getting almost full movement, although it's a slowly reacting iris.  You're already doing better than I did at one year.
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Avatar_m_tn
Hey all
I'm now just about 4 months from my softball injury to my right eye.  I'm still seeing very well in the eye except for a very tiny "wrinkle" in the retina which causes a very small distortion of lines and top parts of letter when reading.  But the pupil is still dilated, BUT my fiance and I swear there is some constricting when im in the sun light for long periods of time.  It is so slight but the shape changes so there is some movement.  

I went to see a Neuro-Opthomologist who actually spent a significant amount fo time with me going through my history and running tests, and she actually saw some movement in the top and bottom portion of the sphincter muscle but not much.  SHe said the same thing most doctors are saying which it wont get much better and rarely does she see anything changed years down the road, but there are always exceptions.  

Here's to hoping we all are exceptions and our bodies will defy what the medical community believes.  Keep you posted in a few months
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Avatar_m_tn
Everything I read says the odds of traumatic mydriasis healing after 8 months are slim.  Waterwings, how long after your injury was it until you felt you were experiencing a significant change in your iris reactivity?
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Avatar_n_tn
Hi hipwr223, from an earlier comment, "Give yourself 6 months to do most of your healing, but as I stated before, I saw significant progress with mine after about 3 years."  It still continues to get marginally better.  
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Avatar_m_tn
Well that certainly gives me some hope to hang on to.  I am hyper sensitive to my visual acuity and rely on it heavily for a discipline I am involved with that really requires great vision.  This injury has been a real morale killer but if you have seen some gradual improvement over a 3 year span maybe I will be fortunate enough to continue to heal.
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Avatar_m_tn
My advice is that you remain hopeful. I perfectly understand how you feel. I've gone through something similar to what happened to you and, after over one year, my mydriasis has gone. Things that I believe really helped me:

- Stay outdoors on really sunny and bright days.
- Vitamin B tables to take during a month (they were prescribed to me by one of the eye doctors that saw me).
- Remain positive - because if there is light reaction, my theory is that it will improve sooner or later. And, by the way... I was also told a few times that there wouldn't be any improvement (what can I say? Wrong, wrong, wrong, ...)
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Avatar_m_tn
Regarding the PVD, I also have it. At the beginning, I could see the debris and kind of a cloud that would move in the opposite direction of the movement of the eye. This sympton has also improve over the months. I have developed some exercices and move the eye to "dilute" the opacities. I don't know if the improvement is due to these exercices but I have slowly improved and my vision is now close to be as clearer as it was before I had my blunt eye trauma.
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Avatar_m_tn
Thanks, I am certainly more hopeful after reading posts like yours.  I guess I will remain patient and optimistic.  Funny how a fraction of a second can alter one's life so dramatically.  
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Avatar_f_tn
Hello,.
my son had a blunt force trauma incident at school,his eye was shot at with an elastic band and a sharp arrow like weapon ,it was 2 months ago,initially he had hyphema, burst vessels,clot and vision loss,was in bed for 14 days completely still as clot was not healing,no excercise for 6 weeks,He is a great athlete and loves his music and photography.this injury has changed my beautiful boy and his confidence in anything.He has an enlarged pupil,was put on the polycarpine 1% ,but says it stings so surgeon gave him the option,to use or not to use,as it is not going to heal it ,but just change it,so he said what ever is comfortable for him.Does anyone know if their is any side affects from the drops. I dont know if thats a good thing,it is so large and I am worried of it getting worse as it is so large. He has bad focus and vision impairment.Pressure around 25,gets dizzy and nauseous.He generally is well but seems to not feel well some days.He is very down because of it..Please if anyone can help me with some sort of advise ,it would be appreciated.
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Avatar_f_tn
Hello,.
my son had a blunt force trauma incident at school,his eye was shot at with an elastic band and a sharp arrow like weapon ,it was 2 months ago,initially he had hyphema, burst vessels,clot and vision loss,was in bed for 14 days completely still as clot was not healing,no excercise for 6 weeks,He is a great athlete and loves his music and photography.this injury has changed my beautiful boy and his confidence in anything.He has an enlarged pupil,was put on the polycarpine 1% ,but says it stings so surgeon gave him the option,to use or not to use,as it is not going to heal it ,but just change it,so he said what ever is comfortable for him.Does anyone know if their is any side affects from the drops. I dont know if thats a good thing,it is so large and I am worried of it getting worse as it is so large. He has bad focus and vision impairment.Pressure around 25,gets dizzy and nauseous.He generally is well but seems to not feel well some days.He is very down because of it..Please if anyone can help me with some sort of advise ,it would be appreciated.
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Avatar_n_tn
Hi Carpdiem.  He may be getting nauseous based solely on the fact that he's in distress, as I did.  I do know that eye injuries cause stomach nausea themselves, so if he still has some remnants of the initial trauma, it may be causing it.  At either rate, I expect it will subside as mine did.  Side effects from pilo are the possibility of a detached retina, but if your doctor isn't telling you that, then he's not a doctor you want to be seeing.  If you can distill the pilo with regular eye drops down to a 0.5% solution, the stinging will be less and may still work for your son.  Talk to your doctor about doing this, as it will require a syringe (from the doctor) and eye drops.  I'm not a doctor, but I've been told the possibility of a detached retina in my case with such a small dose of pilo is very unlikely.  Your son should have his retina evaluated by a retina specialist though.  That's another area of the eye that you want to watch, especially if using pilo.  
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Avatar_m_tn
I would go seek a 2nd opinion from another eye specialist.  If in a larger population city, maybe go see a "neuro-opthamologist" and a retinal specialist to assess the symptoms, especially the pressure and cloudiness due to the

As for Pilo-carpine, the stinging is nly transiently after the administration - that goes away.  But you should be careful using regularly as it does cause tension type headaches in the ocular cavity by tensing all the effected muscles as well.  Another side effect is retinal detachment from consistent use which to me is a MUCH worse problem than the enlarged pupil.  

We all feel for your son and know exactly how he feels.  BUT, I will say things do get better.  All the doctors I've seen say the eye takes 1 year to fully heal and even then can improve after that.  2 months is extremely short time for the journey he's on with this.  
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Avatar_f_tn
Thank You for your help,I appreciate everything
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Avatar_f_tn
Thank you for replying,this is a very helpful site,as people who have been through an eye injury,understand my situatiuon.
                            
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Avatar_m_tn
Dear all,

Some news from me "Capman". I was hit in my right eye in August 2013 and had a traumatic mydriasis thought my pupil was slightly moving (not much).
I had also blur vision in the morning due to light contrast and photophobia at night with car and traffic lights.

As we all experienced medicine has no real cure for that so I went to see a country healer in September. Not sure if it is because of him but very quickly my blurr vision disappeared as well as photophobia.

Today after 6 months my pupil is contracting much better, though still 30% bigger than the other one. I now think that my pupil will recover completely in a few months or years.

I would like to share the following thoughts on my experience :
- do not believe the doctors on this issue : I went to see the best doctors in Paris and was given very little hopes of a recovery. And today I experienced a decisive improvement. So hope is there, keep faith in your body healing.
- I want to thank the blog creator and participants that gave me hope, advices and support. THANK YOU ALL :-)))

Capman from Paris
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Avatar_n_tn
Hi Everyone,

This forum has been most helpful to me. My right eye was hit by a soccer ball - a low probability event given the size of the ball. The string of eye problems followed; Hyphema (blood in eye which eventually drained away in abt 2 weeks), myopia (vision was worse after trauma and only return to normal after a month) from the trauma, traumatic mydriasis (torn iris and pupils can no longer constrict fully) and now posterior vitreous detachment or PVD (seeing flashes of light in the peripheral vision as the gel like vitreous detaches away from the retina). And its not done yet, the worry is that the PVD may result in a retina tear/detachment. It has been abt a week since the onset of flashes and it may last for months. Anyone also experienced the flashes after trauma to the eye? Anyway to deal with it?

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Avatar_m_tn
My recommendation would be not to make any abrupt movements if the vitreous hasn't fully detached from the retina yet. This way you would minimise the risk of a retina detachment.
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Avatar_m_tn
By the way, I had a PVD in my injured eye. Although there is a risk, this process doesn't have to necessarily cause a retina detachment. So, be positive. Believe me, it helps to think for the best outcome.
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Avatar_m_tn
I had an injury to my left eye 6 days ago now with dilated pupil. I m on steroid drops and cyclogel. How long should I avoid exercises, walking since I m a diabetic. Thanks for all ur posts
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Avatar_m_tn
I don't know how bad it is.

I had to wait until the pressure in the eye droped for about one month or so. Then could start cardio and had to wait another two month to weight lift again.
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Avatar_m_tn
It was hyphens with injured sphincter. My visit to ophthalmologist in four times time. All the posts have brought in a ray of hope. Thanks
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Avatar_m_tn
You should be OK! It does take a long time. My photophobia cleared like after a few month.
My blood in the eye cleared after 4 or 5 months.

I have no PVD (yet at least).

but I do have a cataract that has formed and that is continuing to "improve" till I will need to be operated one day. So soon I will also check the forum about that.
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Avatar_m_tn
Thanks for your positive response. As you mentioned I will wait for the better things to happen. Keep the good work. I will post the update as and when.
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Avatar_m_tn
Hi,

I thought I'd give a quick update on how things have gone with my eye injury (see my earlier post in Dec 2013).

At the time I was on medication to keep the pressure down in my eye and my pupil was barely responding to light. However, just 2 weeks after I posted on here, I came off all my meds (as instructed by my eye consultant) and within a week my eye pressure was back to normal. The pupil had started to react to light too. Certainly enough that the doctor was able to properly examine the damage in my eye.

The good news, so far, is that I've been off the meds completely and now nearly 6 mths on the pupil is still not the same size as my good eye (I'd say 3-4mm bigger in diameter) but it has improved a LOT.

I go back in a couple of months for a follow-up check and if my eye pressure is still ok I'll get signed off.

For me, the only problem I have is when I'm out in bright sunlight. But, after the trauma of the injury and the uncertainty of the long term, that's really not an issue.

I can go a few days without thinking about my eye. Don't get me wrong, the eye is still not working properly, but its amazing how your brain compensates and allows you to get back on with life.

I consider myself to be extremely lucky and, as Waterwings says, its definitely worth keeping our hopes up!!

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Avatar_n_tn
Great update, RichyBoy. Glad to hear things are looking up!
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