Traumatic Mydriasis

[mydriasis]

I was recently diagnosed with traumatic mydriasis after a sporting injury. I suffer headaches from the glare and blurred vision in that eye. My concern at the moment (as shallow as it is) is that my eyes look very uneven. After looking around on the internet, I have come across contact lenses that are tinted to cover the dilated pupil however my opthalmologist has said they are not very good. Do you have any advice you could offer?

[Retroillumination]

Hi guys, I have found a few things that help alleviate symptoms of traumatic mydriasis:

-Tinted contact lenses w/ UV protection. Get a second opinion if your eye doctor discourages you from at least trying that. There are no more adverse effects from trying this than there are with trying any other type of contact lens.

-Colored contact lenses with pupil. Doctors and labs are getting really good at matching the two eye colors and pupil sizes these days. Many people are very thankful for these types of lenses, if not only for cosmetic reasons.

-Treatment: Iris Cerclage Suture Technique for Traumatic Mydriasis (not fun)
A surgeon stitches your iris so that it is permanently in a more constricted position.

-Be very careful with pilocarpine. A dangerous side effect is retina detachment. It has happened in the past and should probably be avoided in most cases.

These three methods have proven helpful for many people.

I was hit in the eye a few years ago and still have mydriasis caused by the blunt trauma. This experience motivated me to learn more and eventually become an eye doctor.

[Pianist129]

I have passed through a car accident a month ago, the left side of my face was severely hit. Everything through operations are going back to normal, but my left pupil is dilated more than the other. People told me that directly after the accident it was dilated even more and it has became less dilated currently. The pupil from  the bottom responds to light, but from the top stays as it is. I would appreciate your response to whether the pupil will return to normal or not. Thanks in Advance

[missvicky]

My ophthalmologist diagnosed my large blown pupil as a permanent mydriasis, ( it's been two years) caused by a hit to the eye.   Nothing reduces the size, any light and drops fail to;  there isn't even a quiver.   There are questions raised that in as much as the iris sphincter muscle tear can't be seen by a routine exam, how can he be sure it is a fractured muscle, which is irreparable in my case?  What does the eye specialist need to do to prove an orbit hit paralized the part of the eye that works the expansion and constriction of the pupil?   Are the tears so small one cannot see it?   Help!

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

I did not mean to state that full recovery is not possible. It is and its possible they will work as good as  new several months from now. No way to tell at this point.
JCH MD

[RetiredBaller]

Thanks for your prompt reply.  I didn't receive any atropine or homeatropine.  So full recovery is not possible, only varying degrees of recovery, and sometimes none at all.  I'm heartbroken over my loss of vision and my appearance -- a week ago I would have said my eyes were my best feature.  Doubt I'll get contacts.

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

Time will tell. They Eye MD may have put in some drops that last a long time (like atropine or homeatropine) to treat the iritis. Some cases are permanent. Some cases the pupil works but not as good as normal.  It will probably be several months before you know for sure.

JCH MD

[RetiredBaller]

I was poked in the eye playing basketball less than a week ago.  An opthamologist diagnosed me with traumatic mydriasis and traumatic iritis.  In the affected eye, my eyesight is not as sharp and my pupil is larger -- it looks to me like the inner part of my iris no longer works.  My doctor said it may take up to six weeks for my iris to "snap back," but in reading these accounts, I'm worried I my vision may not recover and I'm going to look a like a Bond villain for the rest of my life.

Most of these accounts sound like the weaker iris is permanent.  Are there cases of full recovery?  Is there anything I can do during the next five weeks to improve my recovery?  I'm currently taking some steroid eye drops for the iritis.

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

-

[VAButterfly]

I've had mydriasis for 13years due to optic nerve damage from a brain tumor.  I too am searching for a cure or alternative treatments. I do plan on trying acupuncture (not in the eye) But "until" I can find a cure that I've been looking for for 13years, I got colored contacts to "hide the pupil" I had to get two different shade of blue to make them look the same, but it works great, not perfect, but it really really makes it so much better. I have blue eyes, but there are so many colors to work with. DO NOT GO WITH PILOCARPINE.  I tried it, all doses/%'s and they make the pupil unusually small, like a pin, then it slowly just gets bigger throughout the day to where it was.  IT HURTS very bad, I'll never try that stuff again.

[mydriasis]

Are they made from the same substance that other contact lenses are made from? What do you think it is about them that causes them to be so painful?

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

Both plus painful, made the eyes red.

JCH MD

[mydriasis]

Was it that they didn't reduce the glare or improve vision?

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

Yes I have had some patients try them. Generally its not worth the time, money or final result.

JCH III MD

[mydriasis]

The two othalmologists I have been seeing have both said they are reluctant to prescribe the drops due to its side effects. Do you know much about the contact lenses? Do they work well to reduce the glare and look relatively natural?

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

You can have your ophthalmologist discuss trying dilate pilocarpine (0.5 to 1%) to constrict the pupil and make it smaller.

JCH III MD