trauma

[Mack512]

I had a baseball hit me directly in the left eye.  2 Opthalmologists say I have no structural damage to the eye and that I should regain 100 % of my vision.  It has been 8 days and I am still blurry.  The biiggest problem seems to be that my pupil is still dilated.  They thought it might be from drops given at the hospital but they should have worn off by now.  It causes glare problems and I am not sure whether the blurry vision(although tests at 20/30) is a result of inflammation (some trace cells remain) or the large pupil. The pupil is slightly responsive to light.  Will it get better?

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

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[vickynavin]

hi i got an eye injury for the past 2 month with a ball hitting me directly in my rigth eye. it cuases the pupil bigger and my vision is still blurry, the doc says i says its a slight mydriasis will become normal but i cant see any improvement. at night i can see better but in the morining it again becomes blurry. is there any treatment for that??

can anyone help me plz
vicky

[loveyourlife]

i had a surfing accident where the surfboard hit me directly in the right eye late October.  I too, have a overblown pupil and have been looking for ways to heal.  Have you found any luck?

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

The iris/pupil problem would not cause flashes. If the flashes persist, if there is an increase in floaters or any loss of peripheral vision I would try and move the appointment up to Monday.

JCH III MD

[Mack512]

It seems now that my pupil is a little smaller in the morning when I wake up - but returns to the larger size by the end of the day.  I have been having some light flashes at 2 positions (say 7:00 and 10:00) on the left side of my far peripheral vision (at the edge of my visual field of view).  They occur randomly, maybe every 20 minutes or so.  I don't notice any flashes at all with my eye closed.  Could iris spasms cause this or are flashes always a retinal problem?  I have a Dr. appt. on Thursday - should I see someone about it before then?  Thanks for your responses!  

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

No danger with a one time trial. It's a good thing it contracted, makes recovery more, rather than less likely but no guarentee it will recovery.

JCH IIIMD

[Mack512]

Is there any risks (other than side effects) with the one dose of pilocarpine that was put in my eye today?  Did the fact that it worked so well to eliminate the dilation tell us anything about the chances of the iris recovering on it's own?  He took me off the steroid drops and ointment altogether - before we knew that that policarpine worked.  

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

You and your physician should do what's best for you. In similar cases I've waited about 6-8 weeks before starting a trial of pilocarpine.  This is to make sure that the muscle is given every chance to heal on its own.

JCH III MD

[Mack51265]

I just finished my Dr. visit.  It has been 2 weeks since the injury.  The vision is still not back to what it was - but it is better (20/25).  The pupil was still the same size - 7.5mm and slightly reactive.  I asked the Dr. about pilocarpine - he had no reservations about side effects.  He said he would try a drop now but did not expect it to work at all due to the fact that he thought the muscles it would work on were damaged.  Within 1 hour my pupil had gone back down to a size even smaller than the unijured eye.  Does this mean the muscles will still work and should recover over time or is this false hope?  I called the Dr.'s office and they scheduled me an appointment in 2 weeks - the earliest available - and said that he would formulate a prescription of a lesser dosage.  What do you think?

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

There is a reason physicians often way "only time will tell", I've seen it go both ways--complete recovery and the pupil being left larger and non-reactive or subnormal reactive.

A partially dilated pupil won't interfere much with distance vision, it is a problem with near and of course glare and bright lights are a problem.

A traumatic iritis (cell and flare) can blur the vision. That should improve a lot over the next week if that is the cause (asuming you are on steroid eye drops for the iritis).

JCH III MD

[Mack51265]

I checked and my pupil was not dilated with atropine.  It has been 12 days since the injury and it is still dilated - maybe a little smaller.  The doctor said 4 days ago that it was slightly reactive to light.  He also said I stll had some trace cells.  My vision is still blurry.  Have you ever seen an iris fully recover over a period of time? how long? Could the dilated pupil be causing the blurred vision or is it more likely the cells?  What are my options for the future?  

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

Its too early to tell and you need to be followed closely. If your pupil was dilated with atropine it could take up to 2 weeks to wear off especially if your have blue iris. On the other hand the injury you sustained often damages the muscle that makes the pupil smaller and it may be permanent (tramatic iridoplegia). Only time will tell. You need to be watched closely for retinal tears/detachments.

JCH III MD