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Angle-Closure
Traumatic Iridodialysis

  • A traumatic separation between the iris root and ciliary body
  • Is not an uncommon cause of trauma related glaucoma
  • May be caused by nonpenetrating trauma by blunt object or penetrating injury to the globe
  • Clinical features:
    • Symptoms: pain, blurred vision, history of blunt or penetrating trauma
    • Signs:
      • Acute phase:
        • Hyphema and an irregular pupil
        • Slightly reduced intraocular pressure due to iritis or increased aqueous
        • outflow through the disrupted structure of the angle
        • Transient elevated intraocular pressure due to hyphema or anteriorly dislocated lens
        • May be associated with lens dislocation
      • Chronic phase:
        • Chronic pressure elevation due to obstruction of the aqueous outflow system from scarring of the torn ciliary body or from peripheral anterior synechiae
        • Optic disc cupping
        • Visual field loss
  • Management:
    • Topical anti-glaucoma agents in the early postinjury period.
    • Surgical repair of iridodialysis if patient symptomatic
    • Filtration surgery (eg, trabeculectomy with antimetabolite therapy) if intraocular pressure uncontrolled medically

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