| 词条 | Iridodialysis |
| 释义 |
| name = Iridodialysis | synonyms = | image = Iridodilaysis - Blunt trauma to the eye.jpg | caption = Iridodialysis caused by blunt trauma to the eye | pronounce = | field = | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }}Iridodialysis, sometimes known as a coredialysis, is a localized separation or tearing away of the iris from its attachment to the ciliary body.[1][2] Symptoms and signsThose with small iridodialyses may be asymptomatic and require no treatment, but those with larger dialyses may have corectopia or polycoria and experience monocular diplopia, glare, or photophobia.[3][4][5] Iridodialyses often accompany angle recession[6] and may cause glaucoma[7] or hyphema.[7] Hypotony may also occur.[8] ComplicationsThose with traumatic iridodialyses (particularly by blunt trauma) are at high risk for angle recession, which may cause glaucoma.[3] This is typically seen about 100 days or three months after the injury, and is thereby called "100-day Glaucoma". Medical or surgical treatment to control the IOP may be required if glaucoma is present.[7] Soft opaque contact lenses may be used to improve cosmesis and reduce the perception of double vision.[7][3] CausesIridodialyses are usually caused by blunt trauma to the eye,[2] but may also be caused by penetrating eye injuries.[9] An iridodialysis may be an iatrogenic complication of any intraocular surgery[10][11][12] and at one time they were created intentionally as part of intracapsular cataract extraction.[13] Iridodialyses have been reported to have occurred from boxing,[14] airbag deployments,[15] high-pressure water jets,[16] elastic bungee cords,[17][18] bottle caps opened under pressure,[19] water balloons,[20] fireworks,[21][22] and various types of balls.[23] TreatmentIridodialysis causing an associated hyphema has to be carefully managed, and recurrent bleeds should be prevented by strict avoidance of all sporting activities. Management typically involves observation and bed rest. Red blood cells may decrease the outflow of aqueous humor, therefore the eye pressure should be kept low by giving oral acetazolamide(a diuretic given to reduce intraoccular pressure). Accidental trauma during sleep should be prevented by patching with an eye shield during night time. Avoid giving aspirin, heparin/warfarin and observe daily for resolution or progression. A large hyphema may require careful anterior chamber washout. Rebleeds may require additional intervention and therapy. Later, surgical repair may be considered for larger avulsions causing significant double vision, cosmesis or glare symptoms.[4] Surgical repair is usually done by 10-0 prolene suture taking the base of iris avulsion and suturing it to the scleral spur and ciliary body junction. See also
References1. ^Cline D; Hofstetter HW; Griffin JR. Dictionary of Visual Science. 4th ed. Butterworth-Heinemann, Boston 1997. {{ISBN|0-7506-9895-0}} 2. ^1 Cassin, B. and Solomon, S. Dictionary of Eye Terminology. Gainesville, Florida: Triad Publishing Company, 1990. 3. ^1 2 Rappon JM. "Ocular Trauma Management for the Primary Care Provider." Pacific University College of Optometry. Accessed October 12, 2006. {{webarchive|url=https://web.archive.org/web/20060901104617/http://opt.pacificu.edu/ce/catalog/10310-SD/Triage.html |date=September 1, 2006 }} 4. ^1 "Cornea & External Diseases: Trauma: Traumatic Iridodialysis." Digital Reference of Ophthalmology. Accessed October 11, 2006. 5. ^{{cite journal | last1 = Brown | first1 = SM | title = A technique for repair of iridodialysis in children | journal = Journal of AAPOS | volume = 2 | issue = 6 | pages = 380–2 | year = 1998 | pmid = 10532731 | doi = 10.1016/S1091-8531(98)90041-6 }} 6. ^Sullivan BR. "Glaucoma, Angle Recession". eMedicine.com. August 16, 2006. Accessed October 11, 2006. 7. ^{{cite journal | last1 = Kiel | first1 = J | last2 = Chen | first2 = S | title = Contusion injuries and their ocular effects | url = http://www.optometrists.asn.au/gui/files/ceo841019.pdf | journal = Clinical & Experimental Optometry | volume = 84 | issue = 1 | pages = 19–25 | year = 2001 | pmid = 12366340 | doi=10.1111/j.1444-0938.2001.tb04931.x}} 8. ^{{cite journal | doi = 10.1034/j.1600-0420.2002.800104.x | last1 = Behndig | first1 = A. | year = 2002 | title = Results with a modified method for scleral suturing of intraocular lenses | url = http://www.blackwell-synergy.com/links/doi/10.1034/j.1600-0420.2002.800104.x/full/ | journal = Acta Ophthalmologica Scandinavica | volume = 80 | issue = 1| pages = 16–18 | pmid = 11906298 }} 9. ^1 2 3 "Glaucoma: Angle Closure: Traumatic Iridodialysis." Digital Reference of Ophthalmology. Accessed October 11, 2006. 10. ^"Manual Small Incision Cataract Surgery: Intraoperative Complications." ORBIS International Inc. Accessed October 11, 2006. 11. ^{{cite journal | last1 = Gashau | first1 = AG | last2 = Anand | first2 = A | last3 = Chawdhary | first3 = S | title = Hydrophilic acrylic intraocular lens exchange: Five-year experience | journal = Journal of Cataract and Refractive Surgery | volume = 32 | issue = 8 | pages = 1340–4 | year = 2006 | pmid = 16863972 | doi = 10.1016/j.jcrs.2006.02.062 }} 12. ^{{cite journal | last1 = Walker | first1 = NJ | last2 = Foster | first2 = A | last3 = Apel | first3 = AJ | title = Traumatic expulsive iridodialysis after small-incision sutureless cataract surgery | journal = Journal of Cataract and Refractive Surgery | volume = 30 | issue = 10 | pages = 2223–4 | year = 2004 | pmid = 15474840 | doi = 10.1016/j.jcrs.2004.03.040 }} 13. ^{{cite journal | last1 = Beetham | first1 = WP. | year = 1941 | title = Cataract Extraction with Iridodialysis | journal = Trans. Am. Ophthalmol. Soc. | volume = 39 | issue = | pages = 104–15 | pmid = 16693243 | pmc = 1315004 }} 14. ^{{cite journal | last1 = Hazar | first1 = M | last2 = Beyleroglu | first2 = M | last3 = Subasi | first3 = M | last4 = Or | first4 = M | title = Ophthalmological findings in elite amateur Turkish boxers | url = http://bjsm.bmjjournals.com/cgi/content/full/36/6/428 | journal = British Journal of Sports Medicine | volume = 36 | issue = 6 | pages = 428–30 | year = 2002 | pmid = 12453836 | pmc = 1724577 | doi=10.1136/bjsm.36.6.428}} 15. ^{{cite journal | last1 = Kenney | first1 = KS | last2 = Fanciullo | first2 = LM | title = Automobile air bags: friend or foe? A case of air bag-associated ocular trauma and a related literature review | journal = Optometry | volume = 76 | issue = 7 | pages = 382–6 | year = 2005 | pmid = 16038865 | doi = 10.1016/j.optm.2005.06.001 }} 16. ^{{cite journal | last1 = Gracner | first1 = B | last2 = Pahor | first2 = D | title = Bilateral eye injury caused by a high-pressure water jet from a fire hose | journal = Wiener Klinische Wochenschrift | volume = 113 Suppl 3 | pages = 62–4 | year = 2001 | pmid = 15503624 }} 17. ^{{cite journal | last1 = Viestenz | first1 = A | last2 = Küchle | first2 = M | title = Ocular contusion caused by elastic cords: a retrospective analysis using the Erlangen Ocular Contusion Registry | journal = Clinical & Experimental Ophthalmology | volume = 30 | issue = 4 | pages = 266–9 | year = 2002 | pmid = 12121366 | doi = 10.1046/j.1442-9071.2002.00529.x }} 18. ^{{cite journal | last1 = Chorich Lj | first1 = 3rd | last2 = Davidorf | first2 = FH | last3 = Chambers | first3 = RB | last4 = Weber | first4 = PA | title = Bungee cord-associated ocular injuries | journal = American Journal of Ophthalmology | volume = 125 | issue = 2 | pages = 270–2 | year = 1998 | pmid = 9467466 | doi = 10.1016/S0002-9394(99)80111-1 }} 19. ^{{cite journal | last1 = Viestenz | first1 = A | last2 = Küchle | first2 = M | title = Eye contusions caused by a bottle cap. A retrospective study based on the Erlangen Ocular Contusion Register (EOCR) | journal = Der Ophthalmologe | volume = 99 | issue = 2 | pages = 105–8 | year = 2002 | pmid = 11871070 }} 20. ^{{cite journal | last1 = Bullock | first1 = JD | last2 = Ballal | first2 = DR | last3 = Johnson | first3 = DA | last4 = Bullock | first4 = RJ | title = Ocular and orbital trauma from water balloon slingshots. A clinical, epidemiologic, and experimental study | journal = Ophthalmology | volume = 104 | issue = 5 | pages = 878–87 | year = 1997 | pmid = 9160038 | doi=10.1016/s0161-6420(97)30218-8}} 21. ^{{cite journal | last1 = Arya | first1 = SK | last2 = Malhotra | first2 = S | last3 = Dhir | first3 = SP | last4 = Sood | first4 = S | title = Ocular fireworks injuries. clinical features and visual outcome | url = http://www.ijo.in/article.asp?issn=0301-4738;year=2001;volume=49;issue=3;spage=189;epage=190;aulast=Arya | journal = Indian Journal of Ophthalmology | volume = 49 | issue = 3 | pages = 189–90 | date = 7/1/2001 | pmid = 15887729 }} 22. ^{{cite journal | last1 = Sacu | first1 = S | last2 = Ségur-Eltz | first2 = N | last3 = Stenng | first3 = K | last4 = Zehetmayer | first4 = M | title = Ocular firework injuries at New Year's eve | journal = Ophthalmologica | volume = 216 | issue = 1 | pages = 55–9 | year = 2002 | pmid = 11901290 | doi = 10.1159/000048298 }} 23. ^{{cite journal | last1 = Purdie | first1 = AT | last2 = Whyte | first2 = IF | title = Shinty and ocular trauma in north west Scotland | url = http://bjo.bmjjournals.com/cgi/content/full/82/12/1444a | journal = British Journal of Ophthalmology | volume = 82 | issue = 12 | pages = 1445 | year = 1998 | pmid = 9930282 | pmc = 1722457 | doi = 10.1136/bjo.82.12.1444a }} External links{{Medical resources| DiseasesDB = | ICD10 = {{ICD10|H|21|5|h|15}} | ICD9 = {{ICD9|364.76}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = | eMedicineTopic = | MeshID = }}{{Eye pathology}} 1 : Disorders of iris and ciliary body |
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