By Stephen B. Wiles, MD, in private practice in Kansas City, Mo.
|Photo Credit: Rachel Tischinski, OD, Deligeorges & Wiles |
A 52-year-old man presented to the ER with forehead lacerations and contusions to the left eye sustained in a car accident.
The patient believed he hit his head on the steering wheel. A few months earlier he had undergone bilateral cataract extraction with implantation of Crystalens IOLs. The patient’s uncorrected visual acuity in the left eye had decreased to hand motions at two feet, and we observed a dense hyphema in the anterior chamber and corneal edema. The right eye appeared unharmed.
After two days, the patient’s acuity in the left eye improved to 20/60 and 20/30 pinhole, and the hyphema had cleared somewhat. No iris was visible in the left eye, but the IOL appeared stable and centered.
The doctors on the case hypothesize that the left iris was expulsed through the corneal incision on impact in the car collision. Pigment was noted at the original incision site, which supports this hypothesis. At one month the patient’s visual acuity returned to 20/20 and J5. The patient was referred for an iris contact lens. Similar reports of traumatic aniridia have been reported in the literature.
Blink is edited by Richard E. Hackel, MA, CRA, FOPS.