Definitions
Iridodialysis: Disinsertion of the iris from the scleral spur. Elevated IOP can result from trabecular meshwork damage and/or formation of peripheral anterior synechiae.
Cyclodialysis: Disinsertion of the ciliary body from the scleral spur. Increased uveoscleral outflow occurs initially resulting in hypotony. IOP elevation can later result from closure of a cyclodialysis cleft, leading to glaucoma.
Symptoms
Usually asymptomatic unless glaucoma or hypotony/hypotony maculopathy develop. Large iridodialyses may be associated with monocular diplopia, glare, and photophobia. Both are associated with blunt trauma or penetrating globe injuries. Typically, unilateral.
Signs
(See Figure 3.7.1.)
Critical
Characteristic gonioscopic findings as described above.
Other
Decreased or elevated IOP, glaucomatous optic nerve changes (see 9.1, PRIMARY OPEN ANGLE GLAUCOMA), angle recession, and hypotony syndrome (see 13.11, HYPOTONY SYNDROME). Other signs of trauma include hyphema, cataract, and pupillary irregularities.
Differential Diagnosis
In setting of glaucoma, see 9.1, PRIMARY OPEN ANGLE GLAUCOMA.
Workup
Treatment
Follow Up