A 48-year-old man presented to the ophthalmology clinic with a 1-week history of pain, double vision, and blurred vision in his left eye. The symptoms started after he was struck in the eye by a retracting rubber bungee cord that he was using to secure goods onto a motorcycle. Physical examination revealed bruising of the left eyelid and a distorted pupil.
The corrected visual acuity with eyeglasses was 20/40 in the right eye and 20/200 in the left eye. Slit-lamp examination of the left eye revealed a deformed iris with the upper portion sagging downward, detached from the 9 o’clock position to the 3 o’clock position. No evidence of lens dislocation, traumatic cataract, or retinal injury was noted.
Separation of the iris from the ciliary body caused by blunt injury, known as traumatic iridodialysis, can lead to blurred vision, monocular double vision, or photophobia. The patient underwent iridoplasty and had restoration of pupil shape and improvement in visual acuity. One year later, the patient’s corrected visual acuity with eyeglasses was 20/50 in the left eye and the iris remained attached with mild deformity and without evidence of glaucoma.