Traumatic cyclodialysis A case report

Traumatic cyclodialysis has been reported by several authors during the last decade (Sedan, I966; Turut, Constantinides, and Asseman, I971). Romem and Singer (1973) described a case of traumatic aniridia without prolapse of iris through an external wound. Trobe and Keeney (1974) reported three cases of traumatic aniridia all of which were accompanied by perforating wounds involving the cornea. This is a report of a case of traumatic cyclo-dialysis with extrusion of most of the iris through a scleral perforation. Case report A 25-year-old White female agricultural worker was admitted to the ophthalmic department of the Barzilai Medical Centre, Ashkelon, after an injury to her left eye caused by a screwdriver (Figure). The injury had been accidentally self-inflicted two hours earlier as she had been trying to repair a tubing of metal in the cow-shed. The visual acuity in the right eye was 6/6, and examination of that eye including the fundus revealed nothing abnormal. The visual acuity in the left eye was hand movements with good perception of light. The upper lid was swollen with ecchymoses and abrasions of the skin. There was conjunctival injection. On the medial side about 4 mm from the limbus, a brown oval mass could be seen under the abraded conjunctiva. The cornea was clear and did not show any signs of per-foration. The anterior chamber was filled with blood and it was impossible to see any further details. The eye was hypotonic, tension by Schiotz tonometry was 5-5/I6. It was decided to proceed with exploration of the ocular injury under general anaesthesia. An operation was performed on the day of admission. On exposure of the sclera medially, a mass of soft brown tissue was seen within the scleral wound which extended along a course roughly parallel to the limbus from 7.0 o'clock 3 mm from the limbus to io.o o'clock 9 mm from the limbus. It was necessary to separate the medial rectus from its insertion to obtain adequate exposure of the scleral wound. The brown mass was identified as prolapsed iris and it was excised level with the sclera. After the excision the intact ciliary body was seen in th