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A Journal on Ophthalmology
Minerva Oftalmologica 2002 September-December;44(3-4):107-26
Traumatology of the iris and ciliary body
Nuzzi R., Fornara E., Donati S.
Bulbar lesions of whatever etiology are one of the most important causes of vision loss. In particular, a damage to the uveal tissue is frequently observed. A sudden high intraocular pressure causes a backward movement of cornea and iris-lens diaphragm and a stress for the iris root and for the ciliary body. After cataract, it represents the first cause of vision loss, mainly in work and sport activities and is important in children. A light trauma causes hyperemia and little hemorrhages with simple irritative iritis, while a strong trauma causes damages to the optic nerve, massive hemor-rhages, fracture and movement of the tissues with necrosis and atrophia. Pupillar diameter and accommodation traumatic alterations (miosis, cycloplegia, iridoplegia) may require a careful examination to find the lesion and its evolution. Vascular alteration causes hyperemia and exudation, hemorrhages and hyphema when iris tissue and ciliary body are involved. Traumatic hyphema needs a correct intervention and effective therapy, to prevent complications (new hemorrhages, glaucoma, corneal pigmentation). Wounds and lacerations of uveal tissue are common and could involve the sphincter, pupillar edge, iris stroma causing iridodialysis and cyclodialysis. Treatment should be carried out with laser or surgical techniques to avoid permanent complications. Traumatic lesions can cause an important inflammatory process leading to endo-phthalmitis: correct management and therapy become important, and urgent treatment should be carried out in highly specialized centers.