Neuro-Ophthalmic
Traumatic Mydriasis
Also known as: traumatic mydriasis, post traumatic dilated pupil, iris sphincter injury, post surgery mydriasis, irregular dilated pupil trauma
Filed as: Urgent
Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed
Clinical decision support only
Overview
A dilated or irregular pupil after blunt injury or intraocular surgery, caused by tearing of the iris sphincter. The pupil margin looks irregular at the slit lamp, transillumination defects may be visible, and glare and light sensitivity are the usual complaints. The pupil is the visible part of a wider injury, so the whole eye is assessed, and any suggestion of a penetrating injury takes precedence over the pupil itself.
Recognition
Symptoms: what patients report
- History of blunt ocular trauma or recent ocular surgery.
- Glare or photophobia may be present.
- Asymmetric pupil noticed after injury.
Signs: what the examination shows
- Dilated or irregular pupil after trauma.
- Iris sphincter tears or damage.
- Torn or irregular iris margin, or transillumination defects, may be visible at slit lamp.
- Associated anterior segment trauma may coexist.
What OptoGuide™ covers for traumatic mydriasis
- Pattern reasoning: what this combination of findings points to, and its differentiators
- Don't-miss risks and escalation triggers
- Management tiers with linked Australian therapeutics
- Referral urgency, specialty, and letter drafting
Sources
- Abnormalities of the pupil — College of Optometrists Clinical Management Guideline
- The Neuro-Ophthalmology Survival Guide (Pane, Miller & Burdon) — standard reference text
Standard texts: Kanski's Clinical Ophthalmology: A Systematic Approach, Oxford Handbook of Ophthalmology, Oxford American Handbook of Ophthalmology, Signs in Ophthalmology: Causes & Differential Diagnosis.