Is there a problem if ur vision gets better n the pupil is larger than the other eye due to a hit on the eye?

Question

some of you may think its crazy but i was hit with a badminton birdy HARD from about 3 feet away. I was wearing contacts (to see far) but i took it out of that eye after i was hit. Now my vision in that eye is like im wearing my contact. I think my reading vision got affected but not so sure. My pupil is also larger in that eye. any advice would help.

Thanks

Answer 1

Direct trauma to an eye that leads to the pupil being larger on that side may be due to a tear of the iris constrictor muscle. These are very small tears that can be seen at the border of the pupillary margin. The muscle itself could be damaged, or the nerve, but usually the sphincter is torn and that pupil won't go down as small as the other. The pupil should REACT NORMALLY, just maybe a little less reaction. Once swelling goes down, it can repair itself somewhat.

You may also have damage further back. Or may have damaged the drain and develop a glaucoma in this eye way down the line. The most common cause of unilateral glaucoma is old trauma (and over 50% of the people with ocular signs that are caused ONLY by trauma actually remember the trauma!)

If light 'hurts', then you have an iritis, or inflammation of the iris. This is usually treated with a mild topical steroid to keep the inflammation limited, and possibly a short acting cycloplegic such as scopolamine. Don't use cyclogel if anyone suggests it...it burns like the ^%#&%*, and there are other dilators or pupil movers that are nicer, such as scopolamine. Atropine lasts too long (2 weeks) and could lead to the iris getting stuck in a dilated position, so that's also not a 'good' cycloplegic to use in acute traumatic iritis.

The trauma can also cause distortion of the globe to the point where the retina can be torn. You'll need a dilated exam by a retina specialist to really rule this out. Most ophthalmologists just don't see the peripheral retina as well as the retina guys do, and miss little tears all the time. A general ophthalmologist might see the tears. There are a few optometrists who are trained well enough and actually bother to look for these tears. Some are pretty good, but you'll not know who is until someone finds a tear someone else missed.