Traumatic Iritis

Pt presents with painful, unilateral vision loss after trauma ___ days ago. Eye exam w ciliary flush and consensual photophobia; slit lamp with cells and flare ___ with hypopyon.

Midface stable, not concerning for Le Fort fracture, and no dental trauma. EOMI reassuring against entrapment. (-) foreign body. No abrasion or ulcer noted on SLE. Unlikely CRAO, CRVO, globe rupture, RD, temporal arteritis, acute angle closure glaucoma.

Plan cycloplegics (homatropine 1 drop TID OR cyclopentolate 1 drop TID) and emergent ophtho consult for immediate evaluation; query steroid use with optho (prednisolone acetate 0.5-1% QID).

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PEARLS:

• Cycloplegics paralyze the ciliary body resulting in a nonreactive and dilated pupil, preventing synechiae, progression of flare, ciliary spasm pain
  • Alexander KL, Dul MW, Lalle PA, Magnus DE. Onofrey B. Optometric Clinical Practice Guideline: Care of the Patient with Anterior Uveitis. St. Louis, MO: American Optometric Association; 1994:3-29.
• Likely follow up:
  • Follow up with optho in 24-48 hours
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