Case Reports

Traumatic aniridia after uveal manipulation: a case report

Case Report Details

First Author: G.Godinho PORTUGAL

Co Author(s):    C. Madeira   P. Neves-Cardoso   F. Falcão-Reis   J. Macedo           

Abstract Details

Purpose:

Aniridia is a congenital or acquired condition, which may be partial or complete. These patients usually present decreased visual acuity (VA), decreased visual quality, photophobia or aesthetic dissatisfaction. To address these difficulties, larger defects of the iris may require prosthesis implantation, which has several options available. The purpose of this paper is to report a case of a complete traumatic aniridia caused by an accidental manipulation of uveal material by a firefighter.

Setting:

This case report was followed in the Ophthalmology Department of Centro Hospitalar e Universitário São João, in Porto, Portugal.

Report of Case:

A female, with a history of phacoemulsification on the left eye (OS), presents to the emergency room with acute visual loss in the OS in the context of trauma due to a fall. During ambulance transportation, it was reported that a firefighter "removed dirt from the eye". At the examination, OS’ VA was counting fingers; intraocular pressure (IOP) was 8 mmHg; biomicroscopy showed a transparent cornea and no spontaneous seidel, hematic Tyndall 3+, complete aniridia and an intact capsular bag with a centered intraocular lens. Firefighter's ocular manipulation or sudden IOP increase due to trauma were the probable causes of iris removal through the 3.2 main port. The resolution of the hyphema was achieved after rest and application of topical corticosteroids. Afterward, the VA was 0.4, but photosensitivity complaints were still present. An aniridia Reper model C0 lens was placed: VA of 0.8 and resolution of photosensitivity was achieved.

Conclusion/Take Home Message:

This case demonstrates a situation of trauma that prompted the reopening of a previous surgery main port, allowing the extrusion of the iris with no other damage on the ocular structures. The treatment involves the reduction of the inflammatory stimulus and, later, the implant of the iris prosthesis, resulting in good functional and esthetical outcomes.

Financial Disclosure:

None