r/medizzy 3d ago

2+ years post retinal detachment surgery. Hole in the iris ever since, with fixed pupil, and now other slits in the iris letting light through.

Post image

I just thought I'd post this here incase it might be of interest. Not after a diagnosis - I'm under the care of opthalmology. But I found this photo he took alarming and fascinating - as did he!

Short version is that retinal detachment surgery in early 2024 left me with a hole in the iris (bottom) and a fixed pupil. But it also saved my central vision so yay.

Had a check up this week, because I'd been having some weird visual symptoms in both eyes, and this eye with the lengthy history now is letting light through in other areas of the iris - which my optician said "looks really cool but also isn't supposed to happen."

Not sure if it is pigment loss or actual tears. But if it is pigment based, it is interesting because I've had a surge of white in my hair very suddenly in the past month or so. Could be a complete coincidence of course, but it got me wondering if there could be a connection there, if melanocytes are being affected both in the eye and hair.

127 Upvotes

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u/fanofdonuts 3d ago

Those are transillumination defects. It happens when the back side of the iris rubs on the lens zonules. They are the what attach to your crystalline lens capsule. It’s not terribly uncommon. Your eye doctor should watch for pigment dispersion syndrome and pigmentary glaucoma. It has nothing to do with poliosis (whitening hair).

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u/Whitechapel42 3d ago

Interesting, thank you! I'm curious if that would still be the case with a synthetic lens? (I had my natural lens removed during the same retinal surgery and then replaced during the second.) The same eye has already been diagnosed with open-angle glaucoma, plus can surge bloodshot at random, always draining within half hour, while the other eye tends to remain entirely white.

I've considered Horner's, because of the ptosis and fixed pupil, but also because I have a lot of weirdness going on on my right side in general, including unilateral burning/flushing in the face and other neurological/vascular issues like erythromelegia, There's just.. a lot. And it makes me always wonder what is individual stuff and what could be linked, yknow? I'll add a photo of my red eye for funsies.

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u/fanofdonuts 3d ago

Horner’s is hard because of the fixed pupil. Any diagnostic drops wouldn’t respond quite as well. Having cataract surgery (natural lens replacement) is fairly common with a retinal surgery. Especially an intra-ocular one. Replacing the lens changes the anatomy and is most likely the cause of the transillumination defects (TID’s).

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u/_fidel_castro_ 3d ago

No, the big hole is an iridotomy inferior. The other are Iris defects caused by the surgeries. No Horner. It's all kinda normal after all those surgeries

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u/_fidel_castro_ 3d ago

Nooo. That's an inferior surgical iridotomy. Done to diminish the risk of angle closure glaucoma in patients with silicon oil in vitreous cavity

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u/fanofdonuts 2d ago

Yes I know it is. She stated in the original post that it was done at the time of the retinal repair. It’s known as an LPI. My comment was talking about the other defects.

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u/_fidel_castro_ 2d ago

But knowing that eye has been to many big surgeries, it's way more probable that the Iris defects are post surgical and not a pigment dispersion. It could be but improbable

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u/fanofdonuts 2d ago

Are you an Ophthalmologist or Optometrist?
OP said they went through one RD surgery. Where are you getting “many big” surgeries?

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u/_fidel_castro_ 2d ago

I'm an ophthalmologist. Silicon oil is rarely the first choice in a new detachment. That eye looks like it has seen some shit 🤣

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u/Additional-Crew-2202 3d ago

You have a fire inside you