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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
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Experience:  Eye Physician and Surgeon
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My son (27yrs old) had an eye injury May 26 and his pupil

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My son (27yrs old) had an eye injury May 26 and his pupil is stuck open and high pressure reading. He is still on drops to control the pressure. We were told the eye is still swollen. Last week he awoke with extreme pain in the eye and went to the emergency room. When he went to his eye doctor during the wee she told him the pain is because his pupil appears to be "coming back". What does that mean?
Submitted: 5 years ago.
Category: Eye
Expert:  Dr. James replied 5 years ago.
What was the pressure in the eye during the ER visit and with they eye doctor? What was the type of eye injury he had in May? Does he still have the pain? How is his vision?
Customer: replied 5 years ago.
A bungee cord hook hit him in the eye. His preesure was 24 at the on-set of the injury in May. He was on 4 different drops and one oral pill untill the pressure got under control. It took until 2 weeks ago for the pressure to fall in the normal range. His injured eye is now 19 and his uninjured eye is 17. The doctor claims his eye is still swollen from the trauma.

The eye injury is where his pupil is stuck open..Wide so light is a problem. Additionally, the doctor said his lens got jostled, and the gel-like substance in his eye is underneath it and that is why his vision is blury. She feels that once the swelling goes down she could correct his vision with lenses as long as the "lens in his eye" does not shift again.

He claims his eye hurts every morning when he wakes us and lessens after that.
Expert:  Dr. James replied 5 years ago.
Hi pain could be related to pressure fluctuations due to intermittent pupillary block.

The fluid in the eye is made by structures behind the iris (colored part of the eye). It has to travel though the pupil to the front of the eye and the drain through poors of the eye (located where the colored part and white parts meet). If the lens and the iris gets "stuck", it can impede the flow of this fluid and cause a pressure rise.

One way to ease this pressure fluctuation is to create a hole in the iris using a laser to create an alternate pathway for the pressure to flow (similar to a pressure-release valve).

I am unclear what "the pupil coming back" could refer to. I would recommend you talk to his ophthalmologist the pain possibly due to intermittent pupillary block.

Remember to press the green accept button. It was a pleasure helping you with your question. Feel free to ask any additional followup questions. Smile

Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2282
Experience: Eye Physician and Surgeon
Dr. James and other Eye Specialists are ready to help you
Customer: replied 5 years ago.
From what I am told the pupil fluctuates slightly.

Are ther such a thing as transitional contact lenses? To control the light.

Do you think accupuncture (not in the eye) could help?
Expert:  Dr. James replied 5 years ago.
If the pupil fluctuates slightly, then your doctor could be commenting that your iris muscle is starting to work again. Your doctor could be commenting that the pain could be coming from a ache the eye feels when the iris muscles are being used after being "stuck" for so long.

If the pain is coming from the recovering iris activity, your doctor may consider using a eyedrop to paralyze the iris muscle (dilator) to help ease the pain.

There are transitional lenses available for contact lenses, but you can get contact lenses that are opaque on the outside with a small opening to limit the light coming in. They do not change color in the sun, but stay that way all the time.

I don't have any experience with accupuncture so not able to give an opinion on that. It is possible that it can help with unexplained pain. I would first ask your doctor to look carefully for anything inside the injured eye causing the pain.
Customer: replied 5 years ago.
Thank you.

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