My question concerns a persistent dilation of the patient’s iris
12 weeks after ceasing use of atropine (after about seven weeks of use) (4 months subsequent to vitrectomy
surgery and 4 and a half months after laser retinal surgery):
My principal question is what are all the treatments available to correct a persistently dilated pupil
when the condition is treatable (I am aware that some conditions may be irreversible).
The patient has already tried pilocarpine for approximately a week. His pupil responds extremely well to the solution of 1% pilocarpine with an immediate and substantial constriction (to the size of a head of a pin) of the iris for approximately 24 hours. However, the iris returns to its original size thereafter. Additionally, he appears to have negative side effects such as waving lines and rectangular imaging in his field of vision from taking the drops and there is concerned about the possibility of the pilocarpine precipitating retinal detachment
. (The more natural and noninvasive the treatment the better.)
Most importantly, what are the treatments (especially nonsurgical) available to cause the iris to once again begin to function. I would like a list irrespective of the cause as the cause cannot be determined.
Your input and recommendation for treatments would be much appreciated.
Dr. Steve Sayre