Double dialysis of the iris.

A 45-year-old male presented to the ophthalmologist with decreased vision in his right eye for 6 months. There was history of blunt trauma to the eye 6 months back. The visual acuity in the right eye was hand-motions close to face and the intraocular pressure was 16 mmHg. On slit-lamp biomicroscopy, there was disinsertion of the iris from its root [Fig. 1] along with separation of the posterior pigmented epithelium (arrow) from the anterior pigmented epithelium and stroma (double-arrow), giving the appearance of double dialysis of the iris. The separation of the iris layers also led to the formation of pseudo-polycoria. Gonioscopy revealed the presence of angle recession. Ultrasonography of the posterior segment was normal. Blunt trauma can lead to varied manifestations in the eye, and it is important to identify the anatomy clearly before planning surgery.[1] This patient underwent cataract surgery with iridodialysis repair[23] and regained 6/9 vision postoperatively.

Figure 1

Anterior segment photograph of the right eye demonstrating iridodialysis with separation of the posterior (arrow) and anterior (double-arrow) epithelium of the iris, pseudo-polycoria, and traumatic cataract

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