Total Traumatic Expulsive Iridodialysis with an Orbital-Floor Fracture

The objective of this report was to describe a case of total traumatic iridodialysis in the context of blunt trauma with an orbital-floor fracture. A 76-year-old female presented post-fall with right-eye blunt trauma. She underwent canthotomy and cantholysis due to concern of orbital compartment syndrome in a regional hospital with emergency physicians clearing dark tissue near the lateral canthus at the time of canthotomy cantholysis. She had a traumatic expulsive iridodialysis with 360° loss of iris through the previous phacoemulsification wound in the clear cornea. The patient also had an orbital-floor fracture, which together with internal decompression through the previous phacoemulsification wound possibly prevented further damage to intraocular structures. There was good visual recovery. Herein, we propose that the combination of the orbital-floor fracture in tandem with the reopening of the previous phaco wound served as a decompressing mechanism to prevent further intraocular injury above that of total iridodialysis.