Cataract Eye Surgery
A patient who recently underwent cataract extraction presented with low Intraocular Pressure. There was quite excessive tearing in the eye.
Upon Fluorescein staining, the Seidel test was negative but strangely the Fluorescein pooled a bit around the limbal margin. What could this presentation indicate since there appeared to be no leakage at the point of incision?
Thanks for your Question
Some patients especially old age or patients who had complicated cataract surgery or patients with excessive post surgery anterior chamber activity, can have hypotony post operation even.
With negative Seidel test, the most likely cause is ciliary body shutdown which can last from few days to few weeks and sometimes take longer than that.
You have to make sure also there is no retinal detachment because with complicated cataract surgery, the risk of retinal detachment increase.
You have to make sure that the Seidel Test is 100% negative by applying mild pressure on the globe. If seidel test still negative, the most likely diagnosis is ciliary shutdown and if the siedel test is positive, you might need to add either bandage contact lens or a stitch.
Pooling of Fluorescein in the limbal area around the wound is normal after cataract surgery and also may last for few days.