Post-Op Cataract Complications
A 61-year-old black female presented complaining of reduced vision in both eyes. She had a positive history of diabetes with current control via insulin. She also reported hypertension and congestive heart failure. Accupril (quinapril) for hypertension, Lanoxin (digoxin) for heart failure, and dialysis were part of her treatment regimen.
How would you approach this case? Read on for further details about the visit. Then test your clinical skills by clicking here for the answer and clicking on Case 92, or calling our Digital Grand Rounds phone line.Best-corrected visual acuity was 20/50 in both eyes. Cataracts were found and surgery was performed on the right eye. No other ocular abnormalities were found prior to the surgery, including diabetic retinopathy.
Post-op findings on day one were normal. But at 12 days, the patient returned to the clinic with ocular complaints of reduced vision, pain, redness and photophobia in the right eye. Vision had dropped. Her corneas were edematous, and she reported nausea. Her biomicroscopic findings can be seen here. Her IOP was 70mm Hg at this visit.
What is your diagnosis? How would you manage this patient? Are there any additional tests that you would like to perform? For answers, follow the instructions in the box below.
Case contributed by Michael Gerstner, O.D., Southern College of Optometry, Memphis, Tenn.
Dr. Mayo, a private practitioner in Georgetown, S.C., is technology director for the Southern Council of Optometrists. You may contact him at waltmayo@aol.com or waltmayo@sccoast.net.
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