Delayed Suprachoroidal Haemorrhage Article Example | Topics and Well Written Essays - 750 words

Delayed Suprachoroidal Haemorrhage - Article Example aphakia or anterior chamber intraocular lens. Few other predisposing factors have been identified. These are old age, diffuse arteriosclerosis, glaucoma itself, suprachoroidal haemorrhage in the fellow eye, and a very short axial length or high myopia. However, the most significant causal factors has been identified to be postoperative hypotony. This may result from sudden inordinate decompression of the eye on the face of glaucoma, particularly when the surgery is initiated when the intraocular pressure has yet not been stabilised (Howe, L.J. and Bloom, P., 1999(5)). Mechanism: The exact mechanism that triggers such complication is unknown. Since the bleeding occurs due to rupture of the choroidal blood vessels, an increase in the transmural pressures of the choroidal vascular arcade that can be precipitated by elevated blood pressure, low intraocular pressure, or combination of both may be the probable causal mechanism. Once blood accumulates in this space, mainly created by the accumulated blood itself, there is almost no way that it gets reabsorbed unless the underlying cause of hypotony is treated. There is associated breakdown of blood-aqueous barrier across the pigmented epithelium. Thus, this blood settles beneath the retina in the posterior segment of the eye. This reduces the visual acuity since this precipitates a retinal detachment (Berke, S.J., Bellows, A.R., and Shingleton, B.J., 1987(6)). Prognosis: Fortunately, delayed suprachoroidal hemorrhages following glaucoma surgery may go unnoticed in most of the cases as they are more subtle, anterior, and shallow. The most significant complication out of untreated suprachoroidal haemorrhage is loss of useful vision in about 40% of cases. On the other end of the... Caution should be exercised when operating on patients with known risk factors since with haemorrhage, there is decrease in the logarithm of the minimal angle of resolution visual acuity from 0.72 to 1.36 that was statistically significant compared with controls. 12. Syam, P.P., Hussain, B., and Anand, N., (2003). Delayed suprachoroidal hemorrhage after needle revision of trabeculectomy bleb in a patient with hairy cell leukemia. American Journal of Ophthalmology; 136(6): 1155-1157