Can chronic bulbar hypotony be responsible for uveal effusion? Report of two cases

We describe two patients with a unilateral uveal effusion syndrome characterized by spontaneous ciliochoroidal and retinal detachment, shallow anterior chamber, poorly reactive pupil, and bulbar hypotony. A space-occupying substance of high molecular weight (sodium hyaluronate), injected into the anterior chamber, raised the intraocular pressure of these patients to 24 mm Hg. Within 24 to 72 hours the uvea flattened, and later the retina settled completely. Satisfactory clinical stability has continued in the follow-up period. Because a rheologic study of the aqueous humor revealed hyposecretion and hypotony in the apparently unaffected fellow eye, it is suggested that a primary bulbar hypotony can trigger a uveal effusion syndrome in an otherwise normal-sized eye with no structural abnormality.