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Published on: December 1, 2023
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Anisocoria Following Uncomplicated Cataract Surgery
Jennifer Larson1, Madeline Arzbecker2
1Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, jciske@wisc.edu.
Summary
This report details a rare case of anisocoria (unequal pupil size) after cataract surgery. The patient developed a tonic pupil, highlighting a potentially underrecognized complication.
Area of Science:
- Ophthalmology
- Surgical Complications
Background:
- Cataract surgery is a common procedure with a low complication rate.
- Anisocoria, or unequal pupil size, can occur postoperatively.
- This case investigates a rare cause of anisocoria following uneventful cataract surgery.
Observation:
- A 69-year-old female presented with anisocoria in her left eye after uncomplicated cataract surgery.
- No intraoperative complications, such as iris prolapse or the use of pupil expansion devices, were noted.
- Pharmacological testing confirmed a tonic and mechanical left pupil.
Findings:
- This is the first reported case of a tonic pupil developing after cataract surgery.
- The anisocoria was attributed to a combination of parasympathetic dysfunction and mechanical trauma.
- The tonic pupil likely resulted from damage to the oculomotor nerve or iris sphincter.
Implications:
- Clinicians should consider tonic and mechanical pupils in the differential diagnosis of postoperative anisocoria.
- This finding expands the known spectrum of potential complications following cataract surgery.
- Early recognition and diagnosis of tonic pupils are crucial for appropriate patient management.
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