Abstract
We report a case of 47 year old male patient with Fuchs heterochromic iridocyclitis and cataract in left eye who developed hyphema after peri-bulbar block for cataract surgery. The patient developed Amsler like Sign. It appeared few minutes after Peri-bulbar block following digital massage before any instrumentation of the globe. Surgery was post-poned to rule out globe perforation or any other pathology for Anterior Chamber bleed. All possible causes were ruled out and patient was eventually taken up for Cataract Surgery which was uneventful without any intra-op or post-op complications.
Highlights
Fuch’s heterochromic uveitis (FHU) is a classic triad of iris heterochromia; cataract, usually posterior subcapsular; and uveitis, usually unilateral, anterior and chronic[1]
We report a case of FHU with very mild heterochromia who developed hyphema pre-operatively at the time of peribulbar block and was eventually well managed
Hyphema eventually subsided after 4 days and the patient was planned for surgery after two weeks under steroid cover; he was counselled for topical anaesthesia which he refused
Summary
Fuch’s heterochromic uveitis (FHU) is a classic triad of iris heterochromia; cataract, usually posterior subcapsular; and uveitis, usually unilateral, anterior and chronic[1]. We report a case of FHU with very mild heterochromia who developed hyphema pre-operatively at the time of peribulbar block and was eventually well managed. Hyphema eventually subsided after 4 days and the patient was planned for surgery after two weeks under steroid cover; he was counselled for topical anaesthesia which he refused. After giving peribulbar anaesthesia, the patient developed hyphema (figure-2); surgery was completed with high density cohesive ophthalmic viscoelastic device to manage the intraoperative bleeding and to maintain the anterior chamber. Hyphema was present post-operatively; IOP was within normal limits; topical and systemic steroids were given and hyphema eventually subsided after 2 days. The patient is on regular follow-up and after 6 months, the best corrected visual acuity is 6/9 OS and there are signs of chronic anterior uveitis as present pre-operatively
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