Indiana University
School of Optometry

Case 5: The Case of the Fixed Pupil

THE PARLOR . . .
The answer revealed: Choroidal effusion

Choroidal effusion is the result of fluid effusion into the suprachoroidal space. It separates the choroid and all anterior structures from the underlying sclera. Choroidal effusion occurs when there is a rapid change in the pressure gradient between the venous pressure and the intraocular pressure. Lobular, elevated areas filled with fluid are seen. Detachment and anterior rotation of the ciliary body results in a flattened anterior chamber.


Resolving Choroidal Effusion
choroidal effusion choroidal effusion

Choroidal Effusion in Another Patient Choroidal Effusion B-Scan
choroidal effusion choroidal effusion choroidal effusion
Retinoschisis
Retinal Detachment
Retinoschisis
Retinal Detachment Retinal Detachment

Surgical drainage is indicated only in cases involving "kissing choroidals" or lens-cornea adhesion. Consider pressure patching to elevate IOP. The condition will resolve on its own as IOP stabilizes--so, patient reassurance is key. Cycloplegics and steroids can be used to restore normal vascular permeability and, thus, speed up the process of resolving the condition.

Differential diagnoses include retinal detachment, retinoschisis, and tumors.



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URL: http://www.opt.indiana.edu/ce/mystery/parlor05.htm
Revised: July 21, 2008

IU Optometry home page: http://www.opt.indiana.edu/
Comments (content): Dr. Brad Sutton
Comments: Web Administrator
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