Viscomydriasis in atonic pupil - is it falsely assuring? Dr Sourabh Patwardhan

• 29 May 2020
• Dr. Sourabh Patwardhan
• 460
• 0

small pupil case where viscomydriasis is tried is discussed. if on decreasing illumination, the pupil dilates, it means that the pupil will dilate with adrenaline. howewer if it does not, its a non dilating pupil. after putting adrnelanine, itdilated only to 3mm. i tried putting viscoat, which dilated pupil dilated to around 5mm- viscomydriasis. there can be two types of pupil- rigid atonic pupil or floppy iris pupil. further mangement depends on the type of pupil. in small pupil, be careful not to inject too much of fluid. as i injected more fluid, the iris prolapsed. now, decompress the chamber to allow the iris to be pushed back. do not push visco. later put some visco over the iris. at this stage, i used B hEX RING. be careful of the CCC margin. While putting the IOL, be careful while putting trailing haptic. next i disinsert B Hex ring.
take home message- if i am getting viscomydriasis , it is a false assuring sgn and i should use a pupil dilating device at beginning.


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Published By Dr. Sourabh Patwardhan

FRCS (UK), MS (AIIMS), DNB, MNAMS, FICO

Director, Nandadeep eye hospital, Sangli,India.
He heads a very popular Phaco training and fellowship program.