⚠️ Choroidal Effusion After Glaucoma Surgery: What You Need to Know
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🟠 STORY AT A GLANCE
Choroidal effusion is a known complication after glaucoma surgery, especially in procedures that sharply reduce intraocular pressure (IOP).
It occurs when fluid collects between the choroid and sclera, leading to visual disturbances, discomfort, and potential retinal complications.
The most common trigger is low IOP (ocular hypotony), often due to excessive aqueous outflow after trabeculectomy or tube shunt surgery.
Mild effusions may resolve on their own, but more severe cases can cause pain, blurry vision, or even vision loss if untreated.
Early detection, pressure control, and in some cases surgical drainage are critical for successful recovery.
⚠️ Choroidal Effusion After Glaucoma Surgery: What You Need to Know
While glaucoma surgery is often essential to save vision, it’s not without risks. One of the complications patients may face—especially when pressure drops too low—is a choroidal effusion.
This condition occurs when fluid accumulates in the space between the choroid and sclera, pushing the choroid inward. Though treatable, it can be alarming to experience and, if severe, may compromise vision.
As your ophthalmologist, I want you to understand what it is, how we manage it, and why close monitoring after surgery is non-negotiable.
👁️ What Is a Choroidal Effusion?
The choroid is the vascular layer of the eye that lies between the retina and the sclera. It supplies oxygen and nutrients to the outer retina. After glaucoma surgery—especially procedures like trabeculectomy or glaucoma drainage device implantation—fluid may begin to accumulate between the choroid and sclera, forming a bulge known as a choroidal effusion (or serous choroidal detachment).
This condition is distinct from a choroidal hemorrhage, which involves bleeding. In an effusion, the fluid is clear and non-bloody.
🔍 What Causes It?
The most common trigger is hypotony, or very low intraocular pressure, often defined as less than 5 mmHg. After glaucoma surgery, this can occur if:
The drainage pathway works “too well” and allows too much fluid to leave the eye.
There is leakage at the surgical wound site.
Medications further suppress fluid production.
The eye has thinner scleral tissue (e.g., in high myopia or prior surgeries).
The low pressure disrupts the normal balance between intraocular and choroidal capillary pressure, allowing fluid to leak into the suprachoroidal space.
🧠 Symptoms Patients Might Experience
Depending on the size and location of the effusion, symptoms may include:
Blurred or distorted vision
A sensation of eye pressure or fullness
Dull aching discomfort
Visual field changes
Rarely, double vision (if the effusion shifts the eye position)