Perforation of the Sclera
During reattachment of an EOM, a needle may penetrate the sclera and pass into the suprachoroidal space or perforate the choroid and retina. Perforation can lead to retinal detachment or endophthalmitis (see BCSC Section 9, Uveitis and Ocular Inflammation); in most cases, it results in only a small chorioretinal scar, with no effect on vision. Most perforations are unrecognized unless specifically looked for by ophthalmoscopy. If vitreous escapes through the perforation site, many surgeons apply immediate local cryotherapy or laser therapy. Topical antibiotics are generally given during the immediate postoperative period, even when vitreous has not escaped. Ophthalmoscopy during the postoperative period is an appropriate precaution, with referral to a retina consultant if needed.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.