A 68-year-old pseudophakic patient with a macula-off rhegmatogenous retinal detachment of 5 days duration undergoes successful 23-gauge PPV with SF6 gas tamponade. Post-operatively on day 3, she develops sudden pain and IOP of 42 mmHg. The most likely cause is:
- A Neovascular glaucoma from retinal ischaemia
- B Cyclitic membrane formation
- C Pupil block glaucoma due to gas bubble migration into the anterior chamber ✓
- D Aqueous misdirection (malignant glaucoma)
Correct answer: C. Pupil block glaucoma due to gas bubble migration into the anterior chamber
Explanation
After PPV with gas tamponade, particularly in pseudophakic or aphakic eyes, the gas bubble can migrate anteriorly through a disrupted posterior capsule-vitreous face, enter the anterior chamber, and cause pupil block by occluding aqueous drainage. This is more common in pseudophakic eyes with posterior capsulotomy. Treatment involves prone positioning to retropulse gas and YAG peripheral iridotomy if needed. Neovascular glaucoma and malignant glaucoma have different presentations and time courses.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.