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Tiny pupil days after cataract surgery

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      07-14-2003, 06:21 PM
Patient undergoing cataract surgery for right eye. Comes home with
pupil tiny. Six days later it is still tiny -- perhaps a bit larger,
then again, perhaps not. Vision is reasonable, considering.

Doctor did intentionally contract pupil to avoid problem that occurred
(with different doctor) when had cataract operation on left eye a
couple of years ago -- part of iris was "accidentally" removed leaving
"keyhole". Results of that operation were otherwise acceptable,
AFAIK. So, given the intentional contraction, is it normal and
reasonable for the effect to last this many days?



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      07-15-2003, 04:06 PM
On Tue, 15 Jul 2003 09:05:31 -0500, George Steber <(E-Mail Removed)>
>During the surgery there was trauma to the eye which caused the
>contraction. It usually clears up in 7 to 10 days. See your doctor for
>more info. George

Wasn't my doctor, but you do confirm that the advice to wait is SOP
and nothing to worry about (yet).


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      07-15-2003, 06:50 PM
On Tue, 15 Jul 2003 18:38:54 GMT, "Dr Judy" <(E-Mail Removed)>
>Did you see the doctor for a one day post op check up? When do you see him
>again? If concerned, call the doctor's office to see if the effect should
>last this long.

Was not me, there was a one-day post-op check, and I did encourage
patient to call office re this effect, but don't know if they have
done so, and in any case wanted some outside opinions on "what the
textbook" says about such cases.


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      07-21-2003, 03:16 PM
On Fri, 18 Jul 2003 05:28:58 GMT, "David Robins, MD"
<(E-Mail Removed)> wrote:
>Medication used during surgery to contract pupil is usualy Miochol (short
>acting) or another one that lasts a day. However, the doctor might be giving
>pilocarpine eyedrops to this patient for a reason, which will maintain a
>small pupil. Trauma during surgery usually causes a shocked, dilated pupil.
>However, an iritis will cause a small pupil, but would have an associated
>red, tender, painful photophobic eye.
>David Robins, MD
>Board certified Ophthalmologist
>Pediatric and strabismus subspecialty

Well, it's not photophobic or tender. In fact, I'm now informed that
patient has had a "pinhole iris" (non-technical description?) his
whole life, and if the doctor further contracted the pupil, then this
small and apparently fixed diameter is only back to what it was
previously, anyway. Frankly, I never noticed this before, and am now
totally confused by the whole thing.

Thanks for the facts, anyway.

Joshua Stern

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