Small eyes big problems: is cataract surgery the best option for the nanophthalmic eyes?

Nanophthalmos refers to an eyeball of short axial length, usually less than 20 mm which leads to angle closure glaucoma due to relatively large lens. Intra-ocular lens extraction relieves the angle closure in nanophthalmos. Cataract surgery in a nanophthalmic eye is technically difficult with high risk of complications such as posterior capsular rupture, uveal effusion, choroidal haemorrhage, vitreous haemorrhage, malignant glaucoma, retinal detachment and aqueous misdirection.

A case of atypical idiopathic choroidal effusion syndrome.

Uveal effusion syndrome is characterized by annular ciliochoroidal detachment, shifting non-rhegmatogenous retinal detachment, unremarkable inflammation in the anterior eye segment and normal intraocular pressure. A 36-year-old Caucasian hypermetropic male presented in the eye casualty with a week history of curtain like effect in front of his left eye associated with worsening of vision and flashing lights. Left fundus examination revealed retinal detachment with smooth shaped elevation superonasaly and detached retina inferiorly confirmed on ultrasound B-scan with no tobacco dust in the anterior vitreous.