A retinopathy may develop after using of an operating microscope during ophthalmologic surgery. This is caused when the light from the microscope is focused on the retina.


Clinical features:

(1) The patient complains of decreased visual acuity and paracentral scotoma on the first few days after ophthalmologic surgery.

(2) The ophthalmologic surgery used an operating microscope, and often is cataract surgery.

(3) A fundoscopic examination done after onset of the symptoms may show a round or oval or yellowish-white retinal lesion, which may show an overlying serous retinal detachment.

(4) Fluorescein angiography may show focal hyperfluorescence early due to leakage, with a window defect developing later.


Risk factors:

(1) duration of light exposure (usually several minutes fixed at one point)

(2) intensity of light source

(3) clarity of the light path to the retina

(4) inclusion of wavelengths < 450 nm

(5) type of light source: A fiberoptic light pipe tends to produce a diffuse lesion, while high-intensity coaxial illuminator may produce a lesion with well-defined borders.


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