Dr.LAKSHMI PRABHA

Dr.Shruthi Tara

Abstract

Routine DCT for NLDO is almost obsolete . However, it is indicated in a few select conditions like tumours of the lacrimal sac,elderly with comorbidities, cicatricial pemphigoid, SLE, severe atrophic rhinitis etc. DCT, inspite of being a simple procedure as conventionally described, can lead to disastrous complications like visual loss if proper precautions particularly, meticulous sac dissection is not carried out. An elderly hypertensive lady underwent an uneventful DCT. During skin closure, an abnormal globe protrusion with lid tightness was noted, digitally the eye was hard and IOP raised. A clinical presumption of retrobulbar haemorrhage was made.She was conservatively managed and was monitored on an hourly basis to rule out any optic nerve dysfunction. She retained her preoperative visual acuity on discharge. Insight into the etiology of visual loss following DCT, early diagnosis of the disastrous complication, its prevention and management is discussed in detail.