CLINICAL COMMUNICATION Post-traumatic cyclodialysis cleft with hypotonic maculopathy Clin Exp Optom 2011; 94: 5: 481–483 DOI:10.1111/j.1444-0938.2011.00599.x Mukesh Kumar BOpt Siddharth Kesarwani MS L V Prasad Eye Institute, Bhubaneswar, Orissa, India E-mail: mukesh.opt@gmail.com Submitted: 17 June 2010 Revised: 30 August 2010 Accepted for publication: 16 October 2010 There have been numerous reports of ocular manifestations of blunt trauma. We describe a case of hypotony due to cyclo- dialysis following blunt injury with a stone. CASE- REPORT A 41-year-old man presented with com- plaints of decreased vision following blunt trauma to his left eye with a stone. At pre- sentation to the clinic, visual acuity in the right eye was 6/6 and left eye was 6/24. The intraocular pressures were 14 mmHg and 6 mmHg in the right and left eye, respectively. Slitlamp examination of the right eye was within the normal limit. A detailed examination of the left eye revealed a faint corneal scar (Figure 1), vitreous in the anterior chamber and a pupillary sphincter tear causing the pupil to remain mid-dilated and fixed. The zonules supporting the lens in the left eye were torn and there was phacodonesis with a faint posterior subcapsular opacity. Ultrasonic biomicroscopy of the left eye showed a superior cyclodialysis cleft from the 9 o’clock to the 3 o’clock position (Figure 2A). The left eye showed extensive chori- oretinal folds involving the macula. There was elevation of the optic disc with blur- ring of margins and hyperaemia. These findings were consistent with hypotonic maculopathy (Figure 3A). The fundus in the right eye was normal. The left eye of the patient was treated with oral corticosteroids starting with 1.0 mg/kg and tapered over two months. We also prescribed topical atropine 1% three times a day for three months. At six months post-injury the visual acuity in the left eye was 6/9 and intraocular pressure was 8 mmHg. There was resolution of the chorioretinal folds and optic disc oedema (Figure 3B). An ultrasonic biomicroscopy showed partial closure of the cyclodialysis cleft with increased intraocular pressure and marked improvement in vision (Figure 2B). DISCUSSION Ocular hypotony causes a decrease in vision secondary to folding of the choroid, retinal pigment epithelium and retina due Figure 1. Slitlamp photograph of the left eye showing faint corneal scar and mydriasis due to sphincter tear CLINICAL AND EXPERIMENTAL OPTOMETRY © 2011 The Authors Clinical and Experimental Optometry 94.5 September 2011 Clinical and Experimental Optometry © 2011 Optometrists Association Australia 481