EXOTROPIA SECONDARY TO VITREOUS HEMORRHAGE

Background: Diplopia after cataract surgery has been reported by sever al authors, but diplopia after recovery from vitreous hemorrhage (VH) has not been described. Methods: We examined eight patients with manif est exotropia and binocular diplopia after recovery from dense VH by v itreous surgery. VH was bilateral in three patients and unilateral in five, and lasted for an average of 7.7 years. Results: Vi sual acuity before vitrectomy ranged from 20/200 to light perception; that after v itrectomy ranged from 20/20 to 20/60. Exotropia was present in all pat ients after vitrectomy. Additionally, seven out of eight patients had vertical strabismus with an average deviation of 6 prism diopters (Del ta). Fusion was confirmed in four patients with an average amplitude o f 13 Delta. Four patients underwent horizontal strabismus surgery. Fus ion was present in two before strabismus surgery and in all four after surgery; however, unstable diplopia persisted in three of the four af ter surgery. Conclusion: Diplopia after vitrectomy for longstanding VH may occur due to fusion impairment comparable to that occasionally se en after surgery for traumatic cataract.