Toxic Anterior Segment Syndrome (TASS)

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Clinical Presentation

  • Severe intraocular inflammation within 6-24 hours after uncomplicated surgery
  • Sterile inflammation as a reaction to non-infectious contamination during surgery (instruments, medications, etc.)
  • Corneal edema, anterior chamber inflammation +/- fibrin, pain, increased intraocular pressure (IOP)

Differential diagnosis

Treatment

  • Rule out endophthalmitis; consider antibiotic treatment if in doubt
    • Examination in mydriasis, ultrasound in case of poor visibility
  • Topical steroids (e.g., Pred Forte (predinsolone) eye drops every 1 hour), +/- cycloplegics, consider topical NSAIDs, IOP-lowering drops

Sources

  • Kanski‚Äôs Clinical Ophthalmology: A Systematic Approach; John E Salmon MD; Elsevier; 9th Edition(2019)
  • Review of Ophthalmology: Neil J. Friedman; Peter K. Kaiser; William B. Trattler; Elsevier, 3rd Edition (2018)
  • The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease; Nika Bagheri MD, Brynn Wajda MD, et al; Lippincott Williams&Wilkins; 7th Edition (2016)