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Year : 2022  |  Volume : 60  |  Issue : 1  |  Page : 66-67

Subtenon's space cilia following subtenon's block

Department of Cataract and IOL, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India

Date of Submission21-Jun-2021
Date of Decision09-Jan-2022
Date of Acceptance10-Jan-2022
Date of Web Publication22-Mar-2022

Correspondence Address:
Dr. Arut Priya
Department of Cataract and IOL, Aravind Eye Hospital, Coimbatore, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tjosr.tjosr_90_21

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The present case concerns what is best to our knowledge the rare case report of postoperative cilia in subtenon's space following subtenon injection of anesthesia, although many cases have been reported on intraocular cilia in the cornea, anterior and posterior chamber, lens, vitreous, and retina following penetrating injury.

Keywords: Penetrating injury, subtenon's block, subtenon's space cilia

How to cite this article:
Priya A, Saraswathy B, Narendran K. Subtenon's space cilia following subtenon's block. TNOA J Ophthalmic Sci Res 2022;60:66-7

How to cite this URL:
Priya A, Saraswathy B, Narendran K. Subtenon's space cilia following subtenon's block. TNOA J Ophthalmic Sci Res [serial online] 2022 [cited 2022 Jun 29];60:66-7. Available from: https://www.tnoajosr.com/text.asp?2022/60/1/66/340376

  Introduction Top

Cilia can enter eye either as a result of penetrating surgery or following penetrating trauma.[1],[2],[3],[4],[5] The presence of intraocular cilia following penetrating injury or surgical injury is rare. It was first reported by Lerche.[1] Cilia can be entrapped in the cornea, anterior chamber, posterior chamber, lens, vitreous, and retina.

  Case Report Top

A 55-year-old male patient visited our hospital with complaints of decreased vision in both eyes (BE) for 6 months of duration with no systemic illness. On examination, BE showed uncorrected visual acuity 6/60 and best-corrected visual acuity 6/12. BE showed nuclear sclerosis grade 2 and posterior subcapsular cataract. He underwent right eye small incision cataract surgery. On the 1st postoperative day, vision improved to 6/9 and advised tapering dose of steroids. Subsequent postoperative visit at 2 weeks, we noted few cilia in the subtenon's space at inferonasal quadrant without any ocular inflammation [Figure 1] and [Figure 2]. He did not have any previous history of ocular trauma. We reviewed the patient after discontinuation of postoperative medication in 1 month and the 3rd month; he did have any irritation and had no signs of ocular inflammation. As the patient was not willing for the second procedure for the removal, and as he did not have any inflammation due to cilia in subtenon's space, he was advised for regular follow-up and to report in case if any signs of inflammation developed.
Figure 1: Arrow showing cilia in the inferonasal quadrant

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Figure 2: After lower lid eversion arrow showing cilia in subtenon's space

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  Discussion Top

The response of the eye to the intraocular cilia is unpredictable and variable. In the early postsurgical or post injury period, infection and inflammation can cause severe corneal edema, graft rejection, nongranulomatous iritis, cyst, abscess formation, retinal detachment, and endophthalmitis.[1],[4],[6],[7],[8] Many cases remain asymptomatic without any inflammation, and only very rare cases end with blinding complications.[6] A literature review revealed that cilia entrapped in the anterior chamber remain innocuous and sometimes cause inflammation.[2],[9] A case report on posttraumatic cilia remaining inert in the anterior chamber for 50 years without any inflammation has been reported.[10]

In our case, cilia were entrapped in subtenon's space, and the cause of cilia entrapment in subtenon' space may be due to following subtenon anesthesia as the site was inferonasal. Moreover, cilia may or may not cause inflammation, but in our case, there are no signs of inflammation, so left without any intervention.

  Conclusion Top

Although many cases reported on intraocular cilia following trauma, to our knowledge, this case is a rare report of subtenon's space cilia following subtenon block. In spite of the organic nature, intraocular cilia can be tolerated for many years without any serious ocular inflammation. However, precautions have to be taken during preoperative and intraoperative periods to avoid entrapment of any intraocular foreign body to avoid further complications.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that his name and initials will not be published and due efforts will be made to conceal his identity.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Gopal L, Banker AS, Sharma T, Parikh S, Bhende PS, Chopra S. Intraocular cilia associated with perforating injury. Indian J Ophthalmol 2000;48:33-6.  Back to cited text no. 1
[PUBMED]  [Full text]  
Olorenshaw GM, Brooks AM, Grant G, Gillies WE. Tolerance of the eye for implanted cilia. Br J Ophthalmol 1991;75:622-3.  Back to cited text no. 2
Seawright AA, Bourke RD, Gray PJ, Cooling RJ. Intravitreal cilia in phakic penetrating eye injury. Aust N Z J Ophthalmol 1997;25:133-5.  Back to cited text no. 3
Humayun M, de la Cruz Z, Maguire A, Dangel ME, Stark WJ, Green WR. Intraocular cilia. Report of six cases of 6 weeks' to 32 years' duration. Arch Ophthalmol 1993;111:1396-401.  Back to cited text no. 4
Kargi SH, Oz O, Erdinc E, Teke MY, Firat E. Tolerated cilium in the anterior. Ocul Immunol Inflamm 2003;11:73-8.  Back to cited text no. 5
Gottlieb F, Finestone J, Ackerman JL. Intravitreal cilia and retinal detachment. Ann Ophthalmol 1982;14:541-4.  Back to cited text no. 6
Walker NJ, Hann JV, Talbot AW. Postoperative cilium entrapment by clear corneal incision. J Cataract Refract Surg 2007;33:733-4.  Back to cited text no. 7
Galloway GD, Ang GS, Shenoy R, Beigi B. Retained anterior chamber cilium causing endophthalmitis after phacoemulsification. J Cataract Refract Surg 2004;30:521-2.  Back to cited text no. 8
Gradle HS. A cilium in the anterior chamber for nineteen years. Am J Ophthalmol 1923;6:764.  Back to cited text no. 9
Yalniz-Akkaya Z. Post-traumatic cilia remaining inert in the anterior chamber for 50 years: A case report. J Med Case Rep 2011;5:527.  Back to cited text no. 10


  [Figure 1], [Figure 2]


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