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Wound dehiscence is a severe post-surgical complication where a wound (incision) in the cornea or sclera partially or completely breaks open after it has been closed by sutures or natural healing. This results in the eye's internal structures being exposed.
read more about wound dehiscence in a cornea ...The primary causes include severe trauma to the eye after surgery, infection that impairs healing, or improperly placed sutures. The underlying mechanism is mechanical failure of the healing tissue. The strain from coughing, vomiting, or heavy lifting can overcome the weak, healing tissue, causing the wound edges to pull apart. This complication is more common in patients whose wounds are not fully stabilized.
Symptoms are associated with severe injury and pressure changes. Patients experience sudden, acute eye pain, redness, and a complete loss of vision. The wound separation causes the intraocular pressure to drop instantly, leading to severe hypotony. Internal eye structures, like the iris, may protrude from the wound (incarceration). This is an obvious and life-threatening ophthalmic emergency.
Wound dehiscence severely impacts vision by exposing the interior of the eye to infection and immediate pressure loss. The sudden hypotony (low pressure) can cause the retina to fold and detach. The open pathway allows external bacteria to enter the eye, causing endophthalmitis, often resulting in permanent vision loss.
Diagnosis is clinical and based on visual inspection of the open wound. The Seidel test (using fluorescent dye) confirms the continuous, rapid leakage of aqueous humor through the separated wound edges. Pressure measurement confirms severe hypotony.
The necessary treatment is immediate emergency surgical repair. The surgeon must close the separated wound edges immediately with multiple sutures to restore the structural integrity of the globe and prevent infection. Aggressive antibiotics are administered to prevent internal infection.
No, wound dehiscence is a rare but severe complication following intraocular surgery.
No, total wound dehiscence is an extreme emergency requiring immediate surgical intervention to save the eye.
The physical separation can be repaired, but the vision lost due to hypotony or infection may be permanent.
If you experience sudden pain and a "gush" of fluid from your eye after surgery, seek emergency help immediately. Ocular wound dehiscence (opening of the surgical cut) carries a high risk of "Expulsive Hemorrhage" and infection. Avoid any pressure on the eye and wear a protective shield until you see a surgeon.
AAO. Ocular Trauma and Dehiscence (aao.org). 2024.
Cleveland Clinic. Post-Surgical Emergencies (clevelandclinic.org). 2024.
StatPearls. Postoperative Endophthalmitis (ncbi.nlm.nih.gov). 2024.
Review of Optometry. Managing Corneal Wounds (reviewofoptometry.com). 2024.