Ocular hypotony


Ocular hypotony, or ocular hypotension, or shortly hypotony, is the medical condition in which intraocular pressure of the eye is very low.

Types

Ocular hypotony is divided into statistical and clinical types. If intraocular pressure is low it is called statistical hypotony, and if the reduced IOP causes a decrease in vision, it is called clinical.

Presentation

Complications

Decreased IOP may lead to phthisis bulbi. Hypotony maculopathy is another complication caused by very low IOP.

Causes

Hypotony may occur either due to decreased production of aqueous humor or due to increased outflow. Hypotony has many causes including post-surgical wound leak from the eye, chronic inflammation within the eye including iridocyclitis, hypoperfusion, tractional ciliary body detachment or retinal detachment. Eye inflammation, medications including anti glaucoma drugs, or proliferative vitreoretinopathy causes decreased production. Increased outflow or aqueous loss may occur following a glaucoma surgery, trauma, cyclodialysis cleft or retinal detachment.

Diagnosis

Normal IOP ranges between 10–20 mm Hg. The eye is considered hypotonous if the IOP is ≤5 mm Hg.

Treatment

Treatment of hypotony is depending on the cause of the condition. Chronic ocular hypotony may be treated with intraocular injection of sodium hyaluronate. If the cause of hypotony is an over filtering bleb, cycloplegia using atropine may be used.