eMedicine Specialties > Ophthalmology > Vitreous

Vitreous Wick Syndrome: Differential Diagnoses & Workup

Author: Manolette R Roque, MD, MBA, DPBO, FPAO, President and CEO, Chief of Service, Ocular Immunology and Uveitis, Consulting Staff, Cornea and Refractive Surgery, Eye Republic Ophthalmology Clinic; General Manager, Ophthalmic Consultants Philippines Co; Consulting Staff, CME Liaison, Section Chief of Ocular Immunology and Uveitis, Department of Ophthalmology, Asian Hospital and Medical Center
Coauthor(s): Barbara L Roque, MD, Full Partner, Ophthalmic Consultants Philippines Co, Chief of Service, Pediatric Ophthalmology and Strabismus, Consulting Staff, Orbit and Eye Plastics, EYE REPUBLIC Ophthalmology Clinic; C Stephen Foster, MD, FACS, FACR, FAAO, Clinical Professor of Ophthalmology, Harvard Medical School; Consulting Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary; Founder and President, Ocular Immunology and Uveitis Foundation, Massachusetts Eye Research and Surgery Institution
Contributor Information and Disclosures

Updated: Dec 20, 2007

Differential Diagnoses

Endophthalmitis, Bacterial
Endophthalmitis, Postoperative
Foreign Body, Intraocular
Iris Prolapse

Workup

Laboratory Studies

  • Depending on presentation, obtain specimens (eg, swab, vitreous wick, aqueous) from the external and internal eye for the following studies:
    • Gram stain/Giemsa stain
    • Cultures and sensitivities
    • Calcofluor white (suspected fungal infection)

Other Tests

  • Seidel test
    • A strip of fluorescein is placed on the area that is suspected for leaks, then the dye color is observed in white light. If a leak is present, the dye will change from orange (concentrated) to green (diluted) and exhibit a waterfall-like effect at the leaking zone.
    • The egress of fluid is noted best under blue light.

Procedures

  • The vitreous wick may appear like a mucoid substance under slit lamp biomicroscopy. The wick may be teased with a cotton applicator or a cellulose sponge while taking note of synchronous movement of the iris or of the vitreous strand in the anterior chamber.
  • A peaked pupil also may indicate a vitreous strand in the anterior chamber.

More on Vitreous Wick Syndrome

Overview: Vitreous Wick Syndrome
Differential Diagnoses & Workup: Vitreous Wick Syndrome
Treatment & Medication: Vitreous Wick Syndrome
Follow-up: Vitreous Wick Syndrome
Multimedia: Vitreous Wick Syndrome
References

References

  1. Ruiz RS, Teeters VW. The vitreous wick syndrome. A late complication following cataract extraction. Am J Ophthalmol. Oct 1970;70(4):483-90. [Medline].

  2. Neetens A, Rubbens MC, Smets RM. Vitreous wick syndrome. Bull Soc Belge Ophtalmol. 1987;223 Pt 2:41-5. [Medline].

  3. Lindstrom RL, Doughman DJ. Bacterial endophthalmitis associated with vitreous wick. Ann Ophthalmol. Nov 1979;11(11):1775-8. [Medline].

  4. Srinivasan BD, Hofeldt A, Coleman DJ, DeVoe AG. Vitreous wick syndrome. Am J Ophthalmol. May 1979;87(5):662-4. [Medline].

  5. Rice TA, Michels RG. Current surgical management of the vitreous wick syndrome. Am J Ophthalmol. May 1978;85(5 Pt 1):656-61. [Medline].

  6. Chen SD, Mohammed Q, Bowling B, Patel CK. Vitreous wick syndrome--a potential cause of endophthalmitis after intravitreal injection of triamcinolone through the pars plana. Am J Ophthalmol. Jun 2004;137(6):1159-60; author reply 1160-1. [Medline].

  7. Sheets JH, Friedberg JG. Vitreous wick syndrome following discission of the posterior capsule. Arch Ophthalmol. Feb 1980;98(2):327. [Medline].

  8. Stainer GA, Binder PS. Vitreous wick syndrome following a corneal relaxing incision. Ophthalmic Surg. Aug 1981;12(8):567-70. [Medline].

  9. Venkatesh P, Verma L, Tewari H. Posterior vitreous wick syndrome: a potential cause of endophthalmitis following vitreo-retinal surgery. Med Hypotheses. Jun 2002;58(6):513-5. [Medline].

Further Reading

Keywords

vitreous wicks, vitrectomy, vitreous loss, vitreous prolapse, anterior segment surgery, vitreoretinal surgery, cataract surgery, endophthalmitis, intraocular inflammation, intraocular trauma, intraocular surgery, vision loss

Contributor Information and Disclosures

Author

Manolette R Roque, MD, MBA, DPBO, FPAO, President and CEO, Chief of Service, Ocular Immunology and Uveitis, Consulting Staff, Cornea and Refractive Surgery, Eye Republic Ophthalmology Clinic; General Manager, Ophthalmic Consultants Philippines Co; Consulting Staff, CME Liaison, Section Chief of Ocular Immunology and Uveitis, Department of Ophthalmology, Asian Hospital and Medical Center
Manolette R Roque, MD, MBA, DPBO, FPAO is a member of the following medical societies: American Academy of Ophthalmic Executives, American Society of Cataract and Refractive Surgery, American Society of Ophthalmic Administrators, American Uveitis Society, International Ocular Inflammation Society, Philippine Medical Association, Philippine Ocular Inflammation Society, and Philippine Society of Cataract and Refractive Surgery
Disclosure: Nothing to disclose.

Coauthor(s)

Barbara L Roque, MD, Full Partner, Ophthalmic Consultants Philippines Co, Chief of Service, Pediatric Ophthalmology and Strabismus, Consulting Staff, Orbit and Eye Plastics, EYE REPUBLIC Ophthalmology Clinic
Disclosure: Nothing to disclose.

C Stephen Foster, MD, FACS, FACR, FAAO, Clinical Professor of Ophthalmology, Harvard Medical School; Consulting Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary; Founder and President, Ocular Immunology and Uveitis Foundation, Massachusetts Eye Research and Surgery Institution
C Stephen Foster, MD, FACS, FACR, FAAO is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Association of Immunologists, American College of Rheumatology, American College of Surgeons, American Federation for Clinical Research, American Medical Association, American Society for Microbiology, American Uveitis Society, Association for Research in Vision and Ophthalmology, Massachusetts Medical Society, Royal Society of Medicine, and Sigma Xi
Disclosure: Nothing to disclose.

Medical Editor

Jerre Freeman, MD, Founder, Chairman, Memphis Eye and Cataract Associates; Clinical Professor, Department of Ophthalmology, University of Tennessee Health Science Center
Jerre Freeman, MD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Cataract and Refractive Surgery, and Tennessee Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

J James Rowsey, MD, Former Director of Corneal Services, St Luke's Cataract and Laser Institute, Florida
J James Rowsey, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for the Advancement of Science, American Medical Association, Association for Research in Vision and Ophthalmology, Florida Medical Association, Pan-American Association of Ophthalmology, Sigma Xi, and Southern Medical Association
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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