Cystoid macular edema with or without papilledema should be suspected in any post-operative cataract patient whose visual acuity either fails to improve to normal or suddenly decreases following cataract extraction.
The slit lamp appearance of the macular lesion is characteristic, but may be difficult to see in the postoperative eye.
The pattern of fluorescence following intravenous injection of fluorescein is diagnostic and provides the clinician with a valuable means of detecting the lesion, which may be difficult to see by other means.
Fluorescein studies suggest that the pathogenesis of the macular and optic nerve lesions involves leakage of serous exudate from the retinal and optic nerve head capillaries.
The cause of this leakage is unknown.
GASS JDM, NORTON EWD. Cystoid Macular Edema and Papilledema Following Cataract ExtractionA Fluorescein Fundoscopic and Angiographic Study. Arch Ophthalmol. 1966;76(5):646-661. doi:10.1001/archopht.1966.03850010648005