Toxic anterior segment syndrome is an acute, sterile

anterior segment The anterior segment or anterior cavity is the front third of the eye that includes the structures in front of the vitreous humour: the cornea, iris, ciliary body, and lens A lens is a transmissive optical device that focuses or dispers ...

inflammation Inflammation (from ) is part of the biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. The five cardinal signs are heat, pain, redness, swelling, and loss of function (Latin ''calor'', '' ...

following generally uneventful

cataract A cataract is a cloudy area in the lens (anatomy), lens of the eye that leads to a visual impairment, decrease in vision of the eye. Cataracts often develop slowly and can affect one or both eyes. Symptoms may include faded colours, blurry or ...

and anterior segment surgery. One of the main factors in differentiating toxic anterior segment syndrome from an infectious endophthalmitis is the rapid onset. Most patients with toxic anterior segment syndrome will develop symptoms within 12 to 24 hours of the surgery. Common findings on anterior segment

slit lamp In ophthalmology and optometry, a slit lamp is an instrument consisting of a high-intensity light source that can be focused to shine a thin sheet of light into the eye. It is used in conjunction with a biomicroscope. The lamp facilitates an ...

examination include increased cell and flare with associated

fibrin Fibrin (also called Factor Ia) is a fibrous protein, fibrous, non-globular protein involved in the Coagulation, clotting of blood. It is formed by the action of the protease thrombin on fibrinogen, which causes it to polymerization, polymerize. ...

and possible hypopyon formation. Patients may show signs of diffuse corneal edema, and they may also show signs of iris

atrophy Atrophy is the partial or complete wasting away of a part of the body. Causes of atrophy include mutations (which can destroy the gene to build up the organ), malnutrition, poor nourishment, poor circulatory system, circulation, loss of hormone, ...

with pupillary abnormalities and eventual increased intraocular pressure. It is important to differentiate sterile postoperative inflammation from infectious endophthalmitis because the treatments of these patients are markedly different. Patients with toxic anterior segment syndrome will often respond rapidly to treatment with topical

corticosteroid Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones. Two main classes of corticosteroids, glucocorticoids and mineralocorticoids, are invo ...

s, while infectious endophthalmitis must be treated with

antibiotics An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting pathogenic bacteria, bacterial infections, and antibiotic medications are widely used in the therapy ...

. It is important that the patients be evaluated often to ensure that the inflammation is clearing and that the patient's intraocular pressure is under control. The clearing of the inflammation and eventual patient outcome is related to the severity of the toxic insult at the time of surgery. Most patients reported to date are in the category of a moderate toxic inflammation. Toxic anterior segment syndrome may be related to problems with any irrigating solution or other solution placed in the patient's eye during surgery, including balanced salt solution or anything added to solutions. Material placed in the eye during surgery such as anesthetics, ophthalmic viscoelastic devices, antibiotics, or other medications has been associated with toxic anterior segment syndrome. Problems related to the cleaning and sterilization of instruments for cataract surgery have been found to be a cause.

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{{Medical resources , ICD10 = , ICD9 = , ICDO = , OMIM = , DiseasesDB = , MedlinePlus = , eMedicineSubj = article , eMedicineTopic = 1190343 , MeSH = , GeneReviewsNBK = , GeneReviewsName = , Orphanet = Eye diseases Syndromes