Video Presentation - VT22

Intraoperative Fundus Examination using the "Visco-Well" Technique reveals a Surprise in a Dense Brown Cataract.

A deaf-mute patient from a remote village presented with dense brown cataracts in both eyes, initially suggesting long-standing neglect as the cause of advanced lens changes. With no preoperative fundus view, surgery proceeded cautiously and was complicated by diffuse zonulopathy. After nucleus removal, intraoperative posterior segment visualisation using the “Visco-Well” technique unexpectedly revealed classic retinitis pigmentosa changes. This enabled immediate counselling of the family regarding visual prognosis and the need for screening first-degree relatives. Only after correlating the RP findings with the patient’s deaf-mutism did the possibility of a syndromic association become evident. The case highlights how enhanced intraoperative visualisation can provide key insights that support clearer, more meaningful communication with the patient and family in the immediate postoperative period.