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Two Cases of Mydriasis following Barrier Photocoagulation at the Peripheral Lattice Degeneration or Retinal Hole

Purpose: To report two cases of pupil dilatation that occurred after laser treatment at the peripheral lattice degeneration or retinal hole. Case summary: A 28-year-old male was treated with a Pascal laser for barrier photocoagulation at 10-12 and 6 o'clock retinal holes and a lattice degeneration. He complained of decreased visual activity at near distance. The right pupil size was 5 mm and the left pupil size was 3 mm. The right eye was more dilatated. The relative afferent pupillary defect test of the right eye was normal and the direct light reflex was slightly decreased in the same eye. A 35-year-old female patient was treated with a barrier grid photocoagulation with an argon laser for peripheral retinal degeneration, which occurred 1 month prior. The right eye dilatation was 4 mm pupil size. Both the pupillary light reflex and the relative afferent pupillary defect test showed normal results. Conclusions: Because mydriasis can occur as an uncommon complication following barrier photocoagulation at the peripheral retinal degeneration and hole, mydriasis before the peripheral retinal treatmen should be fully explained to the patient. In addition, every effort should be made to minimize damage to the distribution of the short ciliary nerve, especially superior and inferior to the peripheral retinal lesion. J Korean Ophthalmol Soc 2020;61(7):823-827