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Cornea

Wound Leak

Also known as: wound leak, seidel positive, post operative leak, post-op wound leak, hypotony after surgery

Filed as: Urgent

Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed

Overview

Aqueous escaping through a surgical or traumatic wound, presenting as a postoperative eye that is not settling, with irritation and unstable vision. A positive Seidel test is the finding, sometimes alongside a shallow anterior chamber or a low pressure. An unsealed wound is a route for infection, so it warrants prompt ophthalmology review rather than continued observation.

Recognition

Symptoms: what patients report

  • Post-operative discomfort or irritation that is not settling as expected.
  • Blurred or unstable vision during early recovery.
  • Symptoms may feel more unstable than routine postoperative redness alone.

Signs: what the examination shows

  • Positive Seidel test.
  • Hypotony if present.
  • Shallow anterior chamber if relevant.
  • Unstable wound healing or poor wound apposition.

What OptoGuide™ covers for wound leak

  • Pattern reasoning: what this combination of findings points to, and its differentiators
  • Don't-miss risks and escalation triggers
  • Management tiers with linked Australian therapeutics
  • Referral urgency, specialty, and letter drafting

Sources

Standard texts: Kanski's Clinical Ophthalmology: A Systematic Approach, The Wills Eye Manual, Oxford Handbook of Ophthalmology, Oxford American Handbook of Ophthalmology, Signs in Ophthalmology: Causes & Differential Diagnosis.

Full bibliography

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