Which of the following is NOT a major cause of hypotony?

• A. Hx of trabeculectomy
• B. Hx of LASIK
• C. Blunt trauma
• D. Intraocular inflammation

Answer: (B)

Hypotony occurs when intraocular pressure drops due to either too much outflow of aqueous humor or insufficient production. A filtering procedure like trabeculectomy creates a new drainage pathway for aqueous; if it overfilters or initially underperforms, pressure can fall below normal, making it a classic cause of hypotony. Blunt eye trauma can damage the ciliary body or create leaks, reducing production or increasing outflow, which also leads to low pressure. Intraocular inflammation (uveitis) can suppress aqueous production and alter outflow dynamics, contributing to hypotony. LASIK, by contrast, is a surface corneal procedure that does not affect aqueous production or drainage pathways; changes in measured IOP after LASIK are usually due to corneal thinning affecting tonometry, not true hypotony.