Quiz: Why does the red reflex change during surgery?

This is a routine cataract surgery, but there is a limited red reflex during the surgery. This is sometimes due to vitreous opacities such as a vitreous hemorrhage, a dense vitritis, or even trans-zonular leakage of trypan blue dye. But in this case, all of a sudden, during the cataract surgery the red reflex returns.

If you look at the Purkinje light reflex in both of these pictures, they are the same The two larger lights are the coaxial illumination which gives the red reflex, while the smaller single light is the traditional paraxial illumination.

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