Traumatic vitreous hemorrhage and choroidal rupture after needleless Dermojet injection to the eyebrow

Abstract

Purpose: In this case report, we discuss a case of ocular insult following a needle-less Dermojet injection to the brow region. Observations: Initial examination revealed pin-point sites of injector contact over the right brow, a dense temporal subconjunctival hemorrhage, a temporal area of commotio retinae, and a vitreous hemorrhage localized to the inferotemporal quadrant of the retina obscuring the view to the retina behind it. The potential for a concealed penetrating globe injury or retinal break was of significant concern. Conservative management was opted with close follow-up. Over a 10-week period, the patient's symptoms and signs improved, and final assessment showed an extramacular choroidal scar indicative of choroidal rupture. Risks of the development of choroidal neovascularization were communicated and a plan for diligent follow up was given. Conclusions and importance: We recommend against using high-pressure, needle-less systems in the periorbital area due to vision-threatening risks, urging caution among healthcare professionals.

Keywords

• Dermojet
• Needleless drug delivery
• Choroidal rupture
• Choroidal neovascularization
• Blunt trauma