Ocular trauma: Occult scleral rupture with macular avulsion

Abstract

Open ocular trauma at the posterior segment can present with nonobvious scleral injuries, which represents a diagnostic challenge. The purpose of this article is to describe an atypical case of occult posterior scleral lesion. We present a clinical case of a 22-year-old man who consulted for a blunt trauma in his left eye. Physical examination revealed decreased visual acuity and vitreous hemorrhage without visualization of the posterior segment. Axial head computed tomography scan showed continuity solution of the posterior ocular wall, so the patient was taken to surgery with intraoperative atypical findings of loss of temporal retinal tissue with macular involvement, with good postoperative clinical course. In conclusion, high-energy trauma with both sharp and blunt mechanisms can generate posterior segment injuries such as occult posterior scleral rupture and even avulsion of retinal tissue in the macular area. Timely diagnosis and treatment of this type of injury is imperative for the patient's visual prognosis.

Keywords

• case report
• eye injuries
• penetrating eye injuries
• posterior scleral rupture
• retinal avulsion