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Abstract
Purpose
To report a case of isolated posterior pole-penetrating ocular injury treated by nonsurgical methods such as argon laser photocoagulation and administration of antibiotics.
Case summary
A 46-year-old male visited the hospital complaining of floaters in his left eye which had occurred when his cheek was penetrated by scissors from the inferior posterior part to the superior anterior part while working earlier that day. Upon initial examination, his best corrected visual acuity (BCVA) in the left eye was 0.8, and his intraocular pressure (IOP) was 10 mmHg. No cells or aqueous flares were observed in the anterior chamber. Fundus examination was performed, and three disc diameter-large breaks of the retina and choroid, scleral rupture and vitreous hemorrhage were observed at the posterior pole three disc diameters away from the fovea. It was difficult to make a surgical approach as the lesion was situated on the posterior pole, and there was the risk of prolapse of the eye contents. Therefore, we first performed argon laser photocoagulation around the lesion and administered topical as well as and systemic antibiotics. After admission the patient was observed carefully as the tractional retinal fold was located at the posterior pole. Additional argon laser photocoagulation was performed. After six months of treatment, BCVA in the left eye was 1.0, IOP was 16 mmHg, and no pathologic change was observed on fundus examination.
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Figure 1.
At the first visit. (A) Clinical photograph shows the scissors penetrating injury from the left lateral cheek to the middle of the lower eyelid. When he came to the clinic, primary repair had already been done at a local plastic clinic. (B) Fundus photograph of the left eye shows 3 disc diameter-large breaks of the retina and choroid, scleral rupture and vitreous hemorrhage were observed at the posterior pole 3 disc diameters away from the fovea. (C) Illustration shows mechanism of ocular isolated posterior pole injury by scissors.
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