DR.MOHAMMED IRFAN SHEIKHabout 3 years ago

Retinal Hemorrhage from Blunt Ocular Trauma

A 24-year-old man presented to the emergency department with pain, swelling, and decreased vision in his right eye 6 hours after it had been directly struck by a tennis ball. Physical examination of the right eye showed a visual acuity of 20/400, with an intraocular pressure of 20 mm Hg (reference range, 10 to 21) and a sluggish pupillary response to light. The left eye appeared normal, with a visual acuity of 20/20 and an intraocular pressure of 18 mm Hg. Slit-lamp examination of the right eye showed edema of the eyelid, conjunctival congestion, and a normal anterior chamber, cornea, and lens. On examination of the fundus, however, the foveal reflex was absent owing to the presence of a retinal hemorrhage at the macula (arrowhead) that measured approximately 5 disk diameters. A D-shaped subhyaloid hemorrhage (arrow) was also seen below the fovea and above the inferior arcade. A pars plana vitrectomy with internal tamponade was performed. At the 8-week follow-up visit, the patient’s visual acuity in the right eye had improved to 20/30, and examination of the fundus showed resolution of the retinal hemorrhage and a normal foveal reflex.