A 66 year old indo-aryan male presented with complaint of blurring of vision in right eye (RE) over 7 months. He had undergone cataract surgery 6 years back following which he had good vision in both the eyes. Seven months back he noticed sudden diminution of vision in RE for which he didn’t seek any medical attention and received no treatment. He had no past history of ocular trauma, any other ocular surgery in both eyes or any relevant systemic illness. There was no history of high myopia, diabetes mellitus, hypertension and connective tissue disorder in the patient. He smoked occasionally but didn’t consume alcohol. He was carpenter by occupation. He had two brothers who didn’t suffer from any similar eye problem. At presentation, his vitals were stable. On systemic examination, he had normal vesicular breath sounds bilaterally, heart beat was normal with no added sound, abdomen was soft to palpation and neurological examination was normal. On local examination, his both eyes were pseudophakic, and vision of the RE was hand movement and that of the left eye (LE) was 6/6. His RE had a subtotal rhegmatogenous retinal detachment (RD) with PVR-B (The updated Retina Society Classification) [] for which vitrectomy was planned. Routine laboratory investigations like CBC, serology, liver and renal functions were performed and were within normal limits. With a diagnosis of subtotal RD, the eye was being operated using 23 gauge vitrectomy systems. After completing near total vitrectomy, perfluorocarbon liquid (PFCL) injection was started using a double bore cannula. During injection of PFCL liquid to flatten the retina, there was sudden change in visibility of the fundus due to increase in haze of the media. There was associated forward protrusion of the eyeball and contact with the binocular indirect ophthalmomicroscope (BIOM) lens. On removing the BIOM, a bullous RD was visible behind the intraocular lens (IOL) and the globe was hypotonus. It was a difficult situation and the surgeon was unable to comprehend what was going on. The cause of hypotony was being explored when the possibility of some mal-functioning of infusion system came into the mind of the surgeon. To overcome the hypotony, air was switched-on in the infusion cannula. This further deteriorated the situation. Air escaped in the anterior chamber, IOL complex dislocated posteriorly, and 180° inferior retinal dialysis was noticed. For some time, the surgeon could not comprehend as to what was going on. Then, ballooning of the conjunctiva was noticed and a provisional diagnosis of scleral rupture was made. Conjunctival peritomy was made superiorly and scleral defect was noticed at 10 o’clock, 10mm behind the limbus extending 9mm in clockwise direction behind the superior rectus muscle. Intraocular tissue incarceration and air leak was visible from the wound. Repairing the ruptured globe with retinal tissue incarceration in a vitrectomised eye during vitrectomy was a challenge. If we switched on air in infusion cannula, the turbulence caused at the site of rupture was far more than when balanced salt solution was switched on. Decreasing the infusion pressure would lead to globe collapse. In any situation, repositioning the incarcerated retina was not possible and retinectomy was performed followed by flattening of detached retina with PFCL. This was followed by repair of scleral defect using 9-0 nylon with lots of difficulty. The superior rectus muscle had to be disinserted and reinserted to facilitate scleral repair. Dislocated IOL was removed, vitrectomy was completed and 360° laser retinopexy was performed. RD surgery was then completed and silicone oil was used for tamponade. On first postoperative day visual acuity was hand movement and cornea was edematous. Retina could be poorly visualized and appeared to be attached under oil clinically. He was given topical prednisolone acetate (1%) drop 2 hourly for a week and then tapered gradually over weeks. He was also given topical moxifloxacin (0.5%) eye drop 6 hourly for 4 weeks and topical atropine (1%) eye drop three times a day for 4 weeks. During follow up visits, the retina remained attached under silicone oil and the best corrected visual acuity was 6/36 at last follow-up of 4 months.