A 42-year-old male patient came to the emergency room after suffering a contusion in his left eye.
The patient had previously undergone a phacoemulsification of the crystalline lens with implantation of an intraocular lens. Subsequently, a cystectomy for retinal detachment was performed.
Keeping a visual acuity after the intervention of 2/10.
The visual acuity of the right eye was 10/10 and perception of light in the left eye was 10.
Biomicroscopically, a moderate hyphema stood out in the left eye, an important dialysis of the iris with pupillary involvement, Descemet folds and an extreme hypotonia of the eyeball (confirmed by cer).
The fundus examination revealed a massive hemovitreous that prevented visualizing the retina.
After ruling out an anterior penetrating wound, a diagnosis of suspected posterior scleral rupture was made and confirmed by an orbital computed axial tomography (CAT).
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Due to the elevated risk of massive suprachoroidal hemorrhage, if operated, the patient was admitted.
Antibiotic and corticoid treatment was applied; an exhaustive follow-up of the affected eye and the adelphic was carried out, as there were possibilities of developing a sympathetic ophthalmia.
Two weeks later, there was an improvement in visual acuity that went from noticing and projecting bubble light, with an improvement in the structure of the eyeball. A new orbital TAC confirmed the sealant, compatible with recovery.
After a few months of follow-up there was progressive reabsorption of the haemovitre, finding a significant macular choroidal rupture and optic nerve, this did not mean improvement in visual acuity due to involvement.
In this case, we initially considered a massive ocular burst due to the initial image of the CT scan, but later, we thought if we really had what happened was a massive hyperpressure that compressed the rupture to the eyeball giving the image.
