Post-traumatic posterior giant retinal tear and macular hole associated retinal detachment

Abstract

Background: Blunt trauma to the eye can present with varied manifestations involving both the anterior and posterior segments of the eye. Giant retinal tear (GRT) following trauma occurs most commonly at the equatorial region or anterior to the equator. GRT posterior to the equator is rare. Purpose: To demonstrate the successful management of a post-traumatic posterior GRT and full-thickness macular hole (MH) associated retinal detachment (RD). Synposis: A 21-year-old-male presented with sudden diminution of vision in the right eye (RE) following blunt-trauma with cricket ball. RE vision at presentation was hand movement close to face. Anterior segment of RE revealed pupillary sphincter tear, posterior synechiae and posterior subcapsular cataract (PSC). RE fundus revealed a posterior-GRT, full thickness MH, mild vitreous haemorrhage and rhegmatogenous RD. He was managed with pars plana vitrectomy, encircling scleral band, perfluorocarbon liquid-assisted flattening of GRT, internal limiting membrane peeling, and endotamponade. Post-operatively the retina was attached, MH was closed and the patient achieved an ambulatory vision of 1/60. Highlights: This video demonstrates the successful management of a posterior-GRT and MH associated RD. Removal of adherent hyaloid from the long anterior flap of posterior GRT, peeling of ILM from temporal narrow mobile strip of retina (which has a risk of radial extension of GRT edges) and manoeuvring in suboptimally dilated pupil are illustrated in this video. Video Link: https://youtu.be/p04-_t0Wuuc

A case of retinal detachment resulting from air bag deployment

“…Retinal detachment is an emergency where the retina is detached from its normal position. 17 Symptoms of retinal detachment include flashes of light in the eyes, blurred vision, the appearance of floaters, small spots that seem to pass through the field of view, gradual decrease in peripheral vision, and a curtain-like shadow in the field of view. Patients with suspected retinal detachment immediately should be consulted to the ophthalmologist.…”

Giant Retinal Tears: A Review With a Focus on Trauma

“…In a closed globe injury, GRTs have resulted from assault, cricket balls, infantile abusive head trauma, and mechanical falls. [28][29][30] In a series of 38 traumatic GRTs from Moorfields Eye Hospital, 63% were found in the setting of blunt trauma, and 37% after penetrating trauma. 31 Of the penetrating injuries, 29% were found to have an intraocular foreign body and 50% required anterior vitrectomy at the time of initial repair.…”

“…GRTs have been described as a sequela of both open and closed globe injury of a variety of mechanisms. In a closed globe injury, GRTs have resulted from assault, cricket balls, infantile abusive head trauma, and mechanical falls 28–30 . In a series of 38 traumatic GRTs from Moorfields Eye Hospital, 63% were found in the setting of blunt trauma, and 37% after penetrating trauma 31 .…”