An Unusual Presentation of Posterior Globe Rupture Detected During Pars Plana Vitrectomy

TL;DR

A 54-year-old man had a hidden eye injury discovered during surgery, showing the difficulty in detecting posterior globe ruptures.

Contribution

Highlights a rare case where posterior globe rupture was undetected pre-surgery and emphasizes the need for high clinical suspicion.

Findings

Posterior globe rupture was identified during vitrectomy despite normal initial eye examination.

No clinical signs were evident during slit lamp examination, making the diagnosis challenging.

Orbital imaging confirmed the presence of an intraorbital foreign body post-surgery.

Abstract

A 54-year-old gentleman presented with a history of poor vision in the right eye for three months and a prior forgotten trauma. The anterior segment was normal. He was diagnosed with subtotal bullous rhegmatogenous retinal detachment (RRD), but no apparent tear was observed. Vitrectomy commenced, and upon exploration, there was a posterior globe rupture with retinal and vitreous incarceration. The scleral wound was sutured with heavy liquid in situ. Orbital imaging post-surgery revealed the presence of an intraorbital foreign body. This is a peculiar presentation of posterior globe rupture, as it was unperceived by the patient, and the slit lamp examination conducted indicated no clinical evidence. Identifying posterior globe rupture remains a challenge that necessitates a high index of suspicion and appropriate management.

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