Se Não Procuras, Não Encontras: Relato de um Caso de um Grande Buraco na Retina Após um Traumatismo Contundente

Abstract

Ocular trauma with blunt objects is the most common cause of closed traumatic eyeball injuries, often leading to retinal lesions such as tears or dialysis. Although traumatic retinal breaks account for a small portion of cases, they are more frequently associated do retinal detachment and have a greater potential for vision loss. The purpose of this report is to describe a case of an atypical large operculated retinal hole following trauma with an iron bar. A 58-year-old woman was admitted after a closed left eye periocular trauma with an iron bar. She complained of decreased visual acuity and floaters. Naked-eye inspection of the face was innocent, and slit-lamp anterior segment evaluation did not show any signs of ocular damage. Fundoscopy revealed a large operculated hole in the supero-temporal periphery of the retina, with an extensive area of retinal tissue suspended in the vitreous and mild vitreous hemorrhage. She immediately underwent extensive LASER retinopexy of the lesion, which was then reinforced after 3 days. The vitreous hemorrhage completely subsided, and she achieved 20/20 visual acuity 2 weeks after the episode. No other complications developed in the remaining follow-up. A blunt trauma to the face may show no signs of damage to naked-eye inspection and may present with a completely innocent anterior chamber examination, despite causing a severe retinal lesion. A high level of suspicion must be held after a blunt periocular trauma, and a detailed fundoscopy should always be done. Prompt diagnosis and treatment may prevent the development of potentially sight-threatening complications.