Dr.Meena Thotakura
We report a case of a sixteen year old boy who presented with defective vision in the right eye following blunt trauma. His best corrected visual acuity (BCVA) was counting fingers at 1 metre. Anterior segment examination was normal. Fundus examination showed commotio retinae with horse shoe tear involving the macula. The patient was managed with prophylactic laser, intravitreal C3F8 injection and positioning. His BCVA at 3 months was counting fingers at 5 metres. Closed globe injuries are known to cause commotio retinae, peripheral retinal tears, retinal dialysis, choroidal rupture and macular holes. A centrifugal force, acting equally in all directions, exerted by the posterior vitreous over the macula due to the coup-counter coup mechanism causes traumatic macular holes. However, unequal vectors lead to traction in one particular direction and result in irregular macular tears. Despite treatment, the visual outcome is usually poor due to extensive macular scarring.
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