Topic outline

  • Grand Rounds

    A patient presented with acute decreased vision in the left eye after motor vehicle accident. The patient stated in the accident his car spun out and airbags deployed. Upon presentation, visual acuity was 20/25 in the right eye and light perception only in the left eye. IOP was 18mmHg in the right eye and check deferred in the left eye. Pupillary reaction was noted to be normal in the right eye and without adequate view in the left eye. Slit lamp examination disclosed 3 clock hour temporal full-thickness corneal laceration with iris plugging and uveal prolapse, traumatized iris, large hyphema, traumatic cataract, and poor posterior view. B-scan ultrasound demonstrated a virtual tract into the ciliary body, vitreous hemorrhage, and multiple opacities with acoustic shadowing and reverberation consistent with intraocular foreign bodies. CT Scan confirmed this diagnosis. The patient was taken for corneal laceration repair, pars plana vitrectomy/ lensectomy, IOFB removal, fluid-air exchange and intravitreal vancomycin and ceftazidime. He was left aphasic under silicone oil. He did well post operatively but later underwent PPV, oil removal, exploration, endolaser and left with C3F8 gas fill due to developing cicatricial membrane and temporal sub retinal fluid. A single additional non-metallic IOFB was identified and removed. Most recently, he doing well, with BCVA of 20/70 with a hard contact lens and normal IOP.

    Presentation Date: 05/25/2023
    Issue Date: 06/02/2023