A Case Report of Traumatic Retinal Detachment

It is your favorite Optometrist and once again i am here to share my knowledge in the world ocular health as i have been doing time and again and i am hoping that as usual we get to learn a thing or two for ourselves as well as our friends and family.

Before then, i do hope that your new year is going great and that things are going well for you, i am very optimistic that the year would be great and that things would continue to look great for us as we move in its fullness of glory.

Today i want to talk about a case i had previously seen, and what or how perhaps the vision of patient X could have perhaps been saved earlier or to some extend had there been more serious care in seeking care.

As i always say, let's love our eyes enough to be particular about it especially in instances where there is any form or even the possbility of damage to it, do not wait, do not get over the counter medication, only seek professional care and advise, you may have just saved your sight by doing so.

My patient, thus patient x was or is a young man in his early 30s who got himself involved in a brawl among peers. Unfortunately for him he was not even the main even or directly involved in the incident as opposed to the others during the cause of events he ended up having a severe blow with club or something like that which he is not so sure, striking his eye.

After the incident he went home with his injuries and was seen by the wife, he applied some basic first aid as he knows, using cold or ice to manage the swellings and then he noticed that his vision had reduced drastically in the affected the next day, he wasn't in much pain as before so he decided to get some drugs from the pharmacy and was given gentamicin for its usage.

3 days after using his vision wasn't getting any better and that was when he got scared and decided to finally come to the hospital. I examined him alongside my assistant and we realized during the vision test that his vision was counting fingers at 1m in the affected eye and could not be improved with refraction and so we continue to examine the ocular adnexa and the interior structures.

Luckily for him any bruises he may have incurred had healed because the cornea was fine however. examination of the retina was not good, and so we requested for an OCT for confirmation which proved that indeed he had developed a retinal detachment. Based on the history we could automatically assume that this has been so for the past 3 days and so had to do an immediate referral to an ophthalmologist for his possibilities of surgical intervention to be explored.

However we made him aware his prognosis is bad, perhaps if he had come in earlier things would have been much better considering the fact that retinal detachment is considered an ocular emergency with irreversible damage. The cells then to die of very quickly once they are detached from their source of nourishment and unless it is resolved through surgery within the shortest possible time, vision loss becomes irreversible and so that was the reason for his bad prognosis.

Further Reading

_{Rossin EJ, Tsui I, Wong SC, Hou KK, Prakhunhungsit S, Blair MP, Shapiro MJ, Leishman L, Nagiel A, Lifton JA, Quiram P, Ringeisen AL, Henderson RH, Arruti N, Buzzacco DM, Kusaka S, Ferrone PJ, Belin PJ, Chang E, Hubschman JP, Murray TG, Leung EH, Wu WC, Olsen KR, Harper CA 3rd, Rahmani S, Goldstein J, Lee T, Nudleman E, Cernichiaro-Espinosa LA, Chhablani J, Berrocal AM, Yonekawa Y. Traumatic Retinal Detachment in Patients with Self-Injurious Behavior: An International Multicenter Study. Ophthalmol Retina. 2021 Aug;5(8):805-814. doi: 10.1016/j.oret.2020.11.012. Epub 2020 Nov 22. PMID: 33238225.}

_{Johnston PB. Traumatic retinal detachment. Br J Ophthalmol. 1991 Jan;75(1):18-21. doi: 10.1136/bjo.75.1.18. PMID: 1991080; PMCID: PMC504099.}

_{Hoogewoud F, Chronopoulos A, Varga Z, Souteyrand G, Thumann G, Schutz JS. Traumatic retinal detachment--the difficulty and importance of correct diagnosis. Surv Ophthalmol. 2016 Mar-Apr;61(2):156-63. doi: 10.1016/j.survophthal.2015.07.003. Epub 2015 Jul 26. PMID: 26216341.}

_{Palioura S, Eliott D. Traumatic endophthalmitis, retinal detachment, and metallosis after intraocular foreign body injuries. Int Ophthalmol Clin. 2013 Fall;53(4):93-104. doi: 10.1097/IIO.0b013e31829ceee1. PMID: 24088936.}