Self-sealing posterior scleral perforation in airgun ocular trauma, surgical tip: a case report

Autor: Fabiana Mallone, Michela Marcelli, Riccardo Monsellato, Federica Franzone, Magda Gharbiya, Alessandro Lambiase
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: BMC Ophthalmology, Vol 20, Iss 1, Pp 1-4 (2020)
Druh dokumentu: article
ISSN: 1471-2415
DOI: 10.1186/s12886-020-01435-8
Popis: Abstract Background Intraorbital metallic foreign bodies have varied clinical presentations. Here, we report the unusual case of intraoperative evidence of spontaneously healed posterior scleral perforation in a severe ballistic trauma without previous instrumental signs of penetrating wound and complete visual restoration after surgery. Case presentation The patient was hit by several lead hunting pellets in the chest, abdomen, limbs, face and orbit. Computed Tomography (CT) images revealed the presence of a pellet within the orbitary cavity, close to the optic nerve, with no signs of penetrating ocular wound. While performing vitrectomy for severe vitreous hemorrhage, a point of strong adherence between a old hemorrhage and retinal surface was identified and managed conservatively, as it was attributed to trauma related-impact area. So, lead foreign body took an unusual trajectory impacting the globe and finally lodging back in the deep orbitary cavity, in absence of significant ocular injury and with visual prognosis preservation. Conclusions Our findings provide further information on orbital injuries from airguns, a theme of growing popularity and concern. Intraoperative recognition of hardly removable old hemorrhagic clot as self-blockage site of posterior scleral penetrating trauma, allowed for surgical stabilization and minimal solicitation of the area to avoid inadvertent perforation.
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