FRAGILE EYES: MAJOR DAMAGE FROM MINOR TRAUMA

To present a case of ocular rupture following a seemingly minor blunt trauma and to emphasise the importance of clinical suspicion and performing prompt surgical management.

University Eye Hospital, Ljubljana, Slovenia

A 69-year-old woman sustained blunt trauma to the left eye after being struck with a rolled newspaper. She experienced immediate visual deterioration. On examination, her visual acuity was counting fingers with low intraocular pressure. Slit-lamp examination revealed a temporal subconjunctival haemorrhage, Descemet’s membrane folds, and a three-quarter hyphema in the anterior chamber. The posterior segment could not be visualised. The patient underwent immediate surgical exploration.

Intraoperative findings revealed a globe rupture at the temporal limbus with iris prolapse. The iris was repositioned, and the sclera and cornea were sutured. Postoperatively, the crystalline lens remained intact and in place. Fundus examination showed mild vitreous hemorrhage without other evidence of posterior segment damage. The patient was treated with systemic and topical antibiotics. Six months after surgery, her best-corrected visual acuity is excellent.

Even minor blunt ocular trauma may result in severe globe rupture, particularly in elderly patients with potentially fragile ocular tissues. A high index of suspicion, immediate surgical repair, and adequate postoperative management can result in excellent anatomical and functional recovery.