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Here you’ll find interesting cases of eye conditions along with news and developments in the ophthalmology world.

Cases are presented as an initial image with history and examination. Health practitioners are encouraged to deduce the condition, before further investigations, diagnosis and management are presented.

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Anterior segment photo of the left eye following primary repair of a globe rupture. The nasal limbal rupture has been closed with interrupted nylon sutures. The eye is aphakic and there is no view of the retina due to a dense vitreous haemorrhage.

Case 49

Figure 1. Anterior segment photo of the left eye following primary repair of a globe rupture. The nasal limbal rupture has been closed with interrupted nylon sutures. The eye is aphakic and there is no view of the retina due to a dense vitreous haemorrhage.

Author and Editor: Adrian Fung

A 71-year-old male suffered blunt trauma to his left eye resulting in a globe rupture.

Case history

A 71-year-old man was referred by after falling and hitting his left eye on a wooden step. He was found to have a globe rupture, with a large nasal limbal wound and traumatic aphakia and aniridia. Visual acuity was hand motions in the left eye and the intraocular pressure was 3mmHg.

The patient was taken for emergency surgery which involved anterior vitrectomy and closure of the limbal wound with 8-0 nylon suture (Figure 1). Post-operatively he had a dense vitreous haemorrhage and remained hypotonous. At this point (3 weeks post primary globe repair) he was referred for a retinal opinion.

Given the fact that there was no view of the fundus, a B-scan ultrasound was performed. This confirmed the presence of a vitreous haemorrhage, but an unusual splitting of the eye wall was also detected superonasally (Figure 2).

B-scan ultrasonography demonstrates a vitreous haemorrhage and splitting of the eye wall superonasally. The transverse T12 scan looks at the superior retina, with the top of the image nasal. The longitudinal L1030 scan looks from anteriorly at the ciliary body (top of the image) to posteriorly at the optic nerve (bottom of the image) in the 1030 meridian.

Figure 2. B-scan ultrasonography demonstrates a vitreous haemorrhage and splitting of the eye wall superonasally. The transverse T12 scan looks at the superior retina, with the top of the image nasal. The longitudinal L1030 scan looks from anteriorly at the ciliary body (top of the image) to posteriorly at the optic nerve (bottom of the image) in the 1030 meridian.

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