A 22-year-old male patient was urgently referred following an all-terrain vehicle (ATV) accident. On presentation, the patient had extensive bilateral periorbital fractures. Dilated fundus exam of the right eye demonstrated a full-thickness chorioretinal and scleral perforation infero-nasal to the optic disc with mild vitreous hemorrhage (Fig. 1A). Laser photocoagulation was performed around the perforation site. Three months after the injury, the patient had visual acuity of 20/20 in his right eye with complete resolution of the vitreous hemorrhage. Gliotic tissue had developed over the perforation site with no evidence of retinal detachment or proliferative vitreo-retinopathy (Fig. 1B). Given the extent and location of his orbital fractures in relation to the injury site as imaged by computed tomography of the head and orbit, it was presumed that one of the bony fragments had likely perforated the posterior globe during the accident (Fig. 2). The perforation site had then spontaneously self-sealed and laser was used to reinforce the surrounding retina and prevent further complications.
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Published online: March 13, 2021
Accepted: February 11, 2021
Received in revised form: February 10, 2021
Received: January 29, 2021
© 2021 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.