Photo Essay| Volume 57, ISSUE 2, e41, April 2022

Commotio retinae secondary to fragmented intraorbital pellets

      A 20-year-old man presented with multiple facial gunshot injuries. Visual acuities were 20/20 each eye, with full color vision and normal pupillary responses. Examination showed subconjunctival hemorrhage, mild anterior chamber inflammation, extensive commotio retinae involving the macula, and inferior retinal hemorrhages (Fig. 1A). Computer tomography (Figs. 1B–D) showed orbital emphysema and multiple fragmented left extraconal and intraconal pellets—one in close proximity to the posterior aspect of globe, adjacent to the optic nerve. The patient was managed conservatively with topical steroids/antibiotics and prophylactic systemic antibiotics. Visual function remained stable after 4 months and no surgical intervention was required.
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