DR. AGRIMA BHATIA

DR. ANJALI MAHESHWARI, DR.SQN LDR (DR). SRIDHARA REDDY, DR.HS TREHAN

Abstract

Case of accidental closed globe injury sustained by a rotating ceiling fan falling on eye of an 11 year old.There was sudden,painful diminution of vision in left eye.On evaluation BCVA of left eye was counting fingers close to face.There was lower lid echymossis,conjunctival tear infero nasally,D shaped pupil with grade 2 RAPD, iridodialysis extending from 5 to 7 o çlock and hyphema.Posterior segment evaluation revealed Berlin’s edema,sub macular haemorrhage(SMH) and choroidal rupture. Intravitreal pure SF6 with paracentesis was performed.Conjunctival tear sutured and strict prone positioning maintained.BCVA improved to 4/60 and child commenced on systemic steroids.After 10 days as SMH was persistent, intravitreal tissue plasminogen activator with pure SF6 was administered.POD 20,BCVA improved to 6/24.This case highlights crucial decision making in management of SMH in a child knowing the poor prognosis of visual outcome in long standing cases of SMH and retinal toxicity of tPA.