Laser photocoagulation may be used to manage a posterior globe perforation, according to a case study presented in the Canadian Journal of Ophthalmology. 

Researchers shared the case of a 22-year-old man who was referred urgently following an all-terrain vehicle (ATV). The patient presented with extensive bilateral periorbital fractures. Results of a dilated fundus exam of the right eye showed full-thickness chorioretinal and scleral perforation inferonasal to the optic disc with mild vitreous hemorrhage. 

Physicians performed laser photocoagulation in the area around the perforation site. 


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Three months after the injury, the patient demonstrated visual acuity of 20/20 in his right eye, as well as complete resolution of the vitreous hemorrhage. Over the site of the perforation, gliotic tissue had developed, with no evidence of either retinal detachment or proliferative vitreoretinopathy. 

“Given the extent and location of his orbital fractures in relation to the injury site…it was presumed that one of the bony fragments had likely perforated the posterior globe during the accident,” according to the findings. “The perforation site had then spontaneously sealed, and laser was used to reinforce the surrounding retina and prevent further complications.” 

Reference

Al-Falah M, Khateb S, Eng KT. Full thickness posterior globe perforation managed with laser photocoagulation. Can J Ophthalmol. Published online March 13, 2021. doi:10.1016/j.jcjo.2021.02.009