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Fig. 2.12.1 Retinal detachment and PVR development following a scleral rupture. This histological specimen is from the enucleated eye of a 17-year-old boy who was injured by fireworks. He had NLP vision, total hyphema, traumatic aniridia and aphakia, and a very severe vitreous hemorrhage. The primary surgery was wound closure and hyphema removal. By day 11 the retina detached; during surgery it was found to have been incarcerated into the scleral wound. Retinectomy was performed with gas tamponade, and the visual acuity temporarily improved to HM. The retina subsequently redetached, the visual acuity became NLP, and by 5 months the eye was painful with an axial length of 17 mm. 1 sclera, 2 choroid, 3 detached retina. The arrowhead shows the site of the border of the retinotomy; the arrows show the path of the "flow" of proliferative cells, originating from the sclero-choroidal wound (Courtesy of A. Viestenz, Magdeburg, Germany)

Table 2.12.1 Findings that should raise the suspicion of an occult1 rupture

Variable

Finding and comment

History

Injury caused by large, blunt object hitting the eye with substantial momentum

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