Case 39: Delayed Presentation Zone I Open Globe Injury at Site of Previous Trauma
A 31-year-old man presented with a Zone I open globe injury 2 days after blunt head trauma. Initial exam was significant for a 6.5 mm full thickness corneal wound, Seidel positive without provocation, and ingrowth of blood vessels from the limbus into the wound and surrounding corneal whitening. There were also posterior synechiae and sectoral iris atrophy inferior and posteriorly to the corneal wound suggesting a previous corneal injury at the site of new acute rupture. Intraoperatively the wound bled while suturing and the corneal tissue in this area was friable, consistent with delayed presentation and possible chronic intermittent low-grade inflammation or infection from a previous trauma. Post-operatively, the patient underwent staged suture removal at 6 and 8 weeks, respectively. His final best-corrected visual acuity was 20/20.
KeywordsEye injuries Lacerations Corneal neovascularization Iris Transillumination Inflammation Debridement Counseling
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