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Case Reports
. 2024 Oct 1:36:102185.
doi: 10.1016/j.ajoc.2024.102185. eCollection 2024 Dec.

An unusual case of a high-impact perforating ocular injury by knife

Philipp K Roberts  1 , Marc A Macek  1 , Annekatrin Rickmann  1 , Philip Wakili  1 , Anna Theresa Lorenz  1 , Berthold Seitz  2 , Peter Szurman  1   3 , Karl T Boden  1   3
Affiliations
Case Reports

An unusual case of a high-impact perforating ocular injury by knife

Philipp K Roberts et al. Am J Ophthalmol Case Rep. .

Abstract

Purpose: To present a case of high-impact perforating eye injury by knife throwing witnessed during a public performance and initially classified as penetrating eye injury.

Observations: During the second reconstructive procedure an exit wound was identified, which had been missed during primary wound repair due to extensive swelling of adjacent soft tissue. The occult exit wound could be sealed and the retina attached under silicone oil.

Conclusions and importance: An exit wound should always be considered in any case of penetrating ocular injury. Uniform terminology in ocular traumatic injuries is important for planning and execution of proper wound management.

Keywords: Ocular trauma score; Open globe; Penetrating eye injury; Perforating eye injury; Proliferative vitreoretinopathy.

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Conflict of interest statement

Prof. Peter Szurman has a patent for a device for preparing and introducing a transplant or an implant into a living body, in particular for ophthalmological interventions: EP2533724 B1; WO2012065602 A3. All other authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Figures

Fig. 1
Fig. 1
Throwing knife (a) causing the injury inflicted during the performance. Photo of the accident, taken from a video of the performance showing the impacted knife (white arrow in b and c).
Fig. 2
Fig. 2
Left eye after open-globe injury at initial presentation (a) and after primary wound closure (b). A lacerating open-globe injury with iris prolapse is evident at the inferior limbus (a). After repositioning the iris tissue, the corneal laceration was sutured watertight with 10–0 nylon interrupted sutures, as shown in (b), and the peritomy was sealed.
Fig. 3
Fig. 3
Microscopic view of the posterior pole during vitrectomy and identification of the exit wound (black arrow) temporal to the macula, in close proximity to a giant retinal tear (white arrowheads) before (a) and after (b) argon laser retinopexy (white asterisks).
Fig. 4
Fig. 4
Slit-lamp photograph (a), anterior segment optical coherence tomography B-scan (b), and color fundus photograph (c) of left eye 2 weeks after internal reconstructive surgery. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
figs1
figs1
figs2
figs2
See this image and copyright information in PMC

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