Abstract

A 28-year-old male presented with decreased vision in his left eye following a hammer and chisel injury. The patient underwent primary repair for Zone-1 open globe injury and was referred with suspected intra-ocular foreign body (IOFB). At presentation his visual acuity was 20/20 in right eye and 20/80 in the left eye. Fundus examination revealed media clarity grade-2 with vitreous hemorrhage and a shiny grayish-white structure temporal to fovea suggestive of IOFB. The roentgenogram of the left orbit confirmed the presence of IOFB. The patient was taken up for Pars Plana Vitrectomy with IOFB removal. Intraoperatively, the grayish-white structure was found to be posterior perforation. The perforation site was plugged with scleral plug. The patient had visual acuity of 20/80 at the final follow-up. The video highlights surgical challenges of hypotony, intra-operative choroidals and posterior perforation. Nevertheless, the video also brings about the role of astute pre-op evaluation.