Double penetrating nail injury to the eye: a case report

We report an unusual double penetrating eye injury in which a 26 mm carpenter's nail pierced the eye. The nail penetrated the sclera equatorially and pierced the retina posteriorly just above the superior temporal retinal vascular arcade. Six hours following the injury the nail was removed from the eye, trans-scleral cryotherapy was applied to the entry site, and an episcleral silicone band was used to create an encircling buckle. Visual acuity at 2 months and most recently at 33 months following the injury was 20/30. This case demonstrates that selected double penetrating injuries of the posterior segment may be successfully managed with conventional scleral buckling techniques and underscores the importance of protective eye wear for hobby work or leisure activities.