Unusual ocular injury by an acupuncture needle

To educate ophthalmologists on the potential dangers of periocular acupuncture and to describe an unusual mechanism of retinal injury.

A 42-year-old woman who presented with blurred central vision and loss of peripheral vision. Her medical history was significant for hemifacial spasms related to a facial nerve injury, for which she had sought treatment. Clinical examination showed vertically oriented subretinal track measuring 12 mm in length, contiguous to the macula, with normal optic nerve appearance and foveal reflexes. Spectral domain optical coherence tomography showed a full-thickness perforation of the neurosensory retina at the inferior retinal arcade. Visual field testing 3 weeks after her injury showed 90% loss of her nasal hemifield. Electroretinography performed 8 weeks postinjury showed a 50% decrease in the right B-wave. Multifocal electroretinography showed a mild decrease in the recording of the right eye versus that of the left eye.

Based on the history and clinical findings, the acupuncture needle penetrated the inferior globe and created a subretinal track. The particular location of the needle entry into the eye and the extreme malleability of the acupuncture needle created a long subretinal track. Ophthalmologists should be familiar with the ocular injuries caused by periocular acupuncture therapies.