Posterior segment manifestations of orbital trauma

The posterior segment of the eye can be affected by blunt orbital trauma by either direct or indirect mechanisms or by equatorial expansion. Commotio retinae can occur either at the site of direct or indirect injury. Retinal detachments can be precipitated at the site of the direct injury by a necrotic tear, at the site of the indirect injury with a macular hole, or just posterior to the vitreous base if equatorial expansion plays a role. Contusion effects on the choroid can manifest as a localized hemorrhage, a hemorrhagic choroidal detachment, or a choroidal rupture. Chorioretinitis sclopetaria results from simultaneous laceration of both the retina and choroid due to the shock waves from a high-velocity missile passing adjacent to the globe in the orbit.