CHORIORETINITIS SCLOPETARIA AND ORBITAL EMPHYSEMA CAUSED BY A HIGH-VELOCITY LIQUID MISSILE

To highlight a case of chorioretinitis sclopetaria, with concomitant macular hole formation and orbital emphysema, caused by a commercial-grade pressure washer.

This is a retrospective case report.

A 19-year-old man presented to the emergency department with a left eye injury, incurred after being sprayed with a commercial-grade pressure washer. He endorsed ipsilateral blurred vision, pain, and linear floaters. Left eye visual acuity was 20/40. Dilated fundus examination showed inferior vitreous hemorrhage, retinal whitening, and preretinal, intraretinal, and subretinal hemorrhages, consistent with chorioretinitis sclopetaria. Optical coherence tomography revealed a full-thickness macular hole. Computed tomography scan of the orbits showed subcutaneous and postseptal orbital emphysema. Two months after injury, vitreous and retinal hemorrhages and macular hole resolved. Five months after injury, visual acuity improved to 20/20.

Chorioretinitis sclopetaria is defined as a full-thickness chorioretinal disruption resulting from a high-velocity projectile passing adjacent to or into the orbit without penetrating the globe. Chorioretinal deformation and ocular comorbidities are influenced by the velocity of the missile and its spatial relationship to the orbit. Although this pattern of injury is typically associated with indirect trauma to the globe by a BB or a bullet, this is the first report of chorioretinitis sclopetaria precipitated by a high-velocity liquid missile.