This 30YO male was hit in his right eye 2 days earlier with a cricket ball. He was visually asymptomatic, and vision was 20/20.
Color photography shows extensive commotio retinae in the inferior retina, with scattered intraretinal hemorrhages. There were no retinal breaks or detachment. Close observation was recommended.
Learning Points:
Commotio retinae is caused by direct, blunt eye trauma. The outer retinal whitening is due to shearing of the photoreceptor outer segments. The term “Berlin’s edema” is a misnomer and should not be used, as the retina is not edematous. The acute white retinal changes usually resolve within several weeks. With resolution, the fundus appearance can normalize. With more severe injury, outer retinal loss can allow RPE cells to migrate into the retina, giving a pseudo-retinitis pigmentosa appearance. Patients can also develop retinal breaks and detachment.
