This 38YO male presented with sudden vision loss in his left eye immediately following blunt trauma from a cricket bat 2 days earlier. Vision was 20/200.
Color fundus photography shows extensive commotio retinae throughout the posterior pole, along with a large retinal tear in the temporal midperiphery. Oral and topical steroids were prescribed, and the retinal break was surrounded with laser photocoagulation.
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.
