This 36YO Ukrainian male sustained a firearm-related facial injury during military combat in 2014 while in Eastern Ukraine. At the time, he was treated in a frontline hospital, where the left eye underwent primary enucleation due to a non-reconstructible globe rupture. His right eye sustained a penetrating injury with scleral rupture, which was primarily repaired. Over the following months, he underwent pars plana vitrectomy with endolaser and silicone oil due to complications, likely including retinal detachment and/or vitreous hemorrhage. Given the complexity of the trauma, the monocular status, and probable limited access to regular follow-up during wartime, silicone oil was likely retained for an extended period, potentially several years, until its removal at an undetermined later date. On our 2024 examination, he had no new visual complaints, and vision was 20/100.
Fundus photography shows atrophic inferior macular chorioretinal scarring, which becomes hyperpigmented as it extends into the inferior midperiphery. A large macular hole is noted funduscopically and on OCT. Macular perimetry shows marked depression within the area of scarring with preservation of some central sensitivity. Observation was recommended.
