A man in his 50s presented to the emergency department with sudden vision impairment in his right eye after a direct blow to the eye from a basketball. Best-corrected visual acuity was counting fingers OD. Slitlamp examination revealed prolapse of vitreous through the pupil into the anterior chamber with some pigment granules dispersed in the anterior layers of the vitreous (Figure, blue arrowhead). A 3 clock-hour superotemporal iridodialysis (Figure, white arrowhead) and subluxation of lens was present. The patient underwent surgical lens extraction, anterior vitrectomy, and sutured posterior chamber intraocular lens implantation uneventfully. Protrusion of vitreous into the anterior chamber and lens subluxation, typically caused by blunt ocular trauma, usually is indicative of focal zonular damage. A common treatment is surgical removal of prolapsed vitreous in the anterior chamber and lens to avoid potential complications, such as secondary glaucoma, uveitis, and corneal endothelial damage.
Fang F, Li H. Vitreous Herniation After a Blow to the Eye. JAMA Ophthalmol. 2017;135(1):e164672. doi:10.1001/jamaophthalmol.2016.4672