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Case Reports and Small Case Series
January 1999

Traumatic Enucleation From a High-Pressure Water Jet

Arch Ophthalmol. 1999;117(1):123-124. doi:

This article describes an unusual case of enucleation from a high-pressure water jet. Treatment is described and an etiologic hypothesis is presented.

A 37-year-old man was seen in the emergency department with a traumatic injury to his right orbit. The patient, not wearing protective eyewear, was tightening a high-pressure industrial pipe that began to leak. Owing to a sudden malfunction, a high-pressure water jet was directed into his right orbit. The right globe was found approximately 45 m (50 yd) from the scene of the injury by emergency personnel. Ophthalmic examination of the right orbit showed relatively clean, soft tissue with conjunctival chemosis and an anophthalmic socket. Gross and histopathologic examination findings of the eye revealed an intact globe with no readily identifiable sites of scleral rupture and 15 mm of optic nerve present (Figure 1). The extraocular muscles were avulsed through their insertions on the globe. A computed tomographic scan of the orbits confirmed the anophthalmic socket. The extraocular muscles were in their normal anatomical positions and intact (Figure 2). Ophthalmic examination of the left eye, including confrontation visual fields, showed no abnormalities.