Occult globe perforation during posterior sub-tenon injection diagnosed by ultrasound biomicroscopy

Sweksha Priya; Amitabh Kumar; Md Shahid Alam

doi:10.4103/ojo.ojo_190_21

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Year : 2022 | Volume : 15 | Issue : 2 | Page : 231-233

Occult globe perforation during posterior sub-tenon injection diagnosed by ultrasound biomicroscopy

Sweksha Priya¹, Amitabh Kumar², Md Shahid Alam³
¹ Department of Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology, Aditya Birla Sankara Nethralaya (A Unit of Medical Research Foundation, Chennai), Kolkata, West Bengal, India
² Department of Uvea, Aditya Birla Sankara Nethralaya (A Unit of Medical Research Foundation, Chennai), Kolkata, West Bengal, India
³ Department of Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Aditya Birla Sankara Nethralaya, (A Unit of Medical Research Foundation, Chennai), Kolkata, West Bengal, India

Correspondence Address:
Dr. Sweksha Priya
Department of Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology, Aditya Birla Sankara Nethralaya, (A Unit of Medical Research Foundation, Chennai), Kolkata - 700 099, West Bengal
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/ojo.ojo_190_21

Inadvertent globe perforation during posterior sub-tenon (PST) injection is rare, and the use of ultrasound biomicroscopy (UBM) in the diagnosis of occult globe perforation is not reported yet in the literature. We hereby intend to discuss the case of a 42-year-old male who presented with left eye loss of vision following PST triamcinolone acetate (TA) injection. On examination, right eye vision was 20/20 and it was 20/120 for the left eye. Fundus examination of the left eye showed a whitish fluffy mass like preretinal lesion over the macula with vitreous haze. The patient was thoroughly investigated for intermediate and posterior uveitis. However, all reports turned out to be within the normal limits. The 360° UBM scan of the left eye showed well-defined hypoechoic scleral tract suggestive of globe perforation at 2 o'clock position. The, whitish preretinal mass in the left eye was suspected to be intravitreal TA deposit following an inadvertent globe perforation during the posterior sub-tenon TA injection. UBM can be considered important diagnostic aid in ruling out possibility of occult globe perforation in certain circumstances.

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