Indirect Ocular Trauma: Purtscher’s Retinopathy
Arterial and venous circulatory disruption in the retina
character-ized by a sudden increase in intravascular pressure may occur
following severe chest injuries (compression trauma such as in a seat-belt
injury) or fractures of long bones (presumably due to fat embolisms or vascular
spasms).
Acute retinal ischemia withimpaired vision and
loss of visual acuity will occur either immediately or within three to four
days of the injury. Examination of the fundus will reveal cotton-wool spots and
intraretinal bleeding indicative of focal retinal ischemia. Lines of bleeding
will also be observed.
Fundus symptoms will usually disappear spontaneously withinfour
to six weeks. Reduced visual acuity and visual field defects may occa-sionally
persist. Occasionally treatment with high doses of systemic steroids and
prostaglandin inhibitors is attempted.
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