Blinding Ocular Trauma Caused by High-Pressure Waterjet

Abstract

Ocular trauma remains a significant cause of visual impairment. Waterjet ocular injury is otherwise uncommon. We report a case of waterjet ocular trauma with penetrating injury to the lateral rectus and underlying sclera, with retinal detachment and lid laceration. This case posed diagnostic and management challenges due to its unusual presentation with an occult globe rupture initially. High index of suspicious globe rupture was made based on lower intraocular pressure with hyphema, and globe irregularities from the CT orbit. Surgical exploration revealed transacted lateral rectus and sclera laceration, with vitreous and uveal prolapse. Postoperative B scan demonstrated retinal detachment. Visual acuity was poor, with the traumatic eye demonstrated constant esotropia and became phthisical. The impact of waterjet in causing severe ocular injury should not be underestimated. Extra precaution should be taken, as severe ocular complications can be avoided with appropriate safety measures in handling the waterjet.