Total Retinal Detachment Following Traditional Couching

A 65-year-old patient with no notable history, from low socioeconomic status, presented to the ophthalmology clinic for visual impairment of the left eye three months after a traditional couching. Visual acuity was limited to light perception. Slit-lamp examination showed cells and flare in the anterior segment and the vitreous. Fundus examination showed a complete retinal detachment including the fovea with proliferative vitreoretinopathy stage B and two large peripheric retinal tears inferiorly contiguous to the crystalline lens. Surgical treatment was based on pars plana vitrectomy with phacofragmentation of the crystalline lens, pneumatic retinopexy and endophotocoagulation of the retinal tears. Clinical evolution was marked by the improvement of the visual acuity to 20/200 two months after surgery.