Indirect Ocular Trauma: Purtscher’s Retinopathy

 Indirect Ocular Trauma: Purtscher’s Retinopathy

Etiology: 

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).

Symptoms and diagnostic considerations: 

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.

Treatment: 

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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