Symptoms
Decreased vision or asymptomatic. History of ocular trauma.
Signs
(See Figure 3.18.1.)
Critical
A yellow or white crescent-shaped subretinal streak, usually concentric to the optic disc. May be single or multiple. Often cannot be seen until several days or weeks after trauma because it may be obscured by overlying subretinal blood.
Other
Rarely, the rupture may be radially oriented. Choroidal neovascularization (CNV) may develop later. TON may be present.
Differential Diagnosis
Workup
Treatment
Follow Up
After ocular trauma, patients with hemorrhage obscuring the underlying choroid are reevaluated every 1 to 2 weeks until the choroid can be well visualized. Although CNV is rare overall, ruptures that are particularly long or closer to the fovea are at greater risk for CNV development. Fundus examinations may be performed every 6 to 12 months depending on the severity and risk of progression to CNV. Patients treated for CNV must be followed closely after treatment to watch for persistent or new CNV (see 11.17, NEOVASCULAR OR EXUDATIVE (WET) AGE-RELATED MACULAR DEGENERATION, for further follow-up guidelines).