An 18-year-old male patient presented to Emergency Room at "blinded for peer review" with right eye (OD) injury by a paintball pellet resulted in sudden drop of his vision and lid laceration which was repaired elsewhere. He was not wearing protective goggles. The patient's previous medical and ocular histories were unremarkable.
At the initial examination his best corrected visual acuity BCVA was 20/400 right eye (OD) and 20/20 left eye (OS).
Right eye examination revealed sutured right upper lid laceration, full extra ocular muscles movements, conjunctival injection with subconjunctival hemorrhage, clear cornea, deep and quite anterior chamber, regular reactive pupil clear lens, and fundus examination showed commotio retinae inferiorly involving the macula (Fig. 1) and minimal vitreous hemorrhage with no visible retinal breaks, documented further by Ultrasound B-Scan. Left eye examination was within normal limit.
On follow-up visit, gonioscopy of the right eye showed angle recession for about two hours with normal intraocular pressure and optic discs. The retinal findings were almost the same with noticed localized sub retinal hemorrhage and multiple choroidal breaks. The sclera depression examination showed operculated retinal break which was managed by laser retinopexy. At the last visit 3 months after the initial visit, the intraocular pressure was in the normal range with 20/200 vision secondary to the non-resolving commotio retinae.