Commotio retinae (Berlin's edema) occurs following a blunt trauma to the eye, with damage to the photoreceptor cells of the posterior pole.


Mechanism: contrecoup injury


Clinical features:

(1) loss of vision following blunt trauma

(2) fundoscopy shows whitening and opacification of the retina along the posterior pole, which may be localized or widespread

(3) focal retinal hemorrhages may be present

(4) traumatic mydriasis may be present


Severe cases may show:

(1) a retinal tear or break

(2) a macular hole

(3) subretinal pigmentation


Most cases resolve spontaneously but severe cases may be associated with permanent visual loss.


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