Traumatic Transection of the Lateral Rectus Muscle with Chorioretinitis Sclopetaria

Abstract

A man, aged 67 years, sustained monocular trauma to the left eye while gardening, presenting with light perception, complete absence of abduction, and chorioretinitis sclopetaria. At surgery, the lateral rectus was found to be transected at the equator of the globe, with an area of locally abraded sclera. A few posterior muscle fibers were identified and sutured to the residual anterior fibers. With a partial improvement of the esodeviation, after a further 6 months he proceeded to lateral transposition of the superior and inferior recti to healthy sclera 4 mm from the limbus, with adjunctive medial rectus botulinum toxin. Six months later, the angle of primary deviation remained stable at 4 prism diopters base out with improved abduction. Vision in the eye remained reduced at 20/200 (with eccentric fixation) due to macular changes secondary to the sclopetaria. In conclusion, this case describes a rare example of complete traumatic transection of the lateral rectus with chorioretinitis sclopetaria, due to orbital injury. With appropriate surgery, the angle of deviation can be considerably improved despite complete muscle transection and scleral injury.

Traumatic chorioretinitis sclopetaria: Risk factors, management, and prognosis

“… 1 Sclopetaria is a rare condition, yet, an increasing number of cases have been reported in the literature over the last several decades – from 11 cases reported between 1980 and 1999 2 , 3 , 4 , 5 to 43 reported between 2000 and 2018. 1 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 …”

“…The term is thought to originate either from the term sclopetum linked to the name of an old Italian handgun or from the term sclow meaning scratch, pull, or tear 1 . Sclopetaria is a rare condition, yet, an increasing number of cases have been reported in the literature over the last several decades – from 11 cases reported between 1980 and 19992, 3, 4, 5 to 43 reported between 2000 and 2018 1 , 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25…”

Chorioretinitis Sclopetaria: A Case Report

“…MacKenzie et al [4] described a case of a patient who in addition to chorioretinitis sclopetaria suffered from a complete traumatic transection of the lateral rectus at the equator of the globe. In another case report, the authors described a concomitant optic nerve transection combined with chorioretinitis sclopetaria [5].…”