Successful management of double penetrating ocular trauma with retinal detachment and traumatic endophthalmitis in a child

The prognosis of double penetrating ocular trauma in children is usually guarded. We report the good anatomic and functional outcome in a child with double penetrating ocular trauma associated with retinal detachment and traumatic endophthalmitis. A 5-year-old boy presented to the emergency room with pain and tearing in his left eye after a penetrating ocular injury by a rusted steel wire. After examination under anesthesia, both entrance and exit wounds in the sclera were found, and were complicated with inferior retinal detachment. There were signs of infection such as corneal edema, increased cell, flare and hypopyon in the anterior chamber, and vitreous opacity. The post-traumatic endophthalmitis was successfully treated with prompt intravenous and intravitreal antibiotics injection. The patient subsequently underwent scleral buckling and transpupillary indirect laser photocoagulation operation on the 10th day after trauma. The retina was completely reattached 2 weeks later, and his vision recovered to 6/10 in his left eye after a 6-month follow-up. Prompt use of antibiotics and meticulous surgical intervention are essential in the successful management of such patients.