Evisceración ocular secundaria a trauma ocular penetrante por proyectil de goma. un reporte de caso

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Introduction: Ocular trauma is a significant cause of preventable monocular blindness among young adults in Latin America, frequently linked to assaults and high-energy projectiles. Case description: A 35-year-old male presented to the emergency department after being struck in the right eye by a compressed-air rubber projectile. Clinical findings: Examination revealed no light perception, enophthalmos, a 1 cm scleral laceration, extensive corneal perforation, intraocular tissue loss, and a central rubber foreign body (OTS category 1; IGATES: penetrating trauma with foreign body). Patient evaluation: Ultrasound and CT scans confirmed intraocular hemorrhage, globe deformity, and periorbital emphysema without bone fracture. Intervention: Urgent primary evisceration was performed under general anesthesia and loco-regional block, involving thorough uveal curettage and hydrogen peroxide irrigation to prevent sympathetic ophthalmia; an orbital conformer was not implanted due to a lack of hospital supplies. The postoperative course was free of pain or infection, and the patient was referred for disability and mental health assessment. Conclusions: Timely primary evisceration under general anesthesia and loco-regional block is an effective approach for non-reconstructible open-globe injuries with irreversible vision loss, mitigating severe immunological complications. Furthermore, this case highlights the critical need to ensure the availability of prosthetic supplies in public facilities and to provide comprehensive psychological and vocational support, given the severe socioeconomic and self-image impact on productive adults.

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