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Purpose: to present the signs, symptoms and management of two cases of traumatic dislocation of implantable collamer lens (ICL) after direct blunt trauma., Observations: at presentation, we noted diffuse conjunctival hyperemia, and clear cornea in the right eye of the first patient. The anterior chamber showed +2 pigmented cells, a distorted, nasally peaked pupil with one-foot plate in front of the iris. The second case had a dislocation of the inferonasal footplate into the anterior chamber without endothelial touch., Conclusions and Importance: Dislocation of an implantable collamer lens (ICL) is rare but carries the risk of long-term complications, particularly after trauma. Ophthalmologists should identify dislocation and timely intervention can mitigate the risk of complications.ICL dislocation can be vision threatening. Ophthalmologists should identify dislocation and timely intervention can mitigate the risk of complications., Competing Interests: No conflict of interest exists., (© 2022 The Authors.)

Purpose: To report a case of corneal edema associated with Descemet membrane (DM) damage likely due to shockwave trauma from a bullet passing by the eye., Observations: A 27-year-old man presented to the emergency department with pain, redness, and severely decreased vision in the left eye immediately following a gun assault. Examination of the eye revealed a temporal conjunctival laceration, corneal edema, hyphema, and vitreous hemorrhage. Bullets were found in the patient's left chest and axilla, and a laceration was present on the bridge of his nose, but no foreign bodies were found in or around the eyes. The intraocular hemorrhage and corneal edema gradually resolved, and it became apparent that there were DM irregularities that possibly represented micro-ruptures. After 7 months, uncorrected visual acuity improved to 20/25, and the cornea was free of edema but had persistent small focal areas of DM thickening and scarring., Conclusions and Importance: This case illustrates that DM and possibly endothelial cell damage can occur due to shockwave injury from high-speed projectiles. In our case of presumed small central DM micro-ruptures, the corneal edema resolved, and the vision significantly improved with topical therapy and observation, suggesting an overall good prognosis from such injuries., (© 2022 Published by Elsevier Inc.)

Purpose: Numerous causes of ocular lacerations, including, open globe injuries have been extensively reported but to our knowledge this is first time that pressure washers have been reported to be the culprit. Thus, in this case series we describe the uniqueness of ocular findings secondary to high-power pressure washer injuries that are a result of their mechanistic function., Observations: Here we report a case series of 3 patients who presented in an emergency department with pain and decreased visual acuity following usage of high-pressure washer machines. All three patients presented with features of both blunt and sharp mechanisms of ocular injury. Most lacerations caused injury that encompassed more than one zone. Two of the patients experienced an open globe injury, and all patients had poor final visual outcomes. Extraocular involvement included fractures and lid lacerations. All patients were managed surgically with repair of the ocular defects. Visual outcome in the first patient was hand motion, while the second patient received a prosthesis following enucleation due to lack of recovery after four months. Lastly, we were unable able to obtain visual outcome for the third patient due to lack of follow up., Conclusion: Ocular injuries due to pressure washers have not been reported in literature, however, this case series serves to elucidate that pressure washers can cause ocular injuries with both blunt and laceration mechanical effects. Moreover, special care should be taken in preventing and managing these injuries due to their high ocular morbidity., Competing Interests: All the authors have no financial disclosures or conflict of interests, (© 2022 The Authors.)

Purpose: We introduce a case with creamy white pearl-like keratin cysts in the anterior chamber after a penetrating injury associated with eyelash implantation., Observations: A 5-year-old girl presented with a history of penetrating corneal injury with a knife ten months ago. An eyelash was removed from the anterior chamber during her previous primary repair. Her parents complained about the presence of a white mass in her repaired eye, which had appeared about nine months after surgery. After the visco-expression of these solid masses, the histopathological evaluation revealed keratinous material surrounded by multinucleated giant cells., Conclusions and Importance: In a case of post-traumatic implantation of eyelash into the anterior chamber, despite removing the cilia, cysts may develop, which suggests proliferating epithelial cells embedded within the anterior chamber., Competing Interests: A.M, S.S., M.S, Z.N, M.S. have no financial disclosures., (© 2022 Published by Elsevier Inc.)

Purpose: To describe a novel surgical technique of a combined implantation of an artificial iris and a scleral fixated intraocular lens (IOL) using flanged IOL haptics ("Yamane" technique)., Observations: The suturelessly implanted artificial iris-IOL-sandwich was stable with good functional as well as aesthetic results. However, our case showed a postoperative intraocular pressure rise., Conclusions: The presented case demonstrates that a visual as well as cosmetical rehabilitation seems to be possible even after severe, penetrating ocular trauma with profound iris defects., Importance: The sutureless IOL scleral fixation technique can also be used in combination with a sutureless artificial iris implantation. Further studies are needed to evaluate the long-term safety profile and rates of postoperative complications., (© 2022 The Authors.)

Purpose: To describe a case of a penetrating ocular trauma and plastic intraocular foreign body (IOFB), undetected on preoperative imaging., Observations: We present the findings of a 40-year-old male who sustained an open globe injury and IOFB composed of plastic following crossbow-related trauma. Preoperative detection of the IOFB was unsuccessful on clinical exam, computed tomography (CT) and ultrasonography. During extraction of the traumatic cataract, an intralenticular IOFB was discovered and removed through an enlarged limbal incision. Postoperative review revealed that a fragmented plastic "nock", from the crossbow arrow bolt, was the likely IOFB source. The bolt was produced by injection molding which may lead to trapped gas within the plastic, causing radiolucency on CT., Conclusions and Importance: Radiolucent plastic warrants consideration on the differential diagnosis when intraocular gas is noted on computed tomography following penetrating ocular trauma. Multimodal imaging should be considered if IOFB is suspected and not detected by CT., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: This report received financial support from an Unrestricted Departmental Grant from Research to Prevent Blindness (New York, NY). The authors have no conflicts of interest to declare., (Published by Elsevier Inc.)

Purpose: To report the case of a 25-year-old male who sustained significant ocular trauma from a confirmed foam round. To review the scientific literature on kinetic impact projectiles and legislation currently proposed to regulate their use., Observations: A 25-year-old male presented to the emergency department with acute pain and vision loss in his left eye after being struck by a foam round. Initial exam showed significant periorbital ecchymosis, multiple eyelid lacerations, microhyphema, and vitreous hemorrhage. Computed tomography revealed fractures of the inferior and medial orbital walls. Optical coherence tomography also demonstrated full-thickness macular hole. Microhyphema resolved after 15 days with steroid and mydriatic drops. Vision at 60 days after injury stabilized at 20/60. Repeat OCT at this time revealed closure of the macular hole. Care for the patient is ongoing., Conclusions and Importance: Foam rounds can cause a pattern of vision-threatening ocular trauma similar to that of rubber bullets with the additional risk of chemical injury. During the George Floyd protests, isolated reports of significant foam round-related ocular injuries have been reported in the press, but systematic epidemiologic and clinical data on the subject remains lacking. While accurate identification of the causative weapon is not required in the management of ocular trauma, it may impact advocacy efforts undertaken by physicians and the subsequent legislative efforts they inspire. Current state and federal law does not adequately protect individuals from these munitions. Multiple proposals in Congress aptly recognize the significant risk of blinding injury and mortality posed by all kinetic impact projectiles., Competing Interests: None., (© 2021 Published by Elsevier Inc.)

Purpose: To describe two cases of Purtscher-like retinopathy after total knee arthroplasty., Observations: Two patients were referred for blurred vision after knee surgery. They received a complete vision examination including slit lamp exam, dilated fundus exam, fluorescein angiogram and optical coherence tomography. Two patients developed Purtscher-like retinopathy after knee surgery. The first was a 58-year-old male who underwent bilateral total knee arthroplasty. The second patient developed an infected joint and subsequently received a total knee arthroplasty revision surgery. Both patients experienced decreased vision and were found to have characteristic findings of Purtscher-like retinopathy including vessel attenuation, cotton wool spots and nerve fiber layer infarcts following their respective operations in the absence of other injury., Conclusions and Importance: Purtscher-like retinopathy can occur immediately following total knee arthroplasty. Factors including fatty acid liberation, endothelial damage, aberrant coagulation cascade activation, leukocyte aggregation, embolic vascular occlusion and microinfarction likely contributed to these findings. When patients undergo knee arthroplasty and complain of visual scotomas, the diagnosis of Purtscher-like retinopathy should be considered with careful ophthalmic examination and work-up., Competing Interests: None., (© 2020 The Authors. Published by Elsevier Inc.)

Purpose: To report a case of self-induced eye injury resulting in lens subluxation combined with avulsion of ciliary processes in a patient with Tourette Syndrome., Observation: A 14-year-old male had repeated involuntary trauma to the left side of his face. On exam, left eye lens subluxation combined with ciliary process avulsion were noted. Pars plana vitrectomy and lensectomy were performed., Conclusions and Importance: This report of self-inflicted ciliary processes detachment in Tourette Syndrome is the first of its kind. Ocular injuries reported in the literature include isolated cases of lens luxation, retinal detachment and orbital hemorrhage. Additionally, iatrogenic conjunctival laceration and corneal abrasion have been reported due to involuntary movements during clinical examination. This case provides further evidence that patients with Tourette Syndrome may be at risk of eye injury due to the involuntary jerk movements associated with this condition. Patients with involuntary tics that put their eyes at risk should be advised to wear safety eye wear to avoid eye trauma and its deleterious visual consequences.

Purpose: The purpose of this case report is to present the novel findings of a drone causing such a traumatic ocular injury and provide recommendations for how it might be prevented., Observations: We report on a recent case where a child presented to our Emergency Department after incurring a blow to the face by the propeller of a remote controlled drone. The patient suffered significant trauma including rupture of the right globe., Conclusions: As drone sales continue to rise, it is important that physicians be prepared to treat the potential injuries that may result from using these devices. Furthermore, in an attempt to reduce the number of visits associated with remote controlled drones, physicians should be prepared to provide advice as to how patients can reduce the risks of injury., Importance: We hope that the framework and recommendations below will help physicians decrease adverse outcomes related to this unusual injury pattern.

Purpose: To describe a case of remarkable visual recovery after severe open globe injury., Observations: We present a case of a 70-year-old man with an open globe injury with no light perception vision before and after primary repair of his ruptured globe and before secondary vitreoretinal surgery to repair a total retinal detachment with a 360° giant retinal tear and retinal incarceration in a posterior scleral wound who proceeded to recover vision to the 20/60 pinhole to 20/50 level., Conclusions and Importance: Poor presenting acuity is a known risk factor for poor visual outcome after open globe injury. We hypothesize this remarkable visual recovery could be attributable to the presence of a massive choroidal hemorrhage and limited intraocular hemorrhage elsewhere. In rare cases, vision can improve from the no light perception level after secondary vitreoretinal surgery.

Purpose: To evaluate the utility of swept source optical coherence tomography (SS-OCT) for the analysis of anterior segment structures in cases with previous traumatic eye injuries., Observations: We report three eyes of three patients with anterior segment traumatic eye injury and highlight the role of SS-OCT in their evaluation and management. This technology enabled us to visualize the structural details of anterior segment of the eye and augment the clinical examination in our patients. Given that it is non-invasive and that there is no contact involved, it may be an ideal imaging modality for traumatic eye injuries for viewing the details before and after any clinical intervention especially in the sub-acute setting., Conclusions: The anterior segment SS-OCT is a useful device allowing non-invasive, non-contact, real-time, cross-sectional anterior segment images of eyes with previous ocular trauma.