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Inadvertent ocular perforation with hypodermic needle during saline irrigation

We present a case of globe perforation with hypodermic needle during saline irrigation. A 24-year-old presented with sudden onset defective vision during saline wash in his left eye. Patient on examination had hypotony and mild lid edema. Scleral wound was only apparent after staining; rest of the anterior segment was within normal limits. Posterior segment showed vitreous hemorrhage with retinal tear nasal to disc and adjacent commotio retinae. Patient was given tapering topical antibiotic steroid eye drops and kept under close observation. On his final follow-up 6 weeks after the initial injury, vitreous hemorrhage was resolving; the retinal tear had scarred with a choroidal rupture. Hypodermic-needle injuries are often complicated by the development of endophthalmitis. Our patient did not develop endophthalmitis, possibly due to the needle being sterile. He regained good vision and was saved from devastating consequences as the needle had missed the disc by a few millimeters.