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Vitreous Base Avulsion
A 27-year-old woman presented three days after experiencing blunt trauma to her left eye during a domestic violence incident. She complained of blurred vision and a “stringy” floater in the eye. Slit-lamp examination and indirect ophthalmoscopy revealed a pigmented, ribbonlike floater in the anterior vitreous, but no retinal tears, detachments or dialyses (above).
Vitreous base avulsions are sometimes referred to as the “bucket-handle sign,” named for the floating opacity over the peripheral retina. They have been considered pathognomonic for blunt ocular trauma, but they have also been reported spontaneously in young patients with inferotemporal retinal dialysis and in a patient with neurofibromatosis.
Although commonly associated with retinal dialysis, iris trauma or hyphema, no treatment is indicated in the absence of associated ocular pathology.
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