The term commotio retinae describes the damage to the outer retinal layers caused by shock waves that traverse the eye from the site of impact following blunt trauma. Ophthalmoscopically, a sheenlike retinal whitening appears some hours following injury (Fig 13-1). It is most commonly seen in the posterior pole but may occur peripherally as well. Several mechanisms for the retinal opacification have been proposed, including extracellular edema, glial swelling, and photoreceptor outer segment disruption. With foveal involvement, a cherry-red spot may appear, because the cells involved in the whitening are not present in the fovea. Commotio retinae in the posterior pole, also called Berlin edema, may decrease visual acuity to as low as 20/200. Fortunately, the prognosis for visual recovery is good, as the condition clears in 3–4 weeks. In some cases, however, visual recovery is limited by associated macular pigment epitheliopathy, choroidal rupture, or macular hole formation. There is no acute treatment.