The fundi of 114 patients were evaluated one to 14 years following contusional
eye injury. Most
injuries to children occurred at sport and play. Domestic and civil assaults, sporting
injuries and industrial accidents were common. Males in the second and third decades of life were predominantly affected. Iris tears, pupillary abnormalities and angle recession were typically associated with the fundal lesions. Contusional
injuries of the retina and choroid were found in 92 patients and were graded according to their location, extent and severity. Twenty-six patients (grade 1) had focal or diffuse disturbances of the inner or outer retina. In 15 patients the lesions predominantly affected the receptor-
retinal pigment epithelial layers and in six patients there were associated breaks in Bruch's membrane. Five further patients had atrophic inner
retinal alterations and lamellar holes at the macula. Most patients in this group retained good visual function. Thirty-six patients (grade 2) had single or multiple choroidal tears. In 21 instances the outer retina was primarily involved; however, in 15 cases there was associated inner
retinal damage. Only three patients developed subretinal neovascularisation. Sixteen patients (grade 3) had extensive areas of chorioretinal
atrophy associated with
retinal pigment epithelial
atrophy, proliferation, plaque and membrane formation. Fourteen patients (grade 4) developed
retinal holes or tears and 10 proceeded to
retinal detachment two weeks to 14 years following injury. Contusional
retinal and choroidal lesions have an unfavourable visual prognosis, only 38.6% of patients regaining a visual acuity of 6/12 or better.