Occult Posterior Scleral Rupture Following Sports-related Orbito-Palpebral Trauma: A Case Report

Abstract

Sports-related orbitopalpebral trauma is a common cause of ocular injury and may lead to complex involvement of both the anterior and posterior segments, with severe visual consequences. Despite prominent external findings, significant intraocular lesions may remain occult at the initial presentation. We present the case of a 22-year-old patient who sustained severe orbitopalpebral trauma during a sports accident, presenting with extensive anterior segment injury. Progressive clinical findings and multimodal imaging raised suspicion of an occult posterior scleral rupture. Urgent surgical exploration confirmed a deeply posterior, surgically inaccessible scleral tear—a rare and easily overlooked complication of blunt ocular trauma—ultimately resulting in a poor visual outcome. This case underscores the necessity of a thorough and systematic ophthalmic evaluation in orbitopalpebral trauma to avoid missed diagnoses with potentially detrimental visual consequences. Early recognition, appropriate imaging, and timely intervention are essential, while preventive strategies such as protective eyewear and education remain crucial in reducing sports-related ocular injuries.