A Surprising Cause of Vitreous Base Avulsion: Presence of an Intraocular Pen Tip

To present the outcomes in a patient who underwent acute vitreous base avulsion as a result of a penetrating ocular trauma with a pen and the intraocular retention of the pen tip. A 13-year-old female patient presented with a penetrating ocular injury with a pen. Upon ophthalmological examination, visual acuity was found to be 20/20 in the right eye, and counting fingers from 3 m in the left eye. Scleral penetration was observed 5 mm temporal from the limbus in the superotemporal region of the left eye. Acute vitreous base detachment was apparent with the slit lamp examination, which became visible as a vertical line in the temporal quadrant. The detachment was imaged with anterior segment and ultra-widefield fundus photography. An intraocular foreign body consisting of the tip of the pen was detected. Although vitreous base avulsion is a common outcome of blunt ocular trauma, it is reported less frequently due to difficulties in its detection. To the best of our knowledge, this is the first case reporting vitreous base avulsion due to an intraocular pen tip, which was treated successfully.