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Severe Macular Commotio Retinae Following a Fall from a Horse in a Pediatric Patient.
Abstract: Background and Clinical Significance: Blunt ocular trauma is a significant but often underestimated cause of visual impairment, particularly among adolescents involved in high-risk activities such as horseback riding. While most equestrian injuries affect the head and extremities, ocular trauma, especially commotio retinae, can result in severe visual complications. Case Presentation: We report the case of a 15-year-old girl who sustained blunt ocular trauma to the left eye following a fall from a horse and presented with decreased visual acuity. Multimodal imaging revealed outer retinal abnormalities on spectral-domain optical coherence tomography (OCT), including ellipsoid zone irregularities. Early-phase fluorescein angiography showed central hypofluorescence in the foveal region with surrounding mild mottled hyperfluorescence, without clear vascular abnormalities. Fundus photography demonstrated subtle macular changes. Visual acuity improved significantly following treatment, with partial resolution of macular changes, although mild outer retinal irregularities persisted on follow-up imaging. Conclusions: These findings underscore the importance of early ophthalmic evaluation and advanced retinal imaging in blunt ocular trauma. Given the high risk of visual injury during equestrian activities, especially in pediatric and adolescent populations, preventive strategies such as mandatory helmet use and rider education are essential. Implementation of standardized follow-up protocols is also recommended to monitor long-term retinal changes in patients with traumatic maculopathy.
Publication Date: 2026-05-02 PubMed ID: 42201198PubMed Central: PMC13214917DOI: 10.3390/pediatric18030065Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Case Reports
- Journal Article
Summary
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Severe blunt eye trauma after a fall from a horse can cause serious damage to the retina in children, leading to vision problems. Early eye exams and advanced imaging are crucial for diagnosis, treatment, and monitoring recovery.
Background and Clinical Significance
- Blunt ocular trauma is a major but often overlooked cause of vision loss, especially in adolescents engaged in activities with high injury risk.
- Horseback riding is known for injuries mainly to the head and limbs, but eye injuries like commotio retinae can also occur.
- Commotio retinae refers to retinal bruising following blunt trauma and can lead to significant visual impairment.
Case Presentation
- Patient: A 15-year-old girl experienced blunt trauma to her left eye after falling from a horse.
- Symptoms: The patient presented with reduced visual acuity (sharpness of vision).
- Diagnostics used:
- Spectral-domain Optical Coherence Tomography (OCT): Detected abnormalities in the outer retinal layers, particularly irregularities in the ellipsoid zone, which is crucial for photoreceptor function.
- Fluorescein Angiography (early phase): Showed a darkened (hypofluorescent) area in the center of the fovea with a slightly patchy brighter (hyperfluorescent) area around it, but no clear blood vessel damage.
- Fundus Photography: Revealed subtle changes in the macular area (the central part of the retina responsible for detailed vision).
- Outcome: After treatment, the patient’s vision improved considerably, and macular abnormalities partially resolved; however, some outer retinal irregularities remained on follow-up OCT scans.
Conclusions and Recommendations
- Early ophthalmic examination with high-resolution imaging techniques is essential to diagnose and assess the severity of retinal trauma after blunt eye injuries.
- Pediatric and adolescent individuals engaged in equestrian activities are at high risk for serious ocular injuries like commotio retinae.
- Preventive measures should be prioritized, notably:
- Mandatory helmet use with face protection designed to reduce ocular injury risk.
- Education of riders regarding safe riding practices and awareness about eye safety.
- Standardized follow-up protocols are important to closely monitor retinal recovery and detect long-term changes or complications in cases of traumatic maculopathy.
Cite This Article
APA
Wójcik-Niklewska B, Oliwa Z, Dzięcioł K, Smędowski A.
(2026).
Severe Macular Commotio Retinae Following a Fall from a Horse in a Pediatric Patient.
Pediatr Rep, 18(3), 65.
https://doi.org/10.3390/pediatric18030065 Publication
Researcher Affiliations
- Department of Pediatric Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland.
- Department of Pediatric Ophthalmology, Professor Kornel Gibiński University Hospital Center, Medical University of Silesia, 40-514 Katowice, Poland.
- Students' Scientific Society, Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
- Students' Scientific Society, Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
- Department of Pediatric Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland.
- Department of Pediatric Ophthalmology, Professor Kornel Gibiński University Hospital Center, Medical University of Silesia, 40-514 Katowice, Poland.
- GlaucoTech Co., 40-282 Katowice, Poland.
Conflict of Interest Statement
The authors declare no conflicts of interest. Although one author is affiliated with a commercial company, this affiliation is unrelated to the subject of the study and did not influence any aspect of the research.
References
This article includes 15 references
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