Traumatic Choroidal Injuries

Traumatic choroidal injuries may occur with severe blunt or penetrating ocular traumas and are often associated with traumatic injuries of the cornea, lens, retina, and other intraocular organs. Identifying the presence, type, and extent of traumatic choroidal and associated ocular injuries is critical to properly treat patients and predict final structural and visual outcomes. Traumatic choroidal injuries vary from inconsequential choroidal ruptures to extensive choroidal lacerations, ruptures, and avulsion associated with severe damage to ocular content that requires urgent and often multiple surgical interventions. Choroidal lacerations are often adjacent to an open globe wound, requiring standard globe repair and vitreoretinal surgery. In contrast, choroidal ruptures result from the indirect impact of blunt traumas and are usually located away from the impact site. Traumatic choroidal detachment, choroidal avulsion, and chorioretinitis sclopetaria are associated with more severe blunt ocular traumas. Multimodal imaging, including fundus photography, optical coherence tomography, angiography, and autofluorescence, is essential for diagnosing choroidal injuries and monitoring complications such as choroidal neovascularization. The management of traumatic choroidal injuries is guided by the nature and extent of the trauma and other comorbidities and may include observation, medical treatment, or surgical intervention. Understanding the patterns and outcomes of traumatic choroidal injuries is crucial for optimizing patient care and visual prognosis. This chapter reviews various patterns of traumatic choroidal injuries, their diagnosis, associated ocular comorbidities, and management strategies.