{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T05:08:38Z","timestamp":1778821718938,"version":"3.51.4"},"reference-count":15,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:00:00Z","timestamp":1777680000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Reports"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3390\/pediatric18030065","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T02:06:21Z","timestamp":1777860381000},"page":"65","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Severe Macular Commotio Retinae Following a Fall from a Horse in a Pediatric Patient"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6753-2904","authenticated-orcid":false,"given":"Bogumi\u0142a","family":"W\u00f3jcik-Niklewska","sequence":"first","affiliation":[{"name":"Department of Pediatric Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland"},{"name":"Department of Pediatric Ophthalmology, Professor Kornel Gibi\u0144ski University Hospital Center, Medical University of Silesia, 40-514 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9595-0031","authenticated-orcid":false,"given":"Zofia","family":"Oliwa","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Society, Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karina","family":"Dzi\u0119cio\u0142","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Society, Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8528-955X","authenticated-orcid":false,"given":"Adrian","family":"Sm\u0119dowski","sequence":"additional","affiliation":[{"name":"Department of Pediatric Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland"},{"name":"Department of Pediatric Ophthalmology, Professor Kornel Gibi\u0144ski University Hospital Center, Medical University of Silesia, 40-514 Katowice, Poland"},{"name":"GlaucoTech Co., 40-282 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2267","DOI":"10.1001\/archopht.1978.03910060563021","article-title":"Traumatic retinopathy in primates. The explanation of commotio retinae","volume":"96","author":"Sipperley","year":"1978","journal-title":"Arch. Ophthalmol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"262","DOI":"10.3341\/kjo.2011.25.4.262","article-title":"Evaluation of the central macula in commotio retinae not associated with other types of traumatic retinopathy","volume":"25","author":"Park","year":"2011","journal-title":"Kor. J. Ophthalmol."},{"key":"ref_3","first-page":"128","article-title":"Pediatric ocular trauma: Recognition and management","volume":"19","author":"Shah","year":"2022","journal-title":"Pediatr. Emerg. Med. Pract."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1016\/j.ajo.2006.09.024","article-title":"Optical coherence tomography findings of acute traumatic maculopathy","volume":"143","author":"Pham","year":"2007","journal-title":"Am. J. Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.jemermed.2025.09.009","article-title":"Horsing Around: A Retrospective Study of Equestrian Related Eye Injuries in the Emergency Department","volume":"79","author":"Moran","year":"2025","journal-title":"J. Emerg. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1136\/bjo.86.4.473-a","article-title":"Optical coherence tomography imaging of severe commotio retinae and associated macular hole","volume":"86","author":"Ismail","year":"2002","journal-title":"Br. J. Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2044","DOI":"10.1097\/IAE.0b013e31820f4bb4","article-title":"Commotio retinae with spectral-domain optical coherence tomography","volume":"31","author":"Oh","year":"2011","journal-title":"Retina"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1159\/000360692","article-title":"Traumatic maculopathy 6 months after injury: A clinical case report","volume":"5","author":"Mendes","year":"2014","journal-title":"Case Rep. Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1588","DOI":"10.1016\/j.ophtha.2013.01.009","article-title":"Visual outcomes after blunt ocular trauma","volume":"120","author":"Blanch","year":"2013","journal-title":"Ophthalmology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1080\/09286586.2021.1914668","article-title":"Characteristics of ophthalmic trauma in fall-related hospitalizations in the United States from 2000 to 2017","volume":"29","author":"Chen","year":"2021","journal-title":"Ophthalmic Epidemiol."},{"key":"ref_11","first-page":"e29","article-title":"Restored photoreceptor outer segment in commotio retinae","volume":"42","author":"Itakura","year":"2011","journal-title":"Ophthalmic Surg. Lasers Imaging Retin."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1046\/j.1442-9071.2001.00430.x","article-title":"Neuro-ophthalmological sequelae of horse-related accidents","volume":"29","author":"Fleming","year":"2001","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.jsr.2019.09.004","article-title":"Horseback riding-related injuries treated in emergency departments: Risk factors and prevention strategies","volume":"71","author":"Asa","year":"2019","journal-title":"J. Saf. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/s13049-014-0040-8","article-title":"Horse-related trauma in children and adults during a two-year period","volume":"22","author":"Hilding","year":"2014","journal-title":"Scand. J. Trauma Resusc. Emerg. Med."},{"key":"ref_15","first-page":"50","article-title":"Horse-related injuries in children: A review","volume":"104","author":"Jagodzinski","year":"2005","journal-title":"Wis. Med. 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