Conservative Management of a Retained Posterior Segment Cilium After Penetrating Ocular Trauma.

Purpose: To describe the clinical course and management of a retained posterior segment cilium following open-globe injury.

Methods

A single case was reviewed.

Results

A high-velocity zone 1 open-globe injury was complicated by a posterior segment cilium detected on ultra-widefield imaging 3 months after trauma. The patient was followed with serial examinations and imaging during a corticosteroid taper. The cilium remained stable and clinically silent, with no evidence of vitritis, traction, or visual decline. Corticosteroids were gradually discontinued. After more than 1 year off steroids, visual acuity remained preserved, and no inflammatory sequelae were observed.

Conclusions

Selected cases of retained posterior segment cilia may be managed conservatively when asymptomatic and without inflammatory or tractional complications. Ultra-widefield imaging facilitates delayed detection, and ocular immune privilege should be considered when weighing the risks and benefits of surgical removal.