Presumed scleral perforation during forced duction testing of the superior oblique muscle.

This is a report a case of presumed scleral perforation during globe retropulsion as part of the Guyton exaggerated traction test in a patient with a history of bilateral keratoconus and scleral thinning. Perforation was indicated by the sudden occurrence of hyphema and globe softening. Postoperatively, the hyphema resolved, the intraocular pressure normalized, and the patient regained preoperative visual acuity.