Vitreous Hemorrhage Following Blunt Ocular Trauma by a Cat's Forepaw: A Case Report and Literature Review.

Traumatic vitreous hemorrhage is most commonly associated with sports injuries or accidental falls. We report an exceptionally rare case of vitreous hemorrhage presumed to result from blunt trauma inflicted by the forepaw of a domestic cat. A 50-year-old man presented with blurred vision and ocular pain in his right eye after being struck by his pet cat. Initial examination revealed an uncorrected visual acuity of 20/200 in the right eye, which improved to 20/25 with correction. Intraocular pressure (IOP) was measured at 16 mmHg in the right eye and 17 mmHg in the left. Slit-lamp and fundoscopic examinations revealed subconjunctival hemorrhage, subretinal hemorrhage, and vitreous hemorrhage in the right eye, with no signs of iritis or other indications of cat scratch disease. Based on these findings, the condition was diagnosed as an intraocular hemorrhage due to blunt ocular trauma. Conservative management was initially pursued; however, because of persistent vitreous opacity, cataract progression, and elevated intraocular pressure (30 mmHg), combined phacoemulsification and pars plana vitrectomy were performed seven months post-injury. Postoperative recovery was favorable, with corrected visual acuity improving to 20/16 and intraocular pressure stabilizing between 14 and 16 mmHg. A comprehensive review of the literature identified 11 previously reported cases of ocular trauma caused by domestic cats, documented in seven separate reports. All involved penetrating globe injuries from cat claws, and no cases of blunt trauma caused by a cat's forepaw were found. This case, therefore, represents, to our knowledge, the first report of such a mechanism. It highlights that even seemingly benign interactions with domestic animals can lead to significant ocular injury. Although uncommon, this case suggests that even benign interactions with domestic animals may pose a risk for ocular trauma, and clinicians should remain vigilant in assessing such presentations.