Abstract
Fat embolismsyndrome is a rare complication following a long bone fracture. It is believed to be caused by the toxic effects of free fatty acids and is clinically characterized by the triad of dyspnea, petechiae and mental confusion. Ocular fat embolism syndrome in the complete absence of any cardiac defects is a rare phenomenon which is not commonly encountered in ophthalmic practice. The authors present a case of fat embolism syndrome with the uncommon finding of bilateral embolism of the central retinal artery after a single femoral fracture without evidence of cardiac defect.
Highlights
Fat Embolism (FE) develops in 90% of all bone fractures
The authors present a case of fat embolism syndrome with the uncommon finding of bilateral embolism of the central retinal artery after a single femoral fracture without evidence of any cardiac defect
Fat embolism is the presence of fat particles within the microcirculation, while Fat Embolism Syndrome (FES) is the systemic manifestation of fat emboli within the microcirculation
Summary
Fat Embolism (FE) develops in 90% of all bone fractures. Fat Embolism Syndrome (FES) is a serious manifestation of FE with an incidence of 0.5-2.0% among all long bone fractures. The authors present a case of fat embolism syndrome with the uncommon finding of bilateral embolism of the central retinal artery after a single femoral fracture without evidence of any cardiac defect. The combination of long-bone fracture, petechial rash, hypoxemia and tachycardia within 24 hours after the accident prompted a diagnosis of FES. This patient was admitted to an Intensive Care Unit (ICU) and was managed conservatively till surgery. Fundoscopy showed Cotton-Wool Spots (CWS) along the major blood vessels and in the macular area, as well as hemorrhages in both eyes These findings are consistent with bilateral embolization of central retinal artery. One year after the accident, he presented with 0.2 visual acuity in his right eye and 0.8 in his left eye, while bilateral CWS were still clearly visible on fundoscopy
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