Mechanisms responsible for retinal break formation in closed globe injury may be as follows: vitreous base avulsion, abnormal sites of vitreoretinal adhesion (e.g., lattice degeneration), coup injury
, contrecoup injury at a location opposite to the site of impact, or sudden posterior vitreous detachment induction .
According to a hypothesis from Banitt et al., (3) isolated anterior lens capsule tear secondary to blunt trauma probably occurs as a result of the rapid focal indentation of the cornea onto the lens (coup injury
) or a rebound effect secondary to the trauma in which the vitreous applies high pressure to the lens (countrecoup injury).
It can occur both as coup and contre coup injury
with predeliction for both being the same.
This coup injury
can result in fracturing of the skull, subdural and epidural haematomas and contusion of the underlying brain tissue.
Direct suppression effect towards the cornea may provide a rapid focal collapse over the lens (coup injury) or a quick rebound of the vitreous directed from posterior to anterior causes fluid-mechanical forces that may lead to a rupture of the anterior capsule (contrecoup injury).
(3) We think that the tear of the anterior capsule was likely related to the coup injury, and the rebound of fluid-mechanical forces (contrecoup injury) is probably responsible for the enlargement of the capsule tear.