A 28-year-old myope presents shortly after blunt trauma with blurred vision. Slit-lamp examination reveals fine pigmented cells suspended in the anterior vitreous. What is the significance of this finding?
- A It is a benign consequence of vitreous liquefaction
- B It indicates a retinal break until proven otherwise ✓
- C It signals early proliferative vitreoretinopathy
- D It suggests traumatic uveitis requiring steroids
Correct answer: B. It indicates a retinal break until proven otherwise
Explanation
Pigmented cells ('tobacco dust') in the anterior vitreous constitute a positive Shafer sign, produced by disruption of the retinal pigment epithelium at a retinal tear. It is one of the strongest clinical indicators of a retinal break and mandates careful indirect ophthalmoscopy with scleral indentation to locate the tear. Vitreous liquefaction produces floaters without pigment, PVR develops late with membranes rather than free pigment, and traumatic uveitis shows inflammatory cells and flare rather than pigment granules.
Reference: Kanski's Clinical Ophthalmology, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.