Initial management of a choroidal rupture after blunt trauma is to do what?

• A. Monitor for resolution and monitor for CNV
• B. Initiate aggressive steroid therapy
• C. Immediate laser photocoagulation
• D. Surgical repair of choroid

Answer: (A)

Observation with vigilant monitoring for choroidal neovascularization is the best initial approach after a choroidal rupture from blunt trauma. The rupture itself may stabilize without specific treatment, and the major late risk is CNV, which can develop weeks to months later and threaten central vision. Therefore, initial care focuses on establishing a baseline and scheduling follow-up with dilated exams and imaging (like OCT and fluorescein angiography) to detect CNV early. If CNV is detected, the standard treatment is intravitreal anti-VEGF therapy. More aggressive options such as steroids, immediate laser photocoagulation, or surgical repair are not indicated initially because they do not prevent CNV and can cause additional damage; those interventions may be considered only for specific complications or later decisions, not as first-line management.