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Etlik City Hospital, Department of Ophthalmology, Ankara, Turkiye DOI : 10.37844/TJ-CEO.2026.21.16 Blunt ocular trauma may cause acute and persistent intraocular pressure (IOP) elevation through hyphema, inflammation, trabecular injury, and angle recession. A 36-year-old man presented after a paintball injury to the left eye with visual acuity of hand motions and an IOP of 45 mmHg. Examination revealed minimal hyphema, a Vossius ring with an associated membranous appearance, and dense vitreous hemorrhage. After hyphema resolution, gonioscopy demonstrated discontinuous angle recession involving all four quadrants, with a cumulative extent of approximately 240°. One month after injury, progressive traumatic lens opacity and persistent vitreous hemorrhage necessitated combined phacoemulsification, intraocular lens implantation, and pars plana vitrectomy. Early postoperatively, IOP increased to 32 mmHg and additional topical therapy was initiated after ocular inflammation had subsided. At the third postoperative month, IOP was 15 mmHg and all antiglaucomatous medications were discontinued; one month later, untreated IOP increased to 26 mmHg. Once-daily carteolol hydrochloride 2% reduced IOP to 17 mmHg at the 6-month postoperative visit. Final visual acuity was 20/400, limited mainly by traumatic macular and outer retinal damage. Serial retinal nerve fiber layer optical coherence tomography showed a persistent inferior abnormality without unequivocal progression, while visual field interpretation was limited by retinal damage and reduced vision. In the absence of definite glaucomatous optic neuropathy, the patient was classified as having persistent post-traumatic ocular hypertension associated with extensive angle recession. Long-term IOP and optic nerve monitoring are essential after blunt ocular trauma. Keywords : angle recession, ocular hypertension, gonioscopy, ocular trauma, paintball injury