<prompt> A 20-year old male presents with history of tennis ball injury to the right eye. On examination, a red spot is seen at the macula. The must likely diagnosis is:Macular holeBerlins edemaMacular tearMacular bleed  <response>: Ans. b. Berlins edema Ref: Kanski 7e p882; Khurana 5e p434; Parsons 20e p367A 20-year-old male presents with history of tennis hall injury to the right eye. On examination, a red spot is seen at the macula. The most likely diagnosis is Berlins edema or commotio retinae.Commotio retinae Berlins Edema is of common occurrence following a blow on the eye. It manifests as milky white cloudiness involving a considerable area of posterior pole with a cherry-red spot in the foveal region. It may appear after some days or may be followed by pigmentary changes.- Khurana 5e p434Commotio retinae most frequently affect the temporal fundus. If the macula is involved, a cherry-red spot may be seen at the fovea.- Kanski 7e p882Berlins Edema Commotio RetinaeMost commonly involves temporal fundus occasionally involves macula with a cherry-red spotQ.Subsequent macular change will include progressive pigmentary degeneration and macular-hole formationQ.Commotio retinae are a contrecoup injury to the retina.It can occur centrally or peripherally, and when it involves the macula, it is called Berlins edema.The retina appears normal on examination although the patient may complain of decreased vision.The affected area becomes white and opaque usually hours after the trauma.Berlins edema is not a true edemaQ.Swelling and disorganization of the outer retinal layers causes the opaqueness and there is no intercellular fluidQ.Clinical Features:This occurs in blunt trauma to eye e.g. Tennis ball injury to eye.The visual acuity in commotion retinae varies from 2020 to 20400 and does not always correlate with the degree of retinal opacification.Course and Prognosis:Berlins edema is usually self-limited and resolves without sequelaeThere is no known intervention that alters its course and prognosis. 