Posterior retinal trauma caused by the distal needle tip is seldom considered when performing intravitreal injections. We present a case of posterior retinal injury (A-B) after intravitreal injection in a short eye with axial length below 21.4 mm, which was subsequently complicated by proliferative vitreoretinopathy. The procedure was performed by a highly experienced injector who had done over 10,000 intravitreal injections. A 30 G needle 13 mm in length was inserted 3.5 mm from the limbus. This injury was attributed to full insertion of the needle, as well as incorrect hand position, resulting in a temporal, rather than posterior, trajectory of the needle. This decreases the distance from the site of needle insertion to the retina and may therefore cause retinal trauma in the midperiphery of short eyes (demonstrated in C).