ABSTRACT
PURPOSE: The authors report a case of optic nerve evulsion with literature review. METHOD: 15-year-old boy, who had optic nerve evulsion by tear of inferior rectus and medial rectus muscles, and hypotony by retinal and choroidal detachment RESULTS: we could preserve the eyeball with normal pressure by pars plana vitrectomy, endolaser photocoagulation and silicone oil injection
Subject(s)
Adolescent , Humans , Male , Choroid , Light Coagulation , Muscles , Optic Nerve Injuries , Optic Nerve , Retinaldehyde , Silicone Oils , VitrectomyABSTRACT
Optic nerve evulsion is a visually devastating and rare manifestation resulting in sudden visual loss after ocular trauma. The several hypothesis of mechanism include penetrating orbital injury causing a backward pull on the optic nerve, extreme rotation and forward displacement of the globe, and sudden increase in intraocular pressure causing rupture of the lamina cribrosa. The authors report a case of optic nerve evulsion in a 25- year old man who was struck in the right eye with a umbrella. The diagnosis was made by fundoscopic findings, fluorescein angiography, visual evoked potential, electroretinography, orbit computed tomography and magnetic resonance image.
Subject(s)
Diagnosis , Electroretinography , Evoked Potentials, Visual , Fluorescein Angiography , Intraocular Pressure , Optic Nerve , Orbit , RuptureABSTRACT
Optic nerve evulsion is a devastating, uncommon cause of sudden visual loss following major head trauma. Less frequently, it is associated with pointed non penetrating orbital injuries with minimal ocular trauma. Possible mechanisms of injury include extreme rotation and forward displacement of the globe, penetrating orbital injury causing a backward, pull on the optic nerve, and sudden increase in intraocular pressure causing rupture of the lamina cribrosa. Funduscopic examination may reveal total or partial lack of the optic disc and variable degrees of intraocular hemorrhage. Fluorescein angiographic finding is variable, visually evoked potential often shows the delay in latency or the decrese in amplitude, Computed tomography or magnetic resonance imaging usually demonstrates an intact optic nerve sheath. We report a case of optic nerve evulsion which diagnosed by retinoscopic finding, fluorescein angiography, computed tomography, and clinical history. We present it with a review of the literature.