Partial Optic Nerve Evulsion

ABSTRACT

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.