Avulsed Eye and Optic Nerve Displaying Little Evidence of Trauma

Abstract

A 68-year-old man collided with a parked car while riding a bicycle, losing all vision in his right eye but not consciousness. Emergency responders found his eye and 4.7 cm of optic nerve lying near him (Fig 1A). The patient had bilateral frontal and parietal subdural hematomas, and a forehead laceration. There were no lacerations of the lids, or fractures of facial or cranial bones. The eye had a 3 to 8 mm skirt of conjunctiva attached at the limbus. The recti muscles were severed 4 to 8 mm from their insertions, and superior oblique at 24 mm. Other than mild autolytic changes, age-related cataract, and retinal drusen, gross and microscopic examinations of the eye (Fig 1B) and optic nerve (Fig 1C) were unremarkable. There were no hemorrhages. The lens was in its normal position and the retina attached.