Traumatic optic neuropathy with combined central retinal artery occlusion (CRAO) and central retinal vein occlusion (CRVO) following blunt ocular trauma

Abstract

A 22-year-old patient came to the emergency department with complaint of severe loss of vision of the left eye following a road traffic accident. He sustained a lacerated injury in the lower lid of left eye with surrounding bruise. External ocular examination revealed subconjuctival hemorrhage, fixed and non-reacting pupil in the left eye. Fundus examination showed pale optic disc, white-out retina and a cherry red spot at the macula in left eye. On the next day fundus examination showed extensive flame shaped and preretinal hemorrhages. A clinical diagnosis of traumatic optic neuropathy with combined central retinal arterial occlusion (CRAO) and central retinal vein occlusion (CRVO) was made. Combined CRAO and CRVO is rare. Our case is the second reported case in English literature of combined CRAO and CRVO following blunt ocular trauma. CRAO and CRVO is a rare disease usually found in patients with cardiac embolic diseases, giant cell arteritis, or systemic vascular inflammations.