Traumatic Optic Nerve Avulsion Research Articles

The Utility of Ocular Imaging in Traumatic Optic Nerve Avulsion: A Case Report

Objective: To describe a detailed presentation and the utility of ocular imaging, both ocular ultrasound and orbital computed tomography (CT), to confirm the diagnosis of traumatic ONA in which megadose steroid would give no advantage. Case Presentation: A five-year-old boy came with a unilateral sudden visual loss after incidentally falling with his left eye struck to a handlebar of a parked bicycle. His left eye had no light perception, ophthalmoplegia, and showing 4+ relative afferent pupillary defect. A hallmark "pit" sign and a pale retina without a tear were noted. B-scan ocular ultrasound displayed retinal step sign, vitreous hemorrhage in front of the optic canal, lamina cribrosa defect, edematous retina, and retracted optic nerve. Orbital computed tomography scan showed a disruption of the optic nerve-globe junction. Steroid infusion was decided not to be given. Conclusion: Ocular imaging, especially ultrasound, along with a thorough examination, is satisfactorily adequate to confirm the diagnosis of traumatic ONA.

Traumatic optic nerve avulsion in indoor sport: A case report

Optic nerve head avulsion is a rare complication of ocular blunt trauma usually seen in outdoor sport. The case reported is a 19-year old male presented due to sudden loss of vision in right eye following injury by jumped off dice while playing carom board. On examination visual acuity was light perception and fundus showed vitreous hemorrhage and deep seated optic nerve head. As visual recovery was unlikely, he advised to follow up after one month after explaining prognosis. We emphasis to suspect optic nerve avulsion in indoor sport injury and early diagnosis to prevent unnecessary treatment.

Unilateral Traumatic Optic Nerve Avulsion: A Case Report

Optic nerve avulsion is a rare presentation of ocular injury. We present a case of a male mechanic who sustained luxation of the globe and optic nerve avulsion as a result of ocular injury from a car antenna while at work. He became blind in that eye with a final visual acuity of no perception of light. The use of protective goggles at work is recommended.

Bilateral traumatic optic nerve avulsion in a Thoroughbred gelding

SummaryThis report describes an unusual case of acute blindness following traumatic head injury in a mature horse. The horse fell over backwards and subsequently presented with bilateral blindness and epistaxis. Vision did not return following medical supportive therapy and euthanasia was elected. Post mortem findings revealed a basisphenoid fracture and bilateral optic nerve avulsion rostral to the optic chiasm, an uncommon presentation of traumatic blindness not previously reported in the horse.

Traumatic optic nerve avulsion: A case report

Case report of a traumatic optic nerve avulsion. We report the case of a traumatic right optic nerve avulsion in an 11-year-old boy as a result of a contusion with a surfboard. On initial examination, the patient exhibited bilateral mydriasis with a right afferent pupillary defect. Visual acuity was no light perception. A moderate microhyphema was noted along with intraocular pressure of 12mmHg and no open globe. Fundus examination revealed retinal ischemia with white retinal edema, attenuated arteries and segmentally occluded vasculature. In place of the optic nerve, there was a hole with associated vitreous hemorrhage. Non-contrast CT and MRI demonstrated vitreous prolapse into the optic nerve sheath, which still appeared securely attached to the globe. Spectral domain OCT and visual evoked potentials confirmed disruption of the ganglion cell layer. While obvious in the presence of clear media, an avulsion may remain undetected in the case of associated vitreous hemorrhage. Orbital imaging may clarify the diagnosis. Although rare, optic nerve avulsions exhibit the same risk profile as open globe injuries and arterial occlusions.

Longterm follow‐up of children with traumatic optic nerve avulsion

We report the longterm follow-up of children with optic nerve avulsion (ONA) caused by traumatic events. The remarkable differences in courses and outcomes may elucidate the spectrum of ONA-associated symptoms and injuries. During the last 15 years, three children with ONA were referred to our department. These cases are presented with special attention to their longterm follow-up. Two patients suffered from complete ONA after head injury. The third patient presented with partial ONA caused by a bicycle accident. Longterm follow-up varied between 7 and 15 years. In the first patient, a pale swollen retina without any visible retinal vasculature was observed early in the course of follow-up. The retina later completely detached. In the second patient, extended fibroglial scarring occurred and an extremely large epiretinal membrane formed and was finally released spontaneously into the vitreous. The third patient developed only mild fibroglial scarring and retinal pigment epithelium hyperplasia. The optic nerve head in this patient came to resemble a morning glory disc. Optic nerve avulsion can adopt different courses and outcomes in different patients. Final visual outcome seems to depend on the degree of visual acuity immediately after injury. Substantial intraocular architecture changes can occur as a result of ONA.

Avaliação ultra-sonográfica da avulsão do nervo óptico utilizando as sondas de 10 MHz e 20 MHz: relato de caso

Traumatic optic nerve avulsion is a rare event. A case of complete unilateral optic nerve avulsion after blunt ocular trauma without major damage to other ocular structures is reported. B-scan ultrasonography with 10 and 20 MHz probes proved to be helpful in diagnosing the optic nerve lesion, whereas orbital computed tomography was inconclusive. The prognosis is ominous and it is dependent on the initial visual acuity, which was no light perception in this case. There is no efficient treatment for complete optic nerve avulsion, and no specific treatment was performed in this case.

Avulsão traumática do nervo óptico por projétil de arma de fogo de grosso calibre: relato de caso

Traumatic optic nerve avulsion occurs most commonly after blunt ocular trauma. Optic nerve avulsion by high caliber bullet is exceptional and must be thought of in the management of those patients victims of gunshot wounds to the globe and orbit. The present paper reports the first documented case of this singular condition of optic nerve injury and comments on several other related causes, pathophysiology mechanisms, histology and management.

Traumatic optic nerve avulsion and central retinal artery occlusion following rugby injury

Optic nerve avulsion (ONA) secondary to finger gouging is a rare complication. A case is reported of a 14-year-old boy who had an acute loss of vision after being poked in his left eye during a game of rugby union. He was later diagnosed with ONA, and this was associated with central retinal artery occlusion, which was rarely reported in the literature. His progress was complicated by a delayed onset of neovascular glaucoma. This is the first report of ONA secondary to a rugby injury and highlights the need for clinicians to be aware of the potential for loss of sight from gouging.

Traumatic Optic Nerve Avulsion

A 10-year-old boy presented with optic nerve avulsion associated with ptosis and limitation of elevation and adduction secondary to blunt ocular trauma. At the initial examination the funduscopic view was hazy because of concurrent vitreous hemorrhage. Ultrasonography revealed a posterior ocular wall defect and a hypolucent area in the region of the optic nerve head.

Ultrasonography in optic nerve head avulsion

The diagnosis of post traumatic optic nerve avulsion is often obscured by the presence of concomitant vitreous haemorrhage. Electrodiagnostic tests, CT scan and fluorescein angiography have not proved helpful in substantiating the diagnosis of this entity in the early stages. We herein present the echographic features in a case of post traumatic optic nerve avulsion that, to the best of our knowledge, have not been previously described. The role of ultrasonography in the diagnosis of suspected optic nerve head avulsion has been high-lighted.