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Case Reports
. 2022 Jun 29;52(3):216-219.
doi: 10.4274/tjo.galenos.2022.05860.

Sheath-Preserving Complete Optic Nerve Avulsion Following Closed-Globe Injury: A Case Report

Seray Şahin  1 , Onur Furundaoturan  1 , Mine Esen Barış  1 , Elif Demirkılınç Biler  1
Affiliations
Case Reports

Sheath-Preserving Complete Optic Nerve Avulsion Following Closed-Globe Injury: A Case Report

Seray Şahin et al. Turk J Ophthalmol. .

Abstract

A 29-year-old man presented with a sudden loss of vision after a closed-globe injury. At presentation, he had no light perception in the right eye and the right pupil was dilated and nonreactive to light. On ophthalmological examination, the area of the optic nerve head was excavated, suggesting optic nerve avulsion. Magnetic resonance imaging scan showed optic nerve avulsion without rupture of the optic nerve sheath. Four months after the injury, the patient's visual acuity remained unchanged. Gliosis developed at the avulsion site. Closed-globe injuries may cause severe posterior injury even if there is no anterior damage in the eye. To prevent unnecessary treatment, trauma patients should be examined carefully appropriate imaging to confirm the diagnosis.

Keywords: Traumatic optic nerve avulsion; closed globe injuries; complete optic nerve avulsion; optic nerve sheath.

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Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1
Image of total optic nerve avulsion showing an empty optic disc, vitreous hemorrhage, and ischemic retina
Figure 2
Figure 2
Initial computed tomography scan showing optic nerve avulsion (red arrow) without rupture of the optic nerve sheath and posttraumatic pneumocephalus (yellow arrow)
Figure 3
Figure 3
T1-weighted axial MRI and T2-weighted sagittal MRI showing the site of optic nerve avulsion (red arrows) and pneumocephalus (yellow arrow) MRI: Magnetic resonance imaging
Figure 4
Figure 4
Gliosis developed months after the incident
See this image and copyright information in PMC

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