Pérez-Salvador GE, Pérez SJL

Language: Spanish
References: 15
Page: 215-218
PDF size: 216.03 Kb.

ABSTRACT

Introduction: Total avulsion of the optic nerve is an infrequent but serious complication after trauma, and is difficult to evaluate because of the existence of opacity of the media and this is sometimes even so with modern neuroimage studies.
Case report: The case of a 25-year-old male who received an accidental blow in the left eye with a tractor tow-hook is presented. The ophthalmologic evaluation reported no light perception in the left eye, non-reactive mydriasis and normal intraocular pressure. The funduscopy showed a pre-retinal and peripapillary hemorrhage and retinal ischemia (cherry-red-spot). Skull tomography showed destruction of the proximal part of the optical nerve, without bone splintering. The real extension of the lesion of the optical nerve was not clear. The Eco-Doppler showed flows in both ophthalmic arteries with similar characteristics. Intravenous treatment with 1 gram per day of methylprednisolone was prescribed for 7 days with a gradual decrease of the dose, without any evident improvement. Both the electroretinogram and the visual evocated potentials in the left eye were abolished. A total avulsion of the optic nerve of the left eye was diagnosed.
Conclusion: Electrophysiological studies as electroretinogram and visual evocated potential testing may be indispensable in those cases in which the opacity of the media or neuroimage tests do not allow us to evaluate up to what point the optic nerve is affected in order to establish a visual prognosis.

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