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Year : 2018  |  Volume : 66  |  Issue : 7  |  Page : 1003

Traumatic optic nerve head avulsion: Multimodal imaging

Department of Vitreoretina, Giridhar Eye Institute, Kochi, Kerala, India

Date of Web Publication25-Jun-2018

Correspondence Address:
Prashant Jain
Department of Vitreoretina, Giridhar Eye Institute, Kochi, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijo.IJO_147_18

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How to cite this article:
Jain P, Gopalakrishnan M, Anantharaman G. Traumatic optic nerve head avulsion: Multimodal imaging. Indian J Ophthalmol 2018;66:1003

How to cite this URL:
Jain P, Gopalakrishnan M, Anantharaman G. Traumatic optic nerve head avulsion: Multimodal imaging. Indian J Ophthalmol [serial online] 2018 [cited 2020 Jul 10];66:1003. Available from: http://www.ijo.in/text.asp?2018/66/7/1003/234969

A 6-year-old boy presented with sudden vision loss after close globe injury with iron rod. Best-corrected visual acuity (BCVA) was Perception of light (PL). Fundus examination showed an area of the optic nerve head (ONH) excavation and filled with hemorrhage with blood emanating into the vitreous [Figure 1]a. The patient underwent MRI orbit which confirms the diagnosis of ONH avulsion. The patient received intravenous steroids, but partial avulsion converted into full [Figure 1]b with BCVA no PL. Optical coherence tomography showed avulsion at ONH section [Figure 1]c. An area of hypolucency on ultrasound was seen at ONH section [Figure 1]d.
Figure 1: (a) Multicolor photo showing partial optic nerve head avulsion with hemorrhage around disc and emanating into vitreous; (b) complete avulsion after three days of presentation; (c) avulsion at optic nerve head section on optical coherence tomography (yellow arrow); (d) an area of hypolucency on B scan at optic nerve head section (white arrow)

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Avulsion of the ONH is a rare complication of ocular trauma. The damage suggests mechanisms involving explosive rise in intraocular pressure blowing nerve off the sclera into its dural sheath which is responsible for visual impairments.[1],[2]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Hillman JS, Myska V, Nissim S. Complete avulsion of the optic nerve. A clinical, angiographic, and electrodiagnostic study. Br J Ophthalmol 1975;59:503-9.  Back to cited text no. 1
Balla L, Ianovici N, Costin D. Pathology of the optic nerve injury. Rev Med Chir Soc Med Nat Iasi 2012;116:1087-90.  Back to cited text no. 2


  [Figure 1]


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