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Gaze-evoked amaurosis produced by intraorbital buckshot pellet
H V Danesh-Meyer1, P J Savino, J R Bilyk
1Neuro-ophthalmology Service, Wills Eye Hospital, Thomas Jefferson Medical College, Philadelphia, Pennsylvania, USA.
Objective:
To report the first case of gaze-evoked amaurosis secondary to an intraocular foreign body and to highlight the characteristic clinical findings of patients with this symptom.
Design:
Case report and review of the literature.
Methods:
Case review, clinical history, electrophysiologic testing, and follow-up.
Main Outcome Measures:
Visual acuity, automated perimetry, and visual fields.
Results:
A case of gaze-evoked amaurosis as a result of an intraorbital foreign body is described, and 19 additional cases of gaze-evoked amaurosis are reviewed from the English language literature. These cases share certain characteristics including good vision in primary position with deterioration of vision in eccentric gaze; concurrent objective pupillary abnormalities in eccentric gaze; stereotypic onset and recovery of vision; and funduscopic abnormalities consisting of disc edema and chorioretinal folds.
Conclusions:
Gaze-evoked amaurosis is a reliable sign of intraconal mass lesion. We report the first case of gaze-evoked amaurosis secondary to an intraorbital foreign body.
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