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Traumatic Globe Luxation With Chiasmal Avulsion.

Sandy Wenting Zhou1, Audrey Yuan Ching Pang, Eugenie Wei Ting Poh

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Journal of Neuro-Ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society
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A rare case of traumatic globe luxation resulted in optic chiasm avulsion. Temporal hemianopia in the unaffected eye suggests a concomitant chiasmal injury, highlighting the need for prompt imaging and visual field testing.

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Area of Science:

  • Ophthalmology
  • Neurology
  • Trauma Surgery

Background:

  • Traumatic globe luxation is a severe ocular injury.
  • Optic chiasmal avulsion is a rare but devastating complication.

Observation:

  • A 28-year-old woman sustained left globe luxation and optic chiasm avulsion from a penetrating orbital injury.
  • Automated visual field testing revealed temporal hemianopia in the unaffected right eye.
  • Magnetic Resonance Imaging (MRI) confirmed the optic chiasm avulsion.

Findings:

  • The case highlights an unusual mechanism of injury involving a stiletto heel.
  • The presence of temporal hemianopia in the fellow eye is a critical indicator of chiasmal involvement.
  • MRI is essential for diagnosing optic chiasm avulsion.

Implications:

  • Perimetry and MRI are crucial diagnostic tools in traumatic globe luxation.
  • Early identification of chiasmal injury can guide management and prognosis.
  • This case expands the understanding of traumatic optic neuropathy mechanisms.