Traumatic bilateral optic nerve avulsion in a teen

A 16-year-old boy presented with bilateral vision loss with severe facial and head injuries after a road traffic accident. Vision was no light perception in both eyes. Examination revealed a complete optic nerve avulsion on the right side and a complete optic nerve avulsion with an intact nerve sheath attachment on the left side, confirmed by B-scan ultrasonography and magnetic resonance imaging. Follow-up visits showed extensive posterior pole gliosis in both eyes. This report emphasizes the critical importance of understanding the severity of injury and the underlying pathomechanism of bilateral optic nerve avulsion, which is associated with a uniformly poor visual prognosis.