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Dissection along the optic nerve axis by a BB

T A Dinkel1, T P Ward, D M Frey

  • 1Ophthalmology Services, Walter Reed Army Medical Center, Washington, DC, USA.

Archives of Ophthalmology (Chicago, Ill. : 1960)
|May 1, 1997
PubMed
Summary
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A BB caused a perforating eye injury in a young boy, lodging within the optic nerve sheath. This rare case highlights the challenges of removing intraorbital foreign bodies and their potential impact on vision.

Area of Science:

  • Ophthalmology
  • Traumatic Eye Injury
  • Ophthalmic Pathology

Background:

  • Perforating ocular injuries require prompt evaluation and management.
  • Intraorbital foreign bodies, particularly those involving the optic nerve, present unique surgical challenges.

Observation:

  • A 13-year-old male sustained a perforating right eye injury from a BB.
  • Initial examination revealed poor light perception and a retrobulbar foreign body on CT scan.
  • A subsequent vitrectomy was unsuccessful in retrieving the foreign body.

Findings:

  • The BB traversed the globe and entered the optic nerve head.
  • The foreign body was ultimately located within the optic nerve sheath.
  • Histopathologic examination confirmed the BB's intraorbital and optic nerve location.

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Implications:

  • This case underscores the rarity and diagnostic difficulty of intraorbital foreign bodies.
  • Optic nerve involvement poses significant visual risk and complicates surgical intervention.
  • Understanding the trajectory of ocular trauma is crucial for effective patient management.