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Optic nerve avulsion from door-handle trauma in children
  1. I A Chaudhry1,
  2. F A Shamsi2,
  3. A Al-Sharif3,
  4. E Elzaridi4,
  5. W Al-Rashed5
  1. 1Oculoplastic and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia
  2. 2Research Department, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia
  3. 3Department of Ophthalmology, King Saud University, Riyadh, Kingdom of Saudi Arabia
  4. 4Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK
  5. 5Anterior Segment and Oculoplastic and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia
  1. Correspondence to: Imtiaz A Chaudhry MD, PhD, FACS, Oculoplastic and Orbit Division, King Khaled Eye Specialist Hospital, PO Box 7191, Riyadh 11462, Kingdom of Saudi Arabia; orbitdr_kkesh{at}yahoo.com

Abstract

Aim: To report severe visual loss caused by optic nerve avulsion (ONA) in children with door-handle trauma.

Methods: Clinical records at a tertiary eye care hospital, of 14 children who sustained severe visual loss as a result of door-handle injuries, were reviewed. The data were analysed for location, presenting symptoms and signs, diagnostic studies, intervention, and the cause of visual loss.

Results: There were 11 males and three females with an average age of 8 years and an average height of 125 cm. The place of trauma was home in 11 and school in three children. Presenting visual acuity (VA) was light perception (LP) in five patients and no light perception (NLP) in nine. All the 14 children had evidence of ONA and four patients had ruptured eye globes that required initial repair. The diagnosis of ONA was made clinically or by imaging studies and confirmed histopathologically in eyes that were enucleated. Average follow up was 28.8 months (range 4 months to 8 years). Final VA was LP in one patient and NLP in 13 patients, eight eyes required enucleation for painful blind eye or to achieve optimal cosmesis.

Conclusion: ONA was the common cause of visual loss in children who sustained ocular trauma caused by door-handles.

  • CT, computed tomography
  • LP, light perception
  • MRI, magnetic resonance imaging
  • NLP, no light perception
  • ON, optic nerve
  • ONA, optic nerve avulsion
  • US, ultrasonography
  • VA, visual acuity
  • VEP, visual evoked potential
  • VER, visual evoked response
  • optic nerve
  • avulsion
  • children
  • trauma
  • CT, computed tomography
  • LP, light perception
  • MRI, magnetic resonance imaging
  • NLP, no light perception
  • ON, optic nerve
  • ONA, optic nerve avulsion
  • US, ultrasonography
  • VA, visual acuity
  • VEP, visual evoked potential
  • VER, visual evoked response
  • optic nerve
  • avulsion
  • children
  • trauma

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