Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India.
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India.
Med Hypotheses. 2019 Apr;125:28-30. doi: 10.1016/j.mehy.2019.02.031. Epub 2019 Feb 11.
Optic nerve avulsion following peri-orbital trauma is an enigmatic clinical entity. Several mechanisms and ideas have been put forward to derive a logical conclusion, however, each factor independently does not appear to explain the mechanism in a logical way, therefore, here we elaborate the probable chain of events responsible for this complication. During isolated blunt trauma to the orbital framework, the globe continues to move anteriorly without any active resistance, in contrast to the globe, the optic nerve with more delicate bony and soft tissue relations, likely to remain relatively static. Thus the junction between the optic nerve and ocular coat suffers the maximum distractive injury due to anteroposterior tractional forces. In addition to this, physiological Bell's phenomenon may induce torsional tension at this junction leading to further worsening of distractive forces and violent separation of optic nerve from the globe.
眼眶外伤后视神经撕脱是一种神秘的临床实体。已经提出了几种机制和想法来得出一个合乎逻辑的结论，然而，每个因素本身似乎并不能以合乎逻辑的方式解释这种机制，因此，在这里我们详细阐述了可能导致这种并发症的一系列事件。在孤立的眼眶结构钝挫伤中，眼球在没有任何主动阻力的情况下继续向前移动，与眼球相反，视神经具有更精细的骨和软组织关系，可能保持相对静止。因此，视神经和眼膜交界处由于前后牵引力而承受最大的分离损伤。除此之外，生理性贝尔现象可能在此交界处引起扭转张力，导致分离力进一步恶化，视神经与眼球剧烈分离。
