Elkbuli Adel, Meneses Evander, Kinslow Kyle, McKenney Mark, Boneva Dessy
Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA.
Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA.
Int J Surg Case Rep. 2020;75:231-234. doi: 10.1016/j.ijscr.2020.09.087. Epub 2020 Sep 15.
Ocular trauma is a common occurrence in trauma settings but often occurs with little to no effect on the vision of the patient. Traumatic enucleation is a rare but devastating injury.
A 40-year-old male presented to our trauma center after an assault resulting in right globe enucleation. CT confirmed absence of the globe with disruption of the ipsilateral orbital contents and distal optic nerve disruption. The patient was started on intravenous antibiotics and the right orbit was packed. He was taken to the operating room for exploration of the right orbit and placement of an implant. His remaining hospital course was unremarkable.
Documented mechanisms of injury for traumatic enucleation are diverse, but often involve significant retro-ocular force to completely dislodge the globe from the orbit. Optic nerve avulsion may cause associated optic nerve chiasm damage leading to temporal hemianopia in the uninjured contralateral eye. Treatment involves stabilization and preparation for future implant placement.
Traumatic enucleation is extremely rare. Development of a grading system applicable to traumatic enucleation may be helpful in guiding management in this complex patient population.
眼外伤在创伤环境中很常见，但对患者视力的影响通常很小或没有影响。外伤性眼球摘除是一种罕见但极具破坏性的损伤。
一名40岁男性在遭受袭击后被送往我们的创伤中心，导致右眼眼球摘除。CT证实眼球缺失，同侧眼眶内容物中断，远端视神经中断。患者开始静脉注射抗生素，并对右眼眶进行填塞。他被送往手术室进行右眼眶探查和植入物植入。他在医院的其余病程无异常。
外伤性眼球摘除的记录损伤机制多种多样，但通常涉及显著的眼球后力量，以将眼球完全从眼眶中移出。视神经撕脱可能导致相关的视神经交叉损伤，导致未受伤的对侧眼出现颞侧偏盲。治疗包括稳定病情并为未来植入物植入做准备。
外伤性眼球摘除极为罕见。开发一种适用于外伤性眼球摘除的分级系统可能有助于指导这一复杂患者群体的管理。
