Agrawal Sahil, Das Deepsekhar, Modaboyina Sujeeth, Singh Pallavi, Samdani Asha, Pushker Neelam
Oculoplasty & Paediatric Ophthalmology Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Clin Exp Optom. 2022 May;105(4):410-413. doi: 10.1080/08164622.2021.1932432. Epub 2021 Jul 28.
Traumatic globe luxation is rare vision-threatening event. Besides causing loss of vision in traumatised eye, it may also cause injury to contralateral optic nerve. Any such limitation in a one-eyed patient can make him crippled in his day-to-day activities. Here we hypothesise cause of contralateral field defect in such patients.
Traumatic globe luxation is a rare event that leads to profound vision loss due to injury of the ipsilateral optic nerve and rarely a visual field defect in the contralateral eye. Through this communication, we report similar case scenarios and intend to hypothesize the mechanism that results in the occurrence of the contralateral visual field defect.
It is a retrospective, observational study. All cases with traumatic globe luxation were enrolled. Visual field analysis of the contralateral normal eye was main outcome measure.
Four patients with traumatic globe luxation and optic nerve injury were studied. There was complete loss of vision in the traumatised eye in all the patients. One patient had complete transection of the optic nerve, whereas in three patients, the course of the optic nerve was intact, on imaging. Three patients had quadrantanopia in the contralateral normal eye for which oral steroids were given. At 1-month follow-up, there was complete recovery of the visual field defect in two patients. We noticed that all the three patients with an intact course of the ipsilateral optic nerve had quadrantanopia in the contralateral normal eye.
We hypothesize that in scenarios where globe luxation is associated with incomplete transection or no transection of the optic nerve, a continuous long standing stretch on the optic nerve, transmits the pulling force to the chiasma which might result in a contralateral field defect as compared to those associated with the complete transection of the optic nerve.
外伤性眼球脱位是一种罕见的、威胁视力的事件。除了导致受伤眼失明外，还可能导致对侧视神经损伤。独眼患者出现的任何此类功能受限都可能使其日常活动受到严重影响。在此，我们对这类患者对侧视野缺损的原因提出假说。
外伤性眼球脱位是一种罕见事件，可因同侧视神经损伤导致严重视力丧失，对侧眼很少出现视野缺损。通过本交流，我们报告类似病例情况，并打算对导致对侧视野缺损发生的机制提出假说。
这是一项回顾性观察研究。纳入所有外伤性眼球脱位病例。主要观察指标是对侧正常眼的视野分析。
研究了4例外伤性眼球脱位合并视神经损伤的患者。所有患者受伤眼均完全失明。1例患者视神经完全横断，而在另外3例患者中，影像学检查显示视神经走行完整。3例对侧正常眼出现象限盲，给予口服类固醇治疗。在1个月的随访中，2例患者的视野缺损完全恢复。我们注意到，同侧视神经走行完整的3例患者对侧正常眼均出现象限盲。
我们推测，在眼球脱位合并视神经不完全横断或未横断的情况下，视神经持续长期受牵拉，将拉力传递至视交叉，与视神经完全横断的情况相比，这可能导致对侧视野缺损。
