Presentation
Presented to the ER post-fall while riding a bicycle.
Patient Data
Mild left-sided proptosis with a divergent gaze associated with complete transection of the intra-orbital segment of the left optic nerve. There are medially displaced fractures of the left lamina papyracea.
The MRI study confirms complete transection of the left optic nerve, which appears thickened, edematous, and deviated laterally. Optic disc swelling is also noted. There is left proptosis and a divergent gaze secondary to edematous, swollen intra-orbital fat. Small herniation of intra-orbital fat into the paranasal sinuses via a lamina papyracea fracture.
Case Discussion
Complete transection of the optic nerve is a rare complication of blunt trauma. The disruption of the nerve usually occurs at the level of orbital apex.
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