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Ultrasonographic Signs in Complete Optic Nerve Avulsion
Scott C. N. Oliver, MD;
Naresh Mandava, MD
Arch Ophthalmol. 2007;125(5):716.
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A 13-year-old boy sustained injury with a metal pipe to his right eye. The patient had no light perception in his right eye and visual acuity was 20/25 OS. A 4+ right afferent pupillary defect, normal intraocular pressures, chemosis, subconjunctival hemorrhage, and iritis were seen.
Dilated funduscopy (Figure 1) revealed avulsion of the right optic nerve and temporal retina. Vascular boxcarring was laid over pale, edematous retinal tissue. A dense hemorrhage obscured the nasal fundus.
Figure appears in full text version.
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Figure 1. Fundus photograph of the right eye revealed a pit where the avulsed optic nerve should be (asterisk), a pale edematous retina (arrow), an exposed bare sclera (dot), vascular boxcarring, intraretinal and preretinal blood, and a vitreous hemorrhage (arrowheads).
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B-scan ultrasonography (Figure 2) displayed a retinal step sign, indicating the transition from an edematousretina to a bare choroid. Multiple sections through the . . . [Full Text of this Article] COMMENT
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