title: Attempted bilateral manual enucleation (gouging) during a physical assault.
abstract: OBJECTIVE
  To report a rare, severe case of partial traumatic bilateral enucleation and its assessment and management.
  
  
  METHODS
  Case report and literature review.
  
  
  METHODS
  A report of clinical and imaging findings, surgical procedure, medical treatment, and final outcome.
  
  
  RESULTS
  Complete avulsion of the extraocular muscles and optic nerve resulted in total loss of vision in one eye. Partial visual recovery was achieved by operating on the fellow eye, which was partially avulsed. Both eyes underwent lateral canthotomy in the emergency room. This was followed by exploration, repair of all ruptured extraocular muscles, and anterior chamber tap under general anesthesia. The few previously reported cases of traumatic manual avulsion of the globe are reviewed and discussed in the context of the present case.
  
  
  CONCLUSIONS
  Partial visual recovery can be achieved after severe orbital and optic nerve trauma. A multidisciplinary approach to the assessment and management of these patients is recommended.
authors.affiliation: Department of Ophthalmology, Soroka Medical Center, Faculty of the Health Sciences, Ben Gurion University of Negev, Beer Sheva, Israel 84101. roni@brgmail.bgu.ac.il
authors.forename: Marina
authors.initials: M
authors.lastname: Shneck
authors.forename: Tzafrir
authors.initials: T
authors.lastname: Oshry
authors.forename: Mira
authors.initials: M
authors.lastname: Marcus
authors.forename: Tova
authors.initials: T
authors.lastname: Lifshitz
mesh_terms: D000328:Adult; D002829:Choroid / Q000293:injuries* / Q000473:pathology; D015353:Eye Enucleation; D005131:Eye Injuries / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D009801:Oculomotor Muscles / Q000293:injuries* / Q000473:pathology; D020221:Optic Nerve Injuries / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D019315:Retrobulbar Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D012421:Rupture; D014057:Tomography, X-Ray Computed; D014754:Violence