[Traumatic lesion of the optic nerve head by flying fish: a case report].
BACKGROUND
Traumatic lesion to the optic nerve often leads to severe and persistent functional loss.


METHODS
A male patient was transferred to our hospital from the University Eye Clinic of Guadeloupe 5 days after ocular injury caused by a flying fish. Visual function was light perception. The anterior part of the eye and retina were unremarkable. A computer tomography disclosed a fracture of the sphenoid sinus, with a little bone fragment (DD: foreign body) located close to the optic nerve.


RESULTS
Therapy had been started with Aminopenicillin combined with clavulan acid (Augmentin) i. v., 500 ml methylprednisolone (Solumedrol) i. v., lysine-acetyl salicylate (Aspegic) and topical application of dexamethasone combined with neomycin/polymyxin B (Maxitrol). We continued this therapy and intensified it by adding nimodipine (Nimotop) 30 1-1-1 and acetazolamide retard (Diamox sustet) 1-0-1. Unfortunately visual function did not recover under therapy.


CONCLUSIONS
Traumatic lesions of the optic nerve head, especially when due to axial or tangential forces, can lead to severe and irreversible functional loss. Severe traumatic lesions, even bone fractures induced by flying fish are not a seldom encounter in the Caribbean Sea.
Martin
M
M
Universitätsaugenklinik, Kantonsspital Basel, Basel, Schweiz. martinmichael@gmx.net
Orgül
S
S
Robertson
A
A
Flammer
J
J
D000086:Acetazolamide / Q000627:therapeutic use; D000328:Adult; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000818:Animals; D003288:Contusions / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D003907:Dexamethasone / Q000627:therapeutic use; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D005129:Eye Foreign Bodies / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D005131:Eye Injuries / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D005399:Fishes; D005451:Fluorescein Angiography; D005477:Fluprednisolone / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D009355:Neomycin / Q000627:therapeutic use; D009553:Nimodipine / Q000627:therapeutic use; D009898:Optic Disk / Q000293:injuries*; D011112:Polymyxin B / Q000627:therapeutic use; D012887:Skull Fractures / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D013101:Sphenoid Sinus / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D014792:Visual Acuity
D004338:Drug Combinations; D009553:Nimodipine; D019980:Amoxicillin-Potassium Clavulanate Combination; C049064:Maxitrol; D003907:Dexamethasone; D005477:Fluprednisolone; D009355:Neomycin; D011112:Polymyxin B; D000086:Acetazolamide; D008775:Methylprednisolone