Optic nerve avulsion from door-handle trauma in children.
OBJECTIVE
To report severe visual loss caused by optic nerve avulsion (ONA) in children with door-handle trauma.


METHODS
Clinical records at a tertiary eye care hospital, of 14 children who sustained severe visual loss as a result of door-handle injuries, were reviewed. The data were analysed for location, presenting symptoms and signs, diagnostic studies, intervention, and the cause of visual loss.


RESULTS
There were 11 males and three females with an average age of 8 years and an average height of 125 cm. The place of trauma was home in 11 and school in three children. Presenting visual acuity (VA) was light perception (LP) in five patients and no light perception (NLP) in nine. All the 14 children had evidence of ONA and four patients had ruptured eye globes that required initial repair. The diagnosis of ONA was made clinically or by imaging studies and confirmed histopathologically in eyes that were enucleated. Average follow up was 28.8 months (range 4 months to 8 years). Final VA was LP in one patient and NLP in 13 patients, eight eyes required enucleation for painful blind eye or to achieve optimal cosmesis.


CONCLUSIONS
ONA was the common cause of visual loss in children who sustained ocular trauma caused by door-handles.
Chaudhry
I A
IA
Oculoplastic and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia. orbitdr_kkesh@yahoo.com
Shamsi
F A
FA
Al-Sharif
A
A
Elzaridi
E
E
Al-Rashed
W
W
D000059:Accidents; D000061:Accidents, Home; D001766:Blindness / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D002648:Child; D015353:Eye Enucleation; D005131:Eye Injuries / Q000209:etiology / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009900:Optic Nerve / Q000473:pathology; D020221:Optic Nerve Injuries / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D012574:Schools; D014823:Vitreous Hemorrhage / Q000209:etiology / Q000473:pathology