title: Choroidal rupture and optic nerve injury with equipment designated as 'child-safe'.
abstract: Blunt ocular trauma from a child's plastic foam-covered toy baseball bat caused traumatic optic neuropathy and choroidal rupture in a 9-year-old child. The examination revealed a visual acuity of 6/60, a relative afferent pupillary defect, optic nerve swelling, commotio retinae and retinal haemorrhages. There was no orbital fracture or intraorbital haematoma on CT scanning. Optical coherence tomography showed macular oedema and disruption of the retinal pigment epithelium and Bruch's membrane. The child was admitted for intravenous methylprednisolone and discharged on topical steroid treatment. At 1&emsp14;month follow-up, visual acuity had improved to 6/12. Optic nerve swelling had resolved and the fundus had two crescent-shaped choroidal rupture scars. Choroidal rupture and optic neuropathy can be secondary to indirect trauma, and even when the mechanism of injury is with a piece of equipment designated as suitable for children, serious ocular injury can occur.
authors.affiliation: Department of Ophthalmology, Conquest Hospital, Hastings, UK. robert.petrarca@kcl.ac.uk
authors.forename: Robert
authors.initials: R
authors.lastname: Petrarca
authors.forename: Manuel
authors.initials: M
authors.lastname: Saldana
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001265:Athletic Injuries / Q000175:diagnosis / Q000209:etiology*; D001484:Baseball / Q000293:injuries*; D016570:Bruch Membrane / Q000187:drug effects / Q000293:injuries; D002648:Child; D002829:Choroid / Q000187:drug effects / Q000293:injuries*; D003257:Consumer Product Safety; D003519:Cyclopentolate / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005131:Eye Injuries / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D009883:Ophthalmic Solutions; D020221:Optic Nerve Injuries / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D010857:Pigment Epithelium of Eye / Q000187:drug effects / Q000293:injuries; D010988:Play and Playthings / Q000293:injuries*; D012421:Rupture; D041623:Tomography, Optical Coherence; D014057:Tomography, X-Ray Computed; D014792:Visual Acuity / Q000187:drug effects; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*
chemical_list: D000893:Anti-Inflammatory Agents; D009883:Ophthalmic Solutions; D003519:Cyclopentolate; D008775:Methylprednisolone