Korean J Ophthalmol.  2010 Dec;24(6):380-383. 10.3341/kjo.2010.24.6.380.

Bilateral Retrobulbar Hemorrhage and Visual Loss Following Traumatic Asphyxia

• Choi YJ
• Lee SJ
• Kim HJ
• Yim JH

• KMID: 1769096
• DOI: http://doi.org/10.3341/kjo.2010.24.6.380

Abstract

Retrobulbar hemorrhage and permanent visual loss are rare presentations following traumatic asphyxia. In this case, bilateral permanent visual disturbance developed in a woman after chest-crushing trauma without direct trauma to the orbits. A computed tomography scan confirmed bilateral retrobulbar hemorrhages. An ophthalmologic exam revealed bilateral subconjunctival hemorrhages and severe lid edema. Despite high-dose steroid therapy, visual recovery was limited, and optic nerve atrophy developed. Ischemia of the optic nerve associated with retrobulbar hemorrhage may be postulated as one of the causes of permanent visual impairment following traumatic asphyxia.

Keyword

Optic nerve atrophy; Retrobulbar hemorrhage; Traumatic asphyxia; Visual loss

MeSH Terms

Asphyxia/*complications/*etiology
Female
Humans
Ischemia/complications
Middle Aged
Optic Nerve/blood supply
Retrobulbar Hemorrhage/*complications/*etiology/radiography
Thoracic Injuries/*complications
Tomography, X-Ray Computed
Vision Disorders/*etiology

Figure

• 

  Fig. 1 Severe bilateral subconjunctival hemorrhages, chemosis, severe eyelid swelling, and mild exophthalmos were found.

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  Fig. 2 Admission axial computed tomography scans of the orbit demonstrated bilateral retrobulbar hemorrhages, mild proptosis, and severe eyelid swelling. Note the orbital fat interposed between the globe and medial wall of the orbit.

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  Fig. 3 Visual field test shows the marked field defects in both eyes 6 weeks after injury.

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