A 13-year-old boy sustained injury with a metal pipe to his right eye. The patient had no light perception in his right eye and visual acuity was 20/25 OS. A 4+ right afferent pupillary defect, normal intraocular pressures, chemosis, subconjunctival hemorrhage, and iritis were seen.
Dilated funduscopy (Figure 1) revealed avulsion of the right optic nerve and temporal retina. Vascular boxcarring was laid over pale, edematous retinal tissue. A dense hemorrhage obscured the nasal fundus.
Oliver SCN, Mandava N. Ultrasonographic Signs in Complete Optic Nerve Avulsion. Arch Ophthalmol. 2007;125(5):716. doi:10.1001/archopht.125.5.716