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K. Flickinger, J. Tao, J. Siddens; Bilateral Anterior–Chiasmal Optic Nerve Avulsion After Airbag Injury . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4253.
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Purpose: To report the case of a 63–year–old woman with bilateral optic nerve avulsion after blunt ocular trauma from airbag deployment during a motor vehicle crash. Design: Observational case report Methods: A 63–year–old woman with a history of hypertension developed acute and complete loss of vision in both eyes after her face struck the deployed airbag during a motor vehicle collision. A complete eye exam, including dilated fundus exam, was performed as was magnetic resonance imaging of the orbits and chiasm. Results: Physical exam findings included bilateral no light perception, 30–40 prism diopter alternating exotropia, bilateral amaurotic pupils, bilateral optic nerve pallor, bilateral diffuse retinal edema with a "cherry red spot" in the fovea, bilateral scattered retinal hemorrhages, and bilateral absent spontaneous venous pulsations. MRI showed discontinuity of the optic nerve just anterior to the optic chiasm bilaterally. The patient was treated with intravenous steroids without improvement of vision. Conclusions: To the authors' knowledge, bilateral anterior chiasmal optic nerve avulsion after airbag injury has not been reported. This represents a rare and unfortunate case.
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