Bilateral Amaurosis Secondary to Thoracic Crush Injury: A Case Report

Abstract

A 46-year-old man was accidentally crushed in the chest by a heavy vehicle. He remained trapped for less than a minute. As a result of the entrapment he developed severe upper-body oedema and bilateral amaurosis. Funduscopic examination at the time he arrived in the emergency room was normal. A computed tomographic scan of the orbit performed 2 hours after trauma showed retro-orbital oedema of the soft tissues and bilateral exophthalmos. Magnetic resonance imaging of the brain performed 48 hours after the episode showed no abnormalities in the cortex or cerebral white matter and in particular no signs of ischaemia. Subsequently total bilateral optic atrophy developed. How the sudden and marked congestion of the orbits secondary to the soft tissue oedema led to optic nerve damage is unknown; possible factors are posterior ischaemia of the nerve secondary to venous congestion and compression and elongation of the optic nerve.

KEYWORDS::

• Axonal injury
• Amaurosis
• Xhest crush
• Exophthalmos

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.