gms | German Medical Science

21st Annual Meeting of the German Retina Society and 8th Symposium of the International Society of Ocular Trauma (ISOT)

German Retina Society
International Society of Ocular Trauma

19.06. - 22.06.2008, Würzburg

Traumatic optic nerve avulsion in children

Meeting Abstract

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  • Veit Sturm - Zürich/Switzerland

Retinologische Gesellschaft. International Society of Ocular Trauma. 21. Jahrestagung der Retinologischen Gesellschaft gemeinsam mit dem 8. Symposium der International Society of Ocular Trauma. Würzburg, 19.-22.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocISOTRG2008P25

The electronic version of this article is the complete one and can be found online at:

Published: June 18, 2008

© 2008 Sturm.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background: Optic nerve avulsion (ONA) is an uncommon presentation of ocular trauma. It is characterized by traumatic disinsertion of the nerve fibres from the globe. ONA can occur completely or partially. We report the long-term follow-up in children with ONA due to traumatic events. The remarkable differences in course and outcome may elucidate the spectrum associated to ONA.

Methods: During the last fifteen years, three children with ONA were referred to our clinic. These case reports are presented with special attention to the long-term follow-up.

Results: Two patients suffered from complete ONA after head injury. The third patient presented with a partial ONA caused by a bicycle accident. Long-term follow-up of the patients varied between seven and fifteen years. In the first patient, a pale swollen retina without any visible retinal vasculature initially occurred. The retina completely detached in the course. In the second patient, extended fibroglial scarring occurred. The enormous epiretinal membrane formation finally teared off spontaneously into the vitreous. The third patient developed only few fibroglial scarring and mild retinal pigment epithelium hyperplasia. The optic nerve head finally resembled a morning glory like disk.

Conclusions: Mechanisms of ONA are not completely understood yet. The most distal part of the optic nerve might be especially vulnerable because of missing myelinisation and only fine arachnoid suspension. Patients with ONA can adopt different courses and outcomes. Individual final visual outcome seems to depend on the first visual acuity measured after injury. Substantial intraocular architecture changes can occur due to ONA.