Citation

Marriott E, Jay WM. Semin. Ophthalmol. 2007; 22(1): 3-7.

Affiliation

Loyola University Medical Center, Maywood, IL 60153, USA.

Copyright

(Copyright © 2007, Informa Healthcare)

DOI

10.1080/08820530601182543

PMID

17366110

Abstract

A 45-year-old male pedestrian was struck by a motor vehicle moving at high speed. Upon initial assessment, the patient scored a 3T on the Glasgow Coma Scale. The patient suffered multiple facial and sinus fractures, a right orbital wall fracture, and a depressed open frontal skull fracture with visible brain parenchyma. Due to the nature of the brain injury, the patient was taken to the operating room emergently for a right frontal craniectomy. The patient required prolonged hospitalization followed by transfer to a rehabilitation facility. Six weeks after the accident, the patient underwent an extensive neuro-ophthalmologic evaluation. At that time, visual acuity was 20/200 in both eyes. On visual field testing, a bitemporal hemianopia was noted. Ophthalmoscopic examination revealed bilateral temporal disc pallor, right greater than left. Neuroimaging demonstrated damage to the optic chiasm. Although rare, head trauma may cause a bitemporal hemianopia secondary to optic chiasmal injury.

Language: en