Optic Nerve Head Avulsion: Clinical, Radiographic, and Sonographic Correlations

A 15-year-old boy presented with immediate vision loss after his left eye struck a rock during a fall. There were no signs of globe rupture. Ophthalmoscopy demonstrated a central retinal artery occlusion. The area of the optic nerve head was excavated and filled with hemorrhage with blood emanating into the vitreous and a ring of peripapillary hemorrhage (Fig 1). Computed tomography (Fig 2) showed orbital fat-stranding around the nerve with a linear hypodensity (arrow) near its attachment to the globe.