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Purpose: Traumatic injury to the optic chiasm is rare and most frequently caused by high-velocity head trauma. It classically results in bitemporal hemianopsia and often presents in conjunction with multiple other traumatic injuries, such as skull fractures and cerebrospinal fluid leaks. We present the case of a 40-year-old woman with pre-existing thyroid orbitopathy who struck her forehead after a fall from standing height. Observations: This patient suffered immediate profound unilateral vision loss from traumatic optic neuropathy and possible optic nerve avulsion. The fellow eye manifested a temporal hemianopsia with delayed retinal nerve fiber layer and nasal hemimacular ganglion cell layer thinning on optical coherence tomography, consistent with chiasmal pathology. Magnetic resonance imaging showed no definitive lesions at the optic chiasm or more posteriorly along the afferent visual pathway. Conclusions and importance: This patient's severe vision loss suggests that proptosis from thyroid orbitopathy can sensitize the anterior visual pathway to trauma. In this case, we propose that the lack of laxity in the intra-orbital optic nerves allowed transmission of stretching forces to the optic chiasm in the setting of low-velocity blunt trauma.

We report a case of isolated bitemporal hemianopia in traumatic chiasmal syndrome. A 20-year-old male motorcyclist was brought unconscious into the emergency department after an alleged accident involving a horse-drawn vehicle. He was intubated for three days. Computed topography of the brain revealed bifrontal and facial bone fractures, associated with subarachnoid haemorrhage. He underwent frontal bone and facial bone reconstruction. Three weeks later, patient complained of left eye blurred vision. On examination, the visual acuity was 6/7.5 in the right eye and 6/12 in the left eye, with a left relative afferent pupillary defect. Visual field charting showed complete bitemporal hemianopia. Over the next six months, the visual acuity of the left eye worsened to 6/45, while the field defect remained static. Bitemporal hemianopia in traumatic chiasmal syndrome is a rare complication of severe head injury. A history of trauma should always be elucidated in patients with visual field defects. [ABSTRACT FROM AUTHOR]

Purpose: To report a case presenting with bitemporal hemianopia due to traumatic chiasmal syndrome after head injury, and to compare the findings with individual case reports published in the literature. Methods: A detailed search was made in PubMed, MedIND, Taylor and Francis online and Wiley online library databases for individual case reports of traumatic chiasmal syndrome. All the case reports were read in full and the findings summarized in a table, which included details of the case who presented with bitemporal hemianopia as an index case. Results: All published cases of traumatic chiasmal syndrome appear to share some common features, such as injury to the frontal bone and fracture of the anterior skull base. Bitemporal hemianopia and visual acuity have a variable presentation, and do not appear to correlate with severity of injury. Isolated bitemporal hemianopia is rare and clinical improvement may or may not occur. Conclusions and importance: Traumatic chiasmal syndrome should be considered as a differential diagnosis in patients presenting with bitemporal hemianopia after head injury causing frontal and anterior skull base fracture.

We present a case report of a young adult male who sustained severe head injury in a bomb blast. He was later detected to have traumatic chiasmal syndrome as well as cerebrospinal fluid rhinorrhoea. There were no other complications associated. He was managed conservatively. A review of the present literature and current understanding of the pathogenesis of this intriguing syndrome is presented. Traumatic chiasmal syndrome must

A 67-year-old former gold miner with rheumatoid arthritis, treated with steroids and methotrexate, presented to eye casualty with a painful right eye. Examination revealed an anterior uveitis and despite an initial response to topical steroids, the intraocular inflammation worsened with anterior and posterior uveitis development. Re-examination showed a white mass in the peripheral nasal retina initially suspected of being active Toxoplasmosis infection and anti-toxoplasmosis treatment commenced. After improvement and tapering of this treatment, the intraocular inflammation reoccurred. Cytopathological examination of a pars plana vitrectomy obtained vitreous sample that showed a non-diagnostic non-infectious chronic vitritis. The vitreoretinal surgeons elected to do a direct biopsy of the white subretinal mass in the peripheral nasal area. This revealed, quite unexpectedly, an abscess containing pigmented phaeohyphomycosis fungi. This case report documents the multidisciplinary approach that assisted in clinching a final diagnosis and the role of sub-retinal biopsy in this unprecedented scenario.

We present a case of mature congenital orbital teratoma managed with lid-sparing exenteration and dermis fat graft. This is a case report on the management of congenital orbital teratoma. A full-term baby was born in Fiji with prolapsed right globe which was surrounded by a nonpulsatile, cystic mass. Clinical and imaging features were consistent with congenital orbital teratoma. Due to limited surgical expertise, the patient was transferred to Adelaide, Australia for further management. The patient underwent a lid-sparing exenteration with frozen section control of the apical margin. A dermis fat graft from the groin was placed beneath the lid skin to provide volume. Histopathology revealed mature tissues from each of the three germ cell layers which confirmed the diagnosis of mature teratoma. We describe the successful use of demis fat graft in socket reconstruction following lid-sparing exenteration for congenital orbital teratoma.

The aim of present study was to compare the efficacy and safety of fixed combination of brimonidine and timolol with individual components used as monotherapy in patients of primary open angle glaucoma. Patients were randomly assigned to receive brimonidine or timolol or brimonidine-timolol fixed combination, with 30 patients in each group. The mean reduction in intraocular pressure in brimonidine, timolol, and brimonidine-timolol group were 4.29 ± 1.97 mm Hg, 4.34 ± 1.21 mm Hg, and 5.54 ± 1.87 mm Hg respectively at 2 weeks and 4.86 ± 1.16 mm Hg, 5.42 ± 1.50 mm Hg, and 7.36 ± 2.58 mm Hg respectively at 6 weeks. When values of mean reduction in intraocular pressure were compared between brimonidine-timolol fixed combination with brimonidine and timolol, it was found to be statistically significant ( P < 0.05) at 2 weeks and highly significant (0.001) at 6 weeks. The overall frequency of adverse effects was similar in all three groups.

We report a 26-year-old man who developed cerebrospinal fluid (CSF) rhinorrhoea and complete bitemporal hemianopia after having sustained a blunt frontal region trauma. The chronology of midline frontal trauma and CSF rhinorrhoea, followed days later by transient diabetes insipidus and discovery of a bitemporal visual field loss, makes up a unique syndrome and must be evaluated for. Mechanism of such injuries, their pertinent complications, and review of literature are herein discussed. [ABSTRACT FROM PUBLISHER]

We report the case of a 12-year-old male who developed corneal arcus and multiple skin lesions with a 10-year history of xanthomas. The lesions appeared over his fingers, hands, elbows, knees, buttocks and feet. Laboratory studies showed a total serum cholesterol level of 752.1 mg/dL; a triglyceride level of 96.6 mg/dL; a low-density lipoprotein cholesterol level of 661.3 mg/dL. Findings were consistent with homozygous familial hypercholesterolemia. To our knowledge, this is the first such case to be reported from China.

A two and half year old female was admitted at the emergency room suffering from gradually worsening headache followed by nausea. The child presented with reduced level of consciousness and bilateral hypoacusis. The patient was lethargic. Ophthalmic examination showed branch retinal artery occlusion (BRAO). This finding was crucial to the diagnosis of Susac′s syndrome (SS), a rare autoimmune disease characterized by, endotheliopathy of retina, encephalic tissues and cochlea. Magnetic resonance imaging of the brain also showed typical features. Thorough blood investigations did not reveal any other abnormality. Patient was treated with immunosuppressive to prevent her from developing severe sequelae of this disease. The child showed dramatic improvement in her systemic condition within 48 h of starting the treatment. This is the youngest ever and first case report from India.

A 29-year-old man presented with a chief complaint of lateral blindness in the left eye at 4 months after an accidental fall. His best corrected visual acuity was 0.7 in the left eye and 1.0 in the right eye. Visual field test showed a complete bitemporal hemianopic defect without any neurologic symptoms. An orbital computed tomography scan with non-enhancement conducted at the time of the visit showed multiple frontal skull fractures and cerebromalacia a small fracture in the sphenoidal boneboth frontal lobes. No radiological abnormalities of the visual pathway were detected. Optical coherence showed reduced thickness in the retinal nerve fiber layer, primarily in the superior and inferior part of the left eye. To our knowledge, a complete bitemporal hemianopia without neurological deficits is extremely rare in traumatic chiasmal syndrome.

Abstract: Traumatic chiasmal syndrome is characterized by the immediate onset of bitemporal hemianopsia after head trauma. This is a rare clinical entity, which is seen after severe frontofacial trauma. Even more rare is complete transection of the optic chiasm. Magnetic resonance imaging is the key modality to visualize injuries to the suprasellar structures. A young male patient is presented with complete bitemporal hemianopsia after a closed head trauma, where MRI successfully demonstrated a complete sagital chiasmatic split. [Copyright &y& Elsevier]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The report highlights a 49-year-old multiple trauma victim who noticed reduced vision in both eyes following recovery from neurosurgical intensive care. Formal perimetry revealed a bitemporal hemianopia and traumatic damage to the optic chiasm was demonstrated on MRI. The multidisciplinary team confirmed traumatic chiasmal syndrome. The case highlights complications of this challenging diagnosis and its implications on patients' lifestyle and long-term prognosis. [ABSTRACT FROM AUTHOR]