Traumatic Globe Luxation With Chiasmal Avulsion

Background: To describe an unusual case of traumatic globe luxation with optic chiasmal avulsion and review the existing literature on this rare condition for further discussion of mechanisms, diagnosis, and management. Methods: Case report and review of existing case reports and case series identified through literature search. Results: A 28-year-old woman, with no previous medical history, had left globe luxation and optic chiasm avulsion after being stabbed directly into the left orbit with the use of the stiletto high heel of a shoe. Automated visual field testing detected a temporal hemianopia in the unaffected eye despite normal central visual acuity. Chiasmal avulsion was demonstrated by MRI. Conclusions: This case suggests that perimetry and MRI should always be considered in traumatic globe luxation to localize the site of injury. Temporal hemianopia in the fellow eye indicates a concomitant chiasmal injury.