Globe Luxation and Optic Nerve Avulsion by Dog Bite

A 9-year-old female presented to the emergency department after being attacked by her family dog. The patient was alone in the passenger seat of a parked car when the dog saw another dog, jumped into the child's seat, and bit her left eye. The child immediately lost all vision. The left globe was luxed onto the cheek [Figure 1a] and a long segment of the optic nerve avulsed [Figure 1b]. Computed tomographic scan showed avulsion of the left globe with transection of superior and medial rectus muscles and optic nerve, as well as hemorrhage near the chiasm [Figure 1c and d]. Enucleation was offered; however, the patient's family elected for globe repositioning. The patient did not develop ocular ischemic syndrome or phthisis bulbi during her 4 years of follow-up. On review of the literature, the authors are unaware of any other reported cases of optic nerve avulsion and globe luxation by dog bite.[1,2,3,4,5]

Figure 1.

External photograph depicting globe luxed onto cheek (a) and long segment of avulsed optic nerve (b) with axial facial computed tomography images (c and d)

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