Traumatic myopia secondary to ciliary spasm after blunt eye trauma and reconsideration of its pathogenesis

Short-Term Refractive Outcomes of Pseudomyopia Induced by Ocular Blunt Trauma

A teenage female patient visited the ophthalmology emergency department reporting blunt ocular trauma from a stretched elastic band, accompanied by blurred vision. At presentation, uncorrected visual acuity (VA) was 6/60 in the affected eye, improving to 6/7.5 with pinhole. A slit lamp examination showed a mild anterior chamber reaction and iridoplegia with pupil shape irregularity. Gonioscopy revealed partial cyclodialysis with angle recession. Fundoscopy revealed focal commotio retinae with blot hemorrhages. B-scan ultrasonography yielded no pathology. Follow-up examination, the day after the injury, included detailed refraction, which showed a myopic shift in the affected eye. Uncorrected VA improved to 6/15 and the patient achieved 6/7.5 with correction. Clinical findings indicated myopia, which resolved within one week from the incident, and refractive error rapidly decreased to prior emmetropic values.

Eye Movements in Mild Traumatic Brain Injury: Ocular Biomarkers

Mild traumatic brain injury (mTBI, or concussion), results from direct and indirect trauma to the head (i.e. a closed injury of transmitted forces), with or without loss of consciousness. The current method of diagnosis is largely based on symptom assessment and clinical history. There is an urgent need to identify an objective biomarker which can not only detect injury, but inform prognosis and recovery. Ocular motor impairment is argued to be ubiquitous across mTBI subtypes and may serve as a valuable clinical biomarker with the recent advent of more affordable and portable eye tracking technology. Many groups have positively correlated the degree of ocular motor impairment to symptom severity with a minority attempting to validate these findings with diffusion tract imaging and functional MRI. However, numerous methodological issues limit the interpretation of results, preventing any singular ocular biomarker from prevailing. This review will comprehensively describe the anatomical susceptibility, clinical measurement, and current eye tracking literature surrounding saccades, smooth pursuit, vestibulo-ocular reflex, vergence, pupillary light reflex, and accommodation in mTBI.

Induced Myopia Secondary to Blunt Trauma

A 28-year-old young man presented with sudden and severe visual loss in the left eye, starting three days ago following blunt head trauma from a closed fist. Vision was not improved to better than 0.4 in the left eye. Slit lamp examinations revealed asymmetric anterior chamber depth (ACD) with shallow ACD in the left eye. The key learning in this report is the use of anterior segment optical coherence tomography (AS-OCT) to better document the anterior segment changes following the blunt trauma. AS-OCT was used to visualize the forward displacement of the iris-crystalline lens diaphragm secondary to ciliary body anterior rotation and ciliochoroidal effusion. There was a temporary myopic shift about 7.00 D which resolved after 15 days.