We report a case of traumatic optic neuropathy accompanying a grease gun injury to the orbit. A 48-year-old man with a grease gun injury visited our clinic with decreased visual acuity, proptosis and limited extraocular movement (EOM). Orbital CT revealed a crescent mass of fat in the medial intraconal space. The grease was exuded from a lacerated conjunctival wound. The visual evoked potential (VEP) test demonstrated a decreased response in the left eye. Proptosis and EOM were improved after surgical removal of the grease. Systemic high-dose corticosteroid therapy was administered for suspected traumatic optic neuropathy, after which VEP nearly recovered, while visual acuity was slightly improved. A second surgery for traumatic cataract did not further improve visual acuity.
*Accidents, Occupational ; Evoked Potentials, Visual ; Eye Injuries, Penetrating/diagnosis/*surgery ; Humans ; *Lubricants ; Male ; Optic Nerve Injuries/diagnosis/*surgery ; Orbit/*injuries ; Visual Acuity

Major orbital complications after the endoscopic sinus surgeries are rare and of these, optic nerve injury is one of the most serious. This study was to undertaken to analyze 3 cases of optic nerve injury after endoscopic sinus surgery. The three cases included one patient with a loss of visual acuity and visual field defect, and two patients with total blindness. In all cases, no improvement of visual acuity was observed despite treatment. It is important to frequently check the location and direction of the endoscope during surgery to avoid optic nerve injury. In addition, surgeons must have a precise knowledge of the detailed anatomy through cadaver dissections, an ability to interpret the PNS CT scan and experienced procedural surgical skills.
Adult ; Blindness/etiology ; Endoscopy/*adverse effects ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Optic Nerve Injuries/diagnosis/*etiology/radiography ; Paranasal Sinuses/*surgery ; Retrospective Studies ; Tomography, X-Ray Computed ; Vision Disorders/etiology ; Visual Acuity ; Visual Fields