A Rare Case of Penetrating Trauma Resulting in Isolated Third Nerve Palsy

Abstract

A 23-year-old male presented to the emergency department with right eye pain, right upper eyelid ptosis, blurry vision, and binocular diplopia that developed immediately after he bent over in a parking lot and the antenna of a car penetrated his right upper eyelid. An extensive workup was performed, and he was found to have an isolated traumatic oculomotor nerve palsy with pupil involvement. No other ocular findings of a traumatic injury were present. The patient was observed for 14 months, during which he continually improved, with almost complete resolution of his diplopia, anisocoria, and ptosis.ARTICLE HISTORY

Minor Traumas with Major Consequences: Penetrating Transorbital Injuries with Sharp Objects

“…To our knowledge, there are only two case reports of transorbital trauma with a penetrating object resulting in isolated oculomotor palsy. One case report described a 23-year-old patient who suffered isolated third nerve palsy with pupil involvement after injury with a car antenna [4]. Another case was published describing a 19-yearold patient who had an injury and thrombosis of the internal carotid artery with ipsilateral third nerve palsy caused by transorbital penetration with an umbrella wire [5].…”