Self-induced Orbital Compression Injury

Williams, Alice; Greven, Margaret A.; Houston, Samuel K.; Mehta, Sonia

doi:10.1001/jamaophthalmol.2015.1114

Cited by 5 publications

(2 citation statements)

References 6 publications

(1 reference statement)

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“…There have only been 5 other reported cases of SNR in the literature to this date, with all cases having no light perception vision, ophthalmoplegia, proptosis, chemosis, and retinal edema. [2][3][4] The proposed mechanism of SNR begins when external pressure is applied to the orbit for a prolonged period of time, as may be from an opioid-induced obtunded state. This pressure initially causes collapse of orbital vessels and ischemia of the retina and choroid.…”

Section: Discussionmentioning

confidence: 99%

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Saturday Night Retinopathy After Intranasal Heroin

Nguyen

North

Oellers

et al. 2018

Journal of VitreoRetinal Diseases

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To describe the clinical features of a case of Saturday night retinopathy (SNR) following intranasal heroin use. Methods: Ophthalmological examination, including optical coherence tomography and fluorescein angiogram, was performed. Serial images were obtained at follow-up visits at 1 week and 1 month. Results: The visual acuity was no light perception vision and there was an afferent pupillary defect in the affected eye. There was also evidence of complete ophthalmoplegia, globe proptosis, conjunctival chemosis, and corneal epitheliopathy and funduscopic evidence of ophthalmic artery occlusion. Follow-up imaging showed choroidal and retinal nonperfusion. Magnetic resonance imaging demonstrated edematous extraocular muscles and a bilateral hippocampal ischemia. Conclusions: This is the first case of SNR following intranasal heroin use and opioidassociated hippocampal ischemia. As physicians witness the impacts of the country's opioid epidemic, it is important to recognize SNR as a cause of acute visual loss.

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Section: Discussionmentioning

confidence: 99%