Attempted bilateral manual enucleation (Gouging) during a physical assault

Objective: To report a rare, severe case of partial traumatic bilateral enucleation and its assessment and management. Design: Case report and literature review. Methods: A report of clinical and imaging findings, surgical procedure, medical treatment, and final outcome. Results: Complete avulsion of the extraocular muscles and optic nerve resulted in total loss of vision in one eye. Partial visual recovery was achieved by operating on the fellow eye, which was partially avulsed. Both eyes underwent lateral canthotomy in the emergency room. This was followed by exploration, repair of all ruptured extraocular muscles, and anterior chamber tap under general anesthesia. The few previously reported cases of traumatic manual avulsion of the globe are reviewed and discussed in the context of the present case. Conclusions: Partial visual recovery can be achieved after severe orbital and optic nerve trauma. A multidisciplinary approach to the assessment and management of these patients is recommended.