飲酒起因の自己眼球摘出により視交叉部血腫を呈した1例

A case of hematoma in the chiasmal region following autoenucleation during drunkenness

　51歳男性が飲酒中に酩酊状態になり，転倒して右眼をジョッキに打ちつけた。脱臼した右眼を自分の指で摘出した。摘出された眼球は形を維持していたが，4直筋は付着部で断裂し，視神経は眼球の50mm後方で断裂していた。左眼に固視点を含む耳側半盲があり，視力は0.08であった。受傷4日後のコンピュータ断層撮影（CT）と磁気共鴫画像検査（MRDで視交叉部に径10mmの血腫があった。左眼の耳側半盲の原因として，血腫による視交叉部圧迫と視交叉部での神経線維損傷が考えられた。左眼の最終矯正視力は0.4に回復した。

A 51-year-old man became heavily inebriated and hit his right eye against a beer mug while losing his balance. The right eye became luxated. He autoenucleated the eye with his fingers. When seen in the emergency ward, the eyeglobe was apparently intact. All the four rectus muscles were torn at the sites of insertion. The optic nerve was torn 50 mm posterior to the eyeglobe. The left eye showed temporal hemianopia involving the point of fixation. The visual acuity was 0.08 left. Computerized tomography (CT) and magnetic resonance imaging (MRI) , performed 4 days later, showed a hematoma of 10 mm in size at the chiasmal region. It appeared that the hemianopia was cause by compression of the optic chiasm by the hematoma and also by injury to nerve fibers at the chiasm. His left eye regained the final visual acuity of 0.4.