転倒による眼球離脱

A case of traumatic avulsion of the eye ball

要約　目的：転倒により眼球離脱を生じた症例報告。

症例：48歳，男性。飲酒後に泥酔状態となり自室で転倒し，家族が倒れているのを発見して救急搬送された。当院受診時の視力は右光覚なし，左1.5（矯正不能）。右眼は眼球が眼窩から遊離した眼球離脱の状態で，外直筋と下斜筋以外は視神経を含めて断裂していた。左眼には異常は認められなかった。当院入院後に全身麻酔下で，右眼の眼球摘出術を施行した。術後は義眼装用となった。眼球離脱の発生機序は転倒時に眼球と眼窩壁の間に入った鈍体の後方からの槓杆作用が働いたためと考えられた。

結論：転倒により，片眼の完全な眼球離脱を生じた1例を経験した。眼球の受傷機転によっては転倒による眼球離脱も稀に生じる。

Abstract　Purpose：To report a case of eye ball avulsion caused by a fall.

Case：A 48-year-old man got extremely drunk and fell unconscious in his room. He was brought to the hospital by an ambulance. His visual acuity was as follows：no light perception on the right and 1.5 on the left eye. The right eye ball had completely prolapsed out of the orbita. The optic nerve was torn. Lateral rectus muscle and inferior oblique muscle were connected. There was no abnormality in his left eye. The enucleation of the right eye ball was performed under general anesthesia. A prosthesis was inserted after the enucleation. It is speculated that he fell on some object that flipped and somehow scooped the eye ball out of the orbita.

Conclusions：We experienced a case of complete eye avulsion due to a fall. It is possible for a complete eye avulsion to occur from a fall on an object.