Avulsion of the Eyeball

AVULSION OF THE EYEBALL (avulsio bulbi oculi), a special form of traumatic injury to the eye, in which the eyeball is torn from the orbit. Even with dislocation of the eye, the normal connection between the septum orbitale located in front and the soft parts of the orbit is disrupted. In avulsion of the eyeball, this connection is either completely or almost entirely destroyed. Three main groups of avulsion of the eyeball are distinguished: 1) cases in newborns intra partum. Here the matter usually concerns the application of forceps and often with a high-lying head. A narrow pelvis with a sharply projecting promontory and unsuccessful positioning of the forceps blades fully explain the mechanism of eye injury. Cases have been described where the eye was torn from a newborn during the act of delivery without the participation of forceps, by the action of a sharp edge, with a certain position of the head in the narrow entrance to the pelvis; 2) cases of avulsion of the eyeball in the mentally ill as a result of self-mutilation under the influence of melancholic or other delusional ideas; 3) cases of traumatic tearing out of the eye from injury by blunt or blunt-pointed objects, which, penetrating into the orbit between the eyeball and the wall of the orbit, first cause the eyeball to protrude and then, going behind the eyeball and resting against the bony edge of the orbit as a fulcrum, by lever action tear out the eye. The instrument of injury in these cases of avulsion of the eyeball was, for example, a key protruding from a keyhole (in the case of Ochapovsky—the end of a pole on a cart), and patients, falling and striking against this object, caused avulsion by the force of gravity of their own falling body. The three groups mentioned also include all cases of dislocation of the eyeball that form under similar conditions under the action of similar causal factors. In mild forms of traumatic dislocation, it is possible to return the eye to its normal position, and the dislocation may pass without consequences; complete avulsion leads to the death of the organ. Between these forms, all possible transitions are observed and described.