Gaze-evoked amaurosis produced by intraorbital buckshot pellet.

OBJECTIVE

To report the first case of gaze-evoked amaurosis secondary to an intraocular foreign body and to highlight the characteristic clinical findings of patients with this symptom.

DESIGN

Case report and review of the literature.

METHODS

Case review, clinical history, electrophysiologic testing, and follow-up.

MAIN OUTCOME MEASURES: Visual acuity, automated perimetry, and visual fields.

RESULTS

A case of gaze-evoked amaurosis as a result of an intraorbital foreign body is described, and 19 additional cases of gaze-evoked amaurosis are reviewed from the English language literature. These cases share certain characteristics including good vision in primary position with deterioration of vision in eccentric gaze; concurrent objective pupillary abnormalities in eccentric gaze; stereotypic onset and recovery of vision; and funduscopic abnormalities consisting of disc edema and chorioretinal folds.

CONCLUSIONS

Gaze-evoked amaurosis is a reliable sign of intraconal mass lesion. We report the first case of gaze-evoked amaurosis secondary to an intraorbital foreign body.