Patricio S Espinosa, Patricio H Espinosa, Charles D Smith and Joseph R Berger
Silicone oils are used for ocular endotamponade to treat complicated retinal detachments. Neurological complications of silicone oil endotamponade are uncommon. Case reports have documented optic nerve atrophy and migration of the silicone oil into the subarachnoid space and ventricular system. However, optic neuritis contralateral to the treated eye has not been previously described. We report a 60 year-old-woman who underwent repair of retinal detachment with silicone oil in the left eye and later developed optic neuritis in the right eye. Immediately after the introduction of the silicone oil, the patient complained of severe pain in the left orbit with radiation into the left temporal and occipital areas. Subsequently, she developed vision loss in the previously unaffected right eye. She received a high dose intravenous steroids for three days with subsequent full recovery of vision in the right eye. Two weeks later, she had a second episode of decreased vision in the right eye, however this time, the vision in her right eye did not improve. MR imaging shows inflammation on the optic nerves and silicone oil in the ventricular system. Conclusions: Silicone oil can migrate into the nervous system and may provoke optic neuritis in the contralateral eye.
