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“Skateboard to the Head” A Case of Persistent Headaches Following Blunt Eye Trauma

Journal: The AAO Journal Date: 2022/06, 32(2):Pages: 23. doi: Subito , type of study: case report

Free full text   (https://meridian.allenpress.com/aaoj/article/32/2/15/482674/LBORC-NUFA-Poster-Abstracts-2022-Students)

Keywords:

blunt eye trauma [1]
case report [514]
headache [127]
ocular injury [1]
OMT [2951]
osteopathic manipulative treatment [2973]

Abstract:

Introduction/Background: The sphenoid is the anchor of the eye. Its architecture maintains the safety and function of the eye by providing protection, access for neurovasculature, and attachment of extraocular muscles. Traumatic manipulation of the sphenoid can disturb these functions. Ocular injuries account for 3% of all emergency room visits in the U.S., with 97% resulting from blunt trauma. This case study supports the evaluation of sphenoid bone motion through osteopathic examination following blunt eye trauma. Case: J.D. is a 54-year-old female who presented twoweeks status post surgical repair of a right dislocated lens caused when a skateboard struck her eye six weeks prior. She complained of a constant, right-sided, periorbital headache rated as 10/10 with photophobia, neck pain, and decreased visual acuity that had continued since the injury. Osteopathic examination revealed a right cranial torsion and somatic dysfunction of the cervical and thoracic spines. Indirect and direct osteopathic manipulative therapy (OMT) techniques were utilized. Results: Following the initial OMT, J.D. reported an immediate reduction of her pain. After five visits she reported complete resolution of her periorbital headache with improvement of sleep, vision, and quality of life. Over one year of follow up she continued to receive OMT for chronic neck pain and occasional exertional periorbital pressure but denied recurrence of the constant severe headache described in her initial visit. Discussion: Addressing derangement of the sphenoid reduced persistent symptoms of blunt eye trauma not addressed by surgical intervention alone. Limitations of this study include not performing pre- and post-treatment imaging. Further research with more objective measures is needed to illustrate the benefits of osteopathic evaluation of the sphenoid in treating complications of blunt eye trauma.


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