Clinical Case Notes.

Luxation of the globe with or without optic nerve avulsion is a rare condition that results from an extreme form of trauma. Globe luxation results from a dynamic interplay of forces. Blunt trauma to the head or face results in coup and contrecoup injuries. Associated optic nerve avulsion is rare, probably because of the nerve's tortuous intraorbital part. It occurs either due to forward propulsion of the globe or a sudden rise in intraocular pressure that leads to avulsion of the nerve from the globe at the optic nerve head or due to a direct hit. If reduction is not possible, which could be because of tissue oedema, retrobulbar haemorrhage or loss of orbital integrity, one should protect the eye with a hard covering such as a cup, followed by imaging studies and surgical exploration under general anaesthesia.