Traumatic central retinal vein occlusion following a hawk attack to the posterior cranium

PURPOSE: We describe a patient who developed a central retinal vein oculsion following a diving hawk attack to her posterior cranium. OBSERVATIONS: A 50-year-old female presented with decreased visual acuity and color perception in the left eye following a diving hawk attack to her right-posterior parietal cranium. Medical history was significant for well-controlled type 2 diabetes, hyperlipidemia, and obesity. Fundoscopy of the left eye revealed pre, intra and subretinal hemorrhages in all 4 quadrants consistent with the “blood and thunder” appearance. Additional findings included optic disk edema, venous dilation and tortuosity. Optical Coherence Tomography of the left eye demonstrated pronounced macular edema with intra and subretinal fluid accumulation. Pattern electroretinography of the left eye was flattened. CONCLUSIONS AND IMPORTANCE: There are few documented cases of central retinal vein occlusion following blunt trauma to the cranium in the literature. To the best of our knowledge, this is the first case of central retinal vein occlusion associated with posterior cranial trauma. Also unique to the case is the mechanism of injury whereby the patient was attacked by a hawk at a high-diving velocity.