Traumatic optic neuropathy secondary to acupuncture treatment for glaucoma: A case report

Internal organ injuries have been recognized as a major complication of acupuncture. Reported ocular adverse events include traumatic cataract, oculomotor nerve injury, endophthalmitis and retinal puncture. We report a case of traumatic optic neuropathy and self-sealed globe perforation following acupuncture. A Chinese gentleman with primary open angle glaucoma presented with sudden loss of vision in the right eye after acupuncture therapy. The vision dropped to 2/60 from 6/6 premorbid. Relative afferent pupillary defect was present. Fundus examination showed hemorrhage from the optic disc into the vitreous. It is likely that the optic nerve injury occurred when the acupuncture needle was advanced deep into locations near the optic nerve. Main acupoints used in acupuncture treatment of glaucoma include Tongziliao GB-1, Jingming BL-1 and Chengqi ST-1. It is crucial to have a good understanding of ocular anatomy to avoid potentially blinding complications.