Imitation of Typical Birdcall Causes Ocular Perforation by a TawnyOwl Attack

mal position. On examination, the patient had blepharitis and corneal haze in both eyes (Figure 3). Ophthalmic examination showed no light perception in the right eye and a visual acuity of 20/200 in the left eye. Slitlamp examination showed palpebral conjunctival hyperemia with papillary hypertrophy and tears in the Descemet membrane in both eyes (Figure 4). Funduscopic examination showed bilateral optic atrophy, more marked in the right eye. The optic disc was uniformly white without cupping in both eyes. The remainder of the results of fundus examination and the intraocular pressure were normal. The patient’s poor vision did not permit visual fields to be obtained. Ultrasound scan, Hertel measurements, and thyroid function test results showed no abnormalities. Electrophysiologic testing showed substantial reduction of the latent time of the visual evoked responses. Results of further neurologic examination, including magnetic resonance imaging, for demyelinating disease, drug toxic effects, and thyroid eye disease were negative. The patient was instructed to avoid luxating his globes, as he refused surgical treatment of the floppy eyelids. Stabilization of his psychiatric disease allowed the patient to be cooperative. Unfortunately, 4 months later he was totally blind. His parents reported that he had never stopped luxating his globes.