Traumatic Optic Neuropathy – A Review

Authors: SARAVANA GNANA BHAVA, SAKTHI GNANA SUNDARAM, SUMA KAMAREDDY, ADWITYA MOHAPATRA

DOI: 10.18231/j.ijceo.9460.1761817498

Keywords: Traumatic optic neuropathy, Optic nerve trauma, Orbital fracture, Corticosteroids, Orbital decompression

Abstract: Traumatic optic neuropathy (TON) is a rare condition resulting in vision loss after a head injury, predominantly affecting men due to accidents, falls, violence, or sports injuries. The chances of recovery from an optic nerve injury depend on whether it is a direct or indirect injury. Direct injuries to the optic nerve often lead to immediate and severe vision loss that may not improve over time. On the other hand, indirect injuries to the optic nerve can lead to better vision recovery, but they may also cause delayed vision loss days after the initial injury. Fractures in the optic canal are effectively detected using thin-section CT scans. MRI is recommended only when intracranial injuries cannot be fully assessed using CT scans. The management of TON includes observation, corticosteroids, and surgery. Doctors typically recommend observing the condition if there are no signs of blood clots or fractures in the optic canal. The treatment for TON involves giving very high doses of intravenous methylprednisolone, followed by slowly lowering the doses of oral prednisolone. Surgery should be done only for patients with signs of compression, which will change in each type of case.