Traumatic optic neuropathy has such clinical manifestations

Traumatic optic neuropathy is a common disease that mostly occurs in male friends and is often caused by car accidents. Once suffering from this disease, if not treated in time, the patient may lose part of his vision, but he may also lose all vision, that is, go blind.

1. Epidemiology and Etiology

Traumatic optic neuropathy is most common in males and occurs mostly in motor vehicle and bicycle accidents. About 5% of patients with head trauma may show damage to different parts of the visual system.

Traumatic optic neuropathy can be caused by a variety of mechanisms. include:

(1) Acceleration-deceleration injury caused by blunt head trauma. The most common cause is the shear force generated by the rapid forward movement of the head and the rapid deceleration after encountering resistance, which causes the separation of blood vessels and nerves, i.e. indirect injury to the optic nerve (optic nerve contusion).

(2) Orbital compartment syndrome caused by optic canal fracture, optic canal or orbital apex hematoma compression, an ophthalmic emergency.

(3) Direct damage to the optic nerve.

(4) Complete or partial avulsion of the optic nerve.

(5) Optic nerve sheath hematoma.

2. Clinical Characteristics

Traumatic optic neuropathy is primarily manifested by partial or complete loss of vision.

While some vision is preserved, there may be visual field loss.

The rate of vision loss is critical to determining the cause.

(1) Indirect damage to the optic nerve caused by shear force, resulting in immediate loss of vision.

(2) Optic neuropathy caused by compression of fracture fragments or hematoma gradually worsens, with vision initially preserved but then lost within a few hours.

(3) Optic nerve avulsion leading to sudden blindness.

Signs include:

(1) Decreased vision;

(2) Impaired color vision;

(3) RAPD may be present if one eye is affected;

(4) Orbital hemorrhage manifests as severe ecchymosis, eyelid edema, exophthalmos, extraocular muscle paralysis, fullness of the orbit on palpation, the need for eyelid retractor, increased intraocular pressure, and fundus vascular pulsation signs;

(5) Partial or complete optic nerve avulsion, with a bleeding ring visible at the site of injury.