Traumatic Optic Neuropathy

Classically divided into:

  • Direct injury: external object penetrates the tissues and impacts the optic nerve.
  • Indirect injury: collision to the skull and the energy is absorbed by the optic nerve.

Usually associated with mid-face trauma

Traumatic Optic Neuropathy

Causes:

  • Motor Vehicle Accident (MVA), most common cause.
  • Falls
  • Assault

Symptomatology:

  • History of trauma
  • Loss of vision after the trauma
  • Commonly associated with loss of consciousness.

Signs:

  • Vision: is often significantly reduced.
  • Afferent pupillary defect
  • Associated ocular injury.

Fundoscopy:

  • Acutely the optic nerve appears normal.
  • Weeks later, optic nerve pallor develops.
  • Vitreous hemorrhage
  • Retinal hemorrhage