Traumatic Optic Neuropathy – Case Report

Abstract

Blunt eye trauma is one of the leading causes of irreversible blindness. In 2013, approximately 18 million people worldwide suffered of unilateral blindness, associated with trauma [3]. The incidence of ocular traumatism is higher among children, compared to adults [3].
We report a case of an 8-year-old girl, hit with a blunt hard object in the area of left orbit. Shortly after the traumatic incident, she complained of total loss of vision in the left eye. The patient was admitted to the Ophthalmology department of the University hospital ,,Aleksandrovska”, where a significant edema of the optic nerve was diagnosed.
Powerful antiedematous therapy was performed with no vision improvement.
Every single head trauma, even a minor, can have a potentially blinding outcome.
 
 Key words: Blindness, optic nerve, optic neuropathy, trauma

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Bibliography

  1. А.Оскар: Анализ на компютърно-периметричната находка при пациенти с лезии на зрителните сензорни пътища с различна локализация и етиология. 2009г. Дисертационен труд.
  2. А.Оскар, С.Чернинкова: Невро-офталмологична симптоматика при придобити и наследствени заболявания в детска възраст.
  3. Abbott J, Shah P. The epidemiology and etiology of pediatric ocular trauma. Surv Ophthalmol. 2013 Sep-Oct;58(5):476-85. doi: 10.1016/j.survophthal.2012.10.007. PMID: 23969021.
  4. Anderson RL, Panje WR, Gross CE. Optic nerve blindness following blunt forehead trauma. Ophthalmology. 1982 May;89(5):445-55. doi: 10.1016/s0161-6420(82)34769-7. PMID: 7099563.
  5. Aritürk N, Sahin M, Oge I, Erkan D, Süllü Y. The evaluation of ocular trauma in children between ages 0-12. Turk J Pediatr. 1999 Jan-Mar;41(1):43-52. PMID: 10770675.
  6. Borel A, Bonnin N, Porte C, Chiambaretta F, Bacin F. Papillopathie traumatique: à propos d’un cas d’arrachement partiel du nerf optique [Optic nerve trauma: case report of partial optic nerve avulsion]. J Fr Ophtalmol. 2013 Apr;36(4):372-7. French. doi: 10.1016/j.jfo.2012.08.003. Epub 2013 Jan 29. PMID: 23375246.
  7. Cho J, Jun BK, Lee YJ, Uhm KB. Factors associated with the poor final visual outcome after traumatic hyphema. Korean J Ophthalmol. 1998 Dec;12(2):122-9. doi: 10.3341/kjo.1998.12.2.122. PMID: 10188374.
  8. Jain P, Gopalakrishnan M, Anantharaman G. Traumatic optic nerve head avulsion: Multimodal imaging. Indian J Ophthalmol. 2018 Jul;66(7):1003. doi: 10.4103/ijo.IJO_147_18. PMID: 29941753; PMCID: PMC6032747.
  9. Kumar M, Kesarwani S. Post-traumatic cyclodialysis cleft with hypotonic maculopathy. Clin Exp Optom. 2011 Sep;94(5):481-3. doi: 10.1111/j.1444-0938.2011.00599.x. Epub 2011 Apr 25. PMID: 21517970.
  10. Levin LA, Beck RW, Joseph MP, Seiff S, Kraker R. The treatment of traumatic optic neuropathy: the International Optic Nerve Trauma Study. Ophthalmology. 1999 Jul;106(7):1268-77. doi: 10.1016/s0161-6420(99)00707-1. PMID: 10406604.
  11.  Mackiewicz J, Tomaszewska J, Jasielska M. Optic nerve avulsion after blunt ocular trauma – Case report. Ann Agric Environ Med. 2016 Jun 2;23(2):382-3. doi: 10.5604/12321966.1203911. PMID: 27294653.
  12. Maegele M. Reversal of isolated unilateral optic nerve edema with concomitant visual impairment following blunt trauma: a case report. J Med Case Rep. 2008 Feb 18;2:50. doi: 10.1186/1752-1947-2-50. PMID: 18282293; PMCID: PMC2263064.
  13. Oh HJ, Yeo DG, Hwang SC. Surgical Treatment for Traumatic Optic Neuropathy. Korean J Neurotrauma. 2018 Oct;14(2):55-60. doi: 10.13004/kjnt.2018.14.2.55. Epub 2018 Oct 31. PMID: 30402419; PMCID: PMC6218351.
  14.  Parab R, Fung CI, Van Der Merwe G. Blunt facial trauma causing isolated optic nerve hematoma. Case Rep Radiol. 2013;2013:235209. doi: 10.1155/2013/235209. Epub 2013 Jan 21. PMID: 23401831; PMCID: PMC3563170.
  15. Pirouzmand F. Epidemiological trends of traumatic optic nerve injuries in the largest Canadian adult trauma center. J Craniofac Surg. 2012 Mar;23(2):516-20. doi: 10.1097/SCS.0b013e31824cd4a7. PMID: 22421873.
  16.  Singman EL, Daphalapurkar N, White H, Nguyen TD, Panghat L, Chang J, McCulley T. Indirect traumatic optic neuropathy. Mil Med Res. 2016 Jan 11;3:2. doi: 10.1186/s40779-016-0069-2. PMID: 26759722; PMCID: PMC4709956.
  17. Sedaghat MR, Momeni-Moghaddam H, Naroo SA, Etezad-Razavi M, Moshirfar M. Induced Myopia Secondary to Blunt Trauma. Case Rep Ophthalmol Med. 2019 Dec 30;2019:1632828. doi: 10.1155/2019/1632828. PMID: 31976104; PMCID: PMC6955130.
  18. Viestenz A, Küchle M. Stumpfes Augentrauma. Teil II: Stumpfes Hinterabschnittstrauma [Blunt ocular trauma. Part II. Blunt posterior segment trauma]. Ophthalmologe. 2005 Jan;102(1):89-99; quiz 100-1. German. doi: 10.1007/s00347-004-1137-7. PMID: 15580509.
  19. Viestenz A, Küchle M. Bulbusrupturen nach stumpfem Trauma–Editorial zu: Wenzel M, Aral H. Gedeckte Bulbusruptur. Klin Monatsbl Augenheilkd 2003 [Globe rupture after blunt ocular trauma–editorial to: Wenzel M, Aral H. Indirect traumatic rupture of the globe without conjunctival injury]. Klin Monbl Augenheilkd. 2003 Jan-Feb;220(1-2):13-4. German. doi: 10.1055/s-2003-37577. PMID: 12612841.

Address for correspondence:

Ophthalmology department, Мedical University – Sofia
UMHAT “Alexandrovska”
1, “St. Georgi Sofiyski”, Blvd.
1431, Sofia
Bulgaria
e-mail: lina_andonova@yahoo.com