Controversy in neuro-ophthalmology steroid therapy for traumatic optic neuropathy

Аннотация

Traumatic optic neuropathy (TON) is an uncommon but devastating cause of permanent visual loss following blunt force trauma to the orbit. Clinically, a patient with acute TON may present with either partial or complete loss of vision, an afferent pupillary defect, normalappearing optic disc, or visual field defects. With time, optic disc pallor will manifest. Likelihood of vision recovery is low in these patients, as visual acuity and visual field results do not show significant difference 5 years after injury when compared to baseline testing following injury.There is an increase in the incidence of traumatic optic neuropathy (TON) due to increasing urbanization and rapid spurt in the number ofmotor vehicles on the road. Despite early presentation and ease of diagnosis the visual outcomes in TON are still limited. There is also significant confusion about the timing, dose and efficacy of steroid treatment in its management.