Optic Neuropathy with Delayed Onset After Trauma: Case Report and Review of the Literature

ABSTRACT

The authors report a case of a 16-year-old healthy male who experienced loss of vision in the right eye immediately after getting punched by a fist. His visual acuity improved to 20/20 within hours, and the optic nerve head appeared normal. Computed tomography (CT) scan of the orbits showed fractures of the right inferior orbital wall and lamina papyracea. The morning after the injury, he awoke with right eye vision decline to count fingers. There was pallid optic nerve swelling. Magnetic resonance imaging (MRI) scan of the orbits showed right medial rectus enlargement and no optic canal abnormalities. The patient was treated with intravenous (IV) methylprednisolone with improvement in visual acuity. Literature of delayed traumatic optic neuropathy (TON) and anterior TON is reviewed.

KEYWORDS:

• Optic neuropathy
• steroid
• trauma

Funding

This work was supported by Unrestricted Departmental Grant from Research to Prevent Blindness, National Institutes of Health grant K23-EY024345, and Research to Prevent Blindness Sybil B. Harrington Special Scholar Award.

Additional information

Funding

This work was supported by Unrestricted Departmental Grant from Research to Prevent Blindness, National Institutes of Health grant K23-EY024345, and Research to Prevent Blindness Sybil B. Harrington Special Scholar Award.