Open AccessTraumatic Optic Neuropathy – A Conundrum
Author(s) -
Vinoth Kanna Selvaraj,
Ramachandran Viswanathan,
Vasudevan Devanathan
Publication year - 2016
Publication title -
journal of clinical and diagnostic research
Language(s) - Uncategorized
Resource type - Journals
eISSN - 2249-782X
pISSN - 0973-709X
DOI - 10.7860/jcdr/2016/16612.7333
Subject(s) - medicine , head trauma , optic neuropathy , presentation (obstetrics) , surgery , closed head injury , head injury , pediatrics , optic nerve , traumatic brain injury , ophthalmology , psychiatry
Visual impairment following head injury may be an enigma especially if the onset of symptoms were to be few days after the actual trauma and the bias arising out of the initial normal ophthalmological examination is not neutralised by unbiased repeated formal clinical evaluation aided with electrophysiology. We report and discuss here a 32-year-old lady with delayed onset of indirect traumatic visual loss with anaemia who failed to improve after blood transfusion but improved immediately following steroid therapy seven days after trauma. Though steroids have not been shown to have a significant contribution on outcomes following Traumatic optic neuropathy, this report rekindles its role in delayed progressive visual loss following head trauma and the need to re-analyse the role of steroids in patients with delayed progressive visual disturbance following head injury excluding those with acute onset symptoms in view of different pathologies in both these presentations. This paper also highlights potential mechanisms for the two major types of presentation.