eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Trauma

Traumatic Optic Neuropathy: Multimedia

Author: Christopher I Zoumalan, MD, Clinical Instructor, Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology, New York University Medical Center and Manhattan Eye, Ear, and Throat Hospital
Coauthor(s): Jonathan W Kim, MD, Director of Oculoplastic and Orbital Surgery, Co-director of Ocular Oncology Service, Co-director of Neuro-ophthalmology Service, Department of Ophthalmology, Stanford Medical Center; James W Gigantelli, MD, Professor of Ophthalmology, Assistant Dean of Government Relations, University of Nebraska Medical Center
Contributor Information and Disclosures

Updated: Jul 28, 2008

Multimedia

Plain film radiograph of a 2-year-old girl follow...
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Media file 1: Plain film radiograph of a 2-year-old girl following blunt periocular trauma. Although a left orbital wall fracture is not evident, a loculated pocket of intraorbital air is highlighted by the arrow.
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Plain film radiograph of a 2-year-old girl follow...

Plain film radiograph of a 2-year-old girl following blunt periocular trauma. Although a left orbital wall fracture is not evident, a loculated pocket of intraorbital air is highlighted by the arrow.

Note the proptosis induced by the large accumulat...
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Media file 2: Note the proptosis induced by the large accumulation of intraorbital emphysema. Also, note the relatively nondisplaced nature of the medial orbital wall fracture. This patient experienced a threatened central retinal artery obstruction due to this condition. Evacuation of the orbital air relieved the compromised retinal circulation.
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Note the proptosis induced by the large accumulat...

Note the proptosis induced by the large accumulation of intraorbital emphysema. Also, note the relatively nondisplaced nature of the medial orbital wall fracture. This patient experienced a threatened central retinal artery obstruction due to this condition. Evacuation of the orbital air relieved the compromised retinal circulation.

Fundus photograph of a 24-year-old man with visio...
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Media file 3: Fundus photograph of a 24-year-old man with vision loss following blunt periocular trauma. The incident occurred during a baseball game when the patient (a base runner) collided with the catcher. The area of opacification extending from the temporal aspect of the optic nerve head represents retinal ischemia and is indicative of an anterior ischemic optic nerve injury. Such injuries may have a better long-term visual prognosis than posterior ischemic optic neuropathies. Indirect traumatic optic neuropathy more commonly results in posterior optic nerve injuries. Posterior injuries usually do not result in any morphologic change to the optic nerve head appearance.
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Fundus photograph of a 24-year-old man with visio...

Fundus photograph of a 24-year-old man with vision loss following blunt periocular trauma. The incident occurred during a baseball game when the patient (a base runner) collided with the catcher. The area of opacification extending from the temporal aspect of the optic nerve head represents retinal ischemia and is indicative of an anterior ischemic optic nerve injury. Such injuries may have a better long-term visual prognosis than posterior ischemic optic neuropathies. Indirect traumatic optic neuropathy more commonly results in posterior optic nerve injuries. Posterior injuries usually do not result in any morphologic change to the optic nerve head appearance.

Axial CT scan of the orbit. Note the mildly disp...
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Media file 4: Axial CT scan of the orbit. Note the mildly displaced fracture at the junction of the posterior medial orbital wall and optic canal.
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Axial CT scan of the orbit. Note the mildly disp...

Axial CT scan of the orbit. Note the mildly displaced fracture at the junction of the posterior medial orbital wall and optic canal.

Fundus photograph of the left eye in a 33-year-ol...
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Media file 5: Fundus photograph of the left eye in a 33-year-old male who suffered a severe head injury after falling off a ladder one year prior to presenting to our clinic. The patient has a visual acuity of counting fingers (CF) of 6 feet in his left eye and a large relative afferent pupillary defect. Note the optic nerve's pale appearance.
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Fundus photograph of the left eye in a 33-year-ol...

Fundus photograph of the left eye in a 33-year-old male who suffered a severe head injury after falling off a ladder one year prior to presenting to our clinic. The patient has a visual acuity of counting fingers (CF) of 6 feet in his left eye and a large relative afferent pupillary defect. Note the optic nerve's pale appearance.

More on Traumatic Optic Neuropathy

Overview: Traumatic Optic Neuropathy
Workup: Traumatic Optic Neuropathy
Treatment: Traumatic Optic Neuropathy
Follow-up: Traumatic Optic Neuropathy
Multimedia: Traumatic Optic Neuropathy
References
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References

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Further Reading

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Keywords

traumatic optic neuropathy, optic neuropathy, optic nerve injury, vision loss, trauma, frontal trauma, orbital trauma, optic nerve avulsion, optic nerve transection, diffuse orbital hemorrhage, localized orbital hemorrhage, optic nerve sheath hematoma, orbital emphysema, TON

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Contributor Information and Disclosures

Author

Christopher I Zoumalan, MD, Clinical Instructor, Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology, New York University Medical Center and Manhattan Eye, Ear, and Throat Hospital
Christopher I Zoumalan, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Medical Association, American Society of Ophthalmic Plastic and Reconstructive Surgery, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Coauthor(s)

Jonathan W Kim, MD, Director of Oculoplastic and Orbital Surgery, Co-director of Ocular Oncology Service, Co-director of Neuro-ophthalmology Service, Department of Ophthalmology, Stanford Medical Center
Jonathan W Kim, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Society of Ophthalmic Plastic and Reconstructive Surgery, and North American Neuro-Ophthalmology Society
Disclosure: Nothing to disclose.

James W Gigantelli, MD, Professor of Ophthalmology, Assistant Dean of Government Relations, University of Nebraska Medical Center
James W Gigantelli, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, American Society of Ophthalmic Plastic and Reconstructive Surgery, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Medical Editor

Hassan H Ramadan, MD, MSc, Professor and Vice-Chair, Department of Otolaryngology-Head and Neck Surgery, Professor, Department of Pediatrics, West Virginia University
Hassan H Ramadan, MD, MSc is a member of the following medical societies: American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, and American Rhinologic Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Stephen G Batuello, MD, Consulting Staff, Colorado ENT Specialists
Stephen G Batuello, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Physician Executives, American Medical Association, and Colorado Medical Society
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo  Consulting; Medvoy Ownership interest Management position

 
 
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