Traumatic Optic Neuropathy: Analysis of Demographic and Clinical Parameters Over Three Years in a Tertiary Care Hospital in India.

Abstract

Background Treatment options for traumatic optic neuropathy (TON) are limited and the role of steroids in the treatment of TON is still controversial. Hence this study was planned to highlight the role of steroids in the treatment of TON. Purpose The study aims to highlight the epidemiological and clinical characteristics, as well as the role of steroids, in TON cases seen during a three-year period at a tertiary care center in India. Methods This was a retrospective study that reviewed records of all cases of TON between January 2018 to January 2020. Results Twenty-three cases of TON were seen representing 1.26% cases of head injuries. The median age was 18 years. One patient (4.34%) had bilateral TON and 18 patients (78.26%) were referred from accident and trauma care. None of the patients presented directly to an ophthalmologist. The most common cause of injury was automobile accident (69.56%). Visual acuity at presentation was 20/80-20/100 in six (26.08%) cases. Fifteen (65.4%) patients had associated closed globe injury. Seven (30.43%) patients had ocular adnexal involvement and 10 (43.47%) patients had orbital fractures. Seventeen (73.91%) received steroid treatment and six of these patients showed visual improvement. Conclusions The study showed that there was no significant association between presenting visual acuity and treatment. The presence of significant ocular injury and orbital injury increased the likelihood of treatment. There was no difference between the treated and untreated groups with respect to final visual acuity.