Cases reported "Optic Nerve Injuries"

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1/54. Traumatic optic neuropathy. A case report.

    A case of visual loss following cranio-maxillofacial trauma is reported. The patient had a sudden partial blindness associated with a fracture of the roof, medial and lateral orbital walls. Access to the orbit was achieved through a transethmoidal approach using the Howarth-Lynch medial incision and resecting the bone fragments which impinged on the optic nerve. The patient had total return of visual acuity, without surgical complications. The role of orbital and optic decompression in the management of patients with traumatic optic neuropathy is discussed. Its indications are controversial and the procedure should be considered only within the context of the specific needs of the individual patient.
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keywords = visual
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2/54. Delayed post-traumatic visual loss: a clinical dilemma.

    A 16-year-old female presented with unilateral blindness in her right eye 2 months after blunt head trauma. Optic nerve edema was demonstrated by funduscopic examination, ultrasonography, and magnetic resonance imaging and failed to respond to medical treatment. Delayed post-traumatic blindness may be a severe complication of head trauma. The late appearance leads to delayed diagnosis and resulting unresponsiveness to treatment. patients who experience head trauma that could involve the optic nerves should undergo ultrasonography of the optic nerves. An abnormal finding should be followed by an intensive evaluation to determine possible damage.
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keywords = visual
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3/54. Major orbital complications of endoscopic sinus surgery.

    BACKGROUND: The paranasal sinuses are intimately related to the orbit and consequently sinus disease or surgery may cause severe orbital complications. Complications are rare but can result in serious morbidity, the most devastating of which is severe visual loss. methods: A retrospective review was undertaken of four cases of severe orbital trauma during endoscopic sinus surgery. RESULTS: All the cases suffered medial rectus damage, one had additional injury to the inferior rectus and oblique, and two patients were blinded as a result of direct damage to the optic nerve or its blood supply. CONCLUSION: Some ophthalmic complications of endoscopic sinus surgery are highlighted, the mechanisms responsible are discussed, and recommendations for prevention, early recognition, and management are proposed.
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keywords = visual
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4/54. Indirect traumatic optic neuropathy--two case report.

    The aim of the study was to evaluate the treatment of indirect traumatic optic neuropathy (ITON). ITON is defined as traumatic loss of vision that occurs without external or initial ophthalmoscopic evidence of injury to the eye or its nerve. The optimal management of ITON remains controversial. history, clinical findings and treatment of two cases of ITON with high-dose corticosteroids are described. Improvement of visual acuity after treatment with high-dose corticosteroids was achieved in both cases. The treatment is evaluated in comparison to endorsed treatment modalities found in literature. We concluded that was clinically reasonable to decide to treat or not to treat the indirect optic neuropathy on an individual patient basis.
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ranking = 0.5
keywords = visual
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5/54. Management of traumatic optic neuropathy.

    Visual loss caused by trauma to the optic nerve is a well-recognized sequela to cranio-maxillofacial trauma. The authors reviewed their experience with 90 patients with pure traumatic optic neuropathy and optic nerve trauma with concomitant maxillofacial injuries. All patients were treated with intravenous steroids. Those not improving underwent extracranial optic canal decompression. patients with initial visual acuity of 20/100 or better all responded favorably with improvement in visual acuity or visual field to a course of intravenous megadose corticosteroids. patients with initial vision of 20/200 or worse who failed to respond to corticosteroids may have improved visual function after undergoing extracranial optic canal decompression. Preoperative and postoperative computed tomography scans on 6 patients enhanced with intrathecal iopamidol indicate the site of optic nerve compression to be at the optic canal. This article discusses the diagnosis and the medical and surgical treatment of pure and complex optic nerve injuries.
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ranking = 2
keywords = visual
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6/54. Complete avulsion of the optic nerve. A clinical, angiographic, and electrodiagnostic study.

    A case of traumatic complete avulsion of the optic nerve is reported together with fluorescein angiography and electrodiagnostic findings. Despite the disappearance of the central vessels, circulation remained in the branch retinal vessels and angiography demonstrated communication between peripapillary choroidal vessels and the superior temporal artery. The visually-evoked cortical response was abolished. electroretinography showed a normal a-wave but reduced amplitude b-wave, not supporting the theory of the existence of centrifugal retino-suppressive fibres in the optic nerve of man.
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keywords = visual
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7/54. Optic neuropathy resulting from indirect trauma.

    Minor blunt injury to the head and face may result in optic nerve contusion with secondary optic atrophy. The resulting visual loss is devastating for the individual. We report an uncommon but important complication that may result from an apparently trivial injury. Early identification and initiation of appropriate management may restore the individual's vision. Emergency physicians are often the first to see patients at risk of this complication yet there is little discussion of this injury in the emergency medicine literature.
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ranking = 0.5
keywords = visual
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8/54. Attempted bilateral manual enucleation (gouging) during a physical assault.

    OBJECTIVE: To report a rare, severe case of partial traumatic bilateral enucleation and its assessment and management. DESIGN: Case report and literature review. methods: A report of clinical and imaging findings, surgical procedure, medical treatment, and final outcome. RESULTS: Complete avulsion of the extraocular muscles and optic nerve resulted in total loss of vision in one eye. Partial visual recovery was achieved by operating on the fellow eye, which was partially avulsed. Both eyes underwent lateral canthotomy in the emergency room. This was followed by exploration, repair of all ruptured extraocular muscles, and anterior chamber tap under general anesthesia. The few previously reported cases of traumatic manual avulsion of the globe are reviewed and discussed in the context of the present case. CONCLUSIONS: Partial visual recovery can be achieved after severe orbital and optic nerve trauma. A multidisciplinary approach to the assessment and management of these patients is recommended.
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ranking = 1
keywords = visual
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9/54. Alterations in retinal nerve fiber layer thickness following indirect traumatic optic neuropathy detected by nerve fiber analyzer, GDx-N.

    PURPOSE: To evaluate changes in the retinal nerve fiber layer following traumatic optic neuropathy. DESIGN: Observational case report. methods: A patient presented with visual loss after an accident. scanning laser polarimetry was performed. RESULTS: Thickness of the retinal nerve fiber layer increased immediately after the trauma but then progressively decreased. Severe loss was observed at day 90 and then ceased. Enlargement of the optic disk cup was also observed. CONCLUSIONS: This is the first report documenting early transient increase followed by progressive loss of the retinal nerve fiber layer in traumatic optic neuropathy.
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keywords = visual
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10/54. blindness following paranasal sinus surgery: a report of two cases.

    Two cases of blindness following paranasal sinus surgery are presented. The first patient, a 38-year old man, developed a delayed massive haemorrhage, after bilateral sphenoethmoidectomy. This hemorrhage could be stopped by electric cauterisation under endoscopical control. During this reintervention the patient developed total blindness of his right eye, and a restriction of the inferotemporal left visual field. The second patient, a 10-year old girl, developed, after bilateral spheno-ethmoidectomy for isolated sphenoiditis, total blindness of the left eye and paralysis of the ipsilateral extraocular muscles. According to the literature, blindness secondary to paranasal surgery is mainly due to retrobulbar hemorrhage. In the first case blindness was due to a direct cauterisation of the optic nerve, after perforation of the lamina papyracea. In the second case, blindness was probably due to a hemorrhage in the orbital apex.
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keywords = visual
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