title: Neuro-ophthalmological findings in closed head trauma.
abstract: Visual abnormalities following closed head trauma are common and can affect any part of the visual pathway. We reviewed 181 consecutive patients referred with visual complaints following closed head trauma. A motor vehicle accident was the most common etiology of trauma in 57% of cases, direct trauma to the head in 15%, and injuries sustained from a fall in 13%. Sixty-three percent of patients lost consciousness and 26% suffered a skull fracture. Thirty-five percent of all patients had visual field defects with functional (tunnel) fields the most common. Over 88% of eyes had 20/20 or better visual acuity. Thirty-three percent of patients suffered a cranial nerve palsy, with 75% resolving without intervention. The severity of head injury was directly related to the lack of proper seat belt and helmet use. Most visual complaints were improved with a simple refraction. Most binocular diplopia cleared with time, with only 15 cases requiring surgical correction.
authors.affiliation: Massachusetts Eye and Ear Infirmary, Boston.
authors.forename: N R
authors.initials: NR
authors.lastname: Sabates
authors.forename: M A
authors.initials: MA
authors.lastname: Gonce
authors.forename: B K
authors.initials: BK
authors.lastname: Farris
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003389:Cranial Nerve Diseases / Q000150:complications / Q000209:etiology; D005260:Female; D016489:Head Injuries, Closed / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010243:Paralysis / Q000150:complications / Q000209:etiology; D012017:Referral and Consultation; D012189:Retrospective Studies; D012887:Skull Fractures / Q000175:diagnosis; D013285:Strabismus / Q000209:etiology; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology*; D014792:Visual Acuity; D014794:Visual Fields