Endoscopic approach to traumatic visual loss.
OBJECTIVE
To review our experience with the use of endoscopic optic nerve decompression in traumatic blindness.


METHODS
We did a retrospective analysis of patients with traumatic blindness that underwent endoscopic decompression of the optic canal to determine postoperative visual acuity and correlate it to preoperative visual loss and intraoperative findings. The setting was a Level I university trauma center. We identified 8 patients treated with both surgery and steroids over a 10-month period beginning in 1993 (Seven males, one female).


RESULTS
Four of six patients with total blindness (no light perception) had improvements in visual acuity. In three patients, visual acuity returned to preinjury levels. One patients with total blindness was operated on 6 weeks after injury and had a visual acuity of 20/800 at 1-year follow-up. Two patients with hand motion preoperatively had improvement in visual acuity. In one patient, vision returned to normal (20/20), and in the other it improved to 20/200). Five patients were operated on after megadose steroid treatment for at least 48 hours failed; four of five noted dramatic improvements in visual acuity.


CONCLUSIONS
The endoscopic approach may be used to successfully decompress the optic nerve in traumatic blindness.
Kountakis
S E
SE
Department of Otolaryngology-Head and Neck Surgery, University of Texas, Houston, USA.
Maillard
A A
AA
Urso
R
R
Stiernberg
C M
CM
D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001766:Blindness / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D009900:Optic Nerve / Q000601:surgery*; D020221:Optic Nerve Injuries; D012189:Retrospective Studies; D014792:Visual Acuity
D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone