title: Endoscopic approach to traumatic visual loss.
abstract: 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.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Texas, Houston, USA.
authors.forename: S E
authors.initials: SE
authors.lastname: Kountakis
authors.forename: A A
authors.initials: AA
authors.lastname: Maillard
authors.forename: R
authors.initials: R
authors.lastname: Urso
authors.forename: C M
authors.initials: CM
authors.lastname: Stiernberg
mesh_terms: 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
chemical_list: D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone