Cirugía y Cirujanos

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board

>Journals >Cirugía y Cirujanos >Year 2009, Issue 4

Razo-Blanco-Hernández DM, Lima-Gómez V
Neuropatía óptica traumática bilateral asimétrica. Informe de un caso
Cir Cir 2009; 77 (4)

Language: Español
References: 17
Page: 309-312
PDF: 102.45 Kb.

Full text


Background: Diagnosis of traumatic optic neuropathy is difficult during primary care as a result of the absence of optic disk changes or coexisting injuries that may be more apparent. Although there are functional signs that suggest its presence, the lack of a comparison parameter may further prevent its detection. A case of bilateral traumatic optic neuropathy is analyzed to emphasize the need for functional evaluation in the injured eye. Clinical case: A 34-year-old male presented with severe head trauma, loss of consciousness and type III Lefort facial fracture as a result of a vehicular accident. Seventy two hours after the accident, the left eye had only light perception and an afferent papillary defect. The right eye had visual deficiency not explained by anterior segment injuries. Therapy was aimed at the left eye and, during follow-up, involvement of the right eye was identified very late. The patient’s evolution is analyzed, as well as the causes that prevented early detection of traum atic optic neuropathy in the right eye. Conclusions: Functional evaluation must be used to search for traumatic optic neuropathy in every eye injury. The absence of ocular fundus abnormalities does not rule out the disease, especially when visual deficiency exists. Detection of patients with a positive pupil during initial evaluation of trauma is required in order to refer the patient in a timely manner to the ophthalmologist. The specialist should identify atypical cases and therapy should be initiated as early as possible.

Key words: Ocular trauma, optic atrophy, traumatic optic neuropathy.


  1. Shibuya TY, Feinber SM, Mathog RH, Li K, Kim SA, Stachler RJ, et al. Visual risks of facial fracture repair in the setting of traumatic optic neuropathy. Arch Otolaryngol Head Neck Surg 2006;132:258-264.

  2. Ching-Hua H, Yur-Ren K, Hsin-Chia H, Hui-Hong T, Seng-Feng J. Indirect traumatic optic neuropathy complicated with periorbital facial bone fracture. J Trauma 2003;56:795-801.

  3. Carta A, Ferrigno L, Salvo M, Bianchi-Marzoli S, Boschi A, Carta F. Visual prognosis after indirect traumatic optic neuropathy. J Neurol Neurosurg Psychiatry 2003;74:246-248.

  4. Maegele M. Reversal of isolated unilateral optic nerve edema with concomitant visual impairment following blunt trauma: a case report. J Med Case Reports 2008;2:50.

  5. Rajiniganth MG, Gupta AK, Gupta A, Rajiv BJ. Traumatic optic neuropathy. Visual outcome following combined therapy protocol. Arch Otolaryngol Head Neck Surg 2003;129:1203-1206.

  6. Albert DM, Jakobiec FA. Principles and Practice of Ophthalmology. St. Louis: CV Mosby; 1994 (CD).

  7. Pieramici DJ, Sternberg P, Aaberg TM, Bridges WZ, Capone A, Cardillo JA, et al. A system for classifying mechanical injuries of eye (globe). Am J Ophthalmol 1997;123:820-831.

  8. Lima-Gómez V. Alteraciones pupilares en trauma ocular. Trauma 2003; 6:76-82.

  9. Mattox KL, Feliciano DV, Moore EE. Trauma. 4th ed. New York: McGraw-Hill; 2000. p. 404.

  10. Levin LA, Beck RW, Joseph MP, Seiff S, Kraker R. The treatment of traumatic optic neuropathy: the International Optic Nerve Trauma Study. Ophthalmology 1999;106:1268-1277.

  11. Yu-Wai-Man P, Griffiths PG. Steroids for traumatic optic neuropathy. Cochrane Database Syst Rev 2007:CD006032.

  12. Kountakis SE, Maillard AA, El-Harazi SM, Longhini L, Urso RG. Endoscopic optic nerve decompression for traumatic blindness. Otolaryngol Head Neck Surg 2000;123:34-37.

  13. Yu Wai Man P, Griffiths PG. Surgery for traumatic optic neuropathy. Cochrane Database Syst Rev 2005:CD005024.

  14. Glaser JS. Neuro-ophthalmology. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 1999. p. 187.

  15. Wu N, Yin ZQ, Wang Y. Traumatic optic neuropathy therapy: an update of clinical and experimental studies. J Int Med Res 2008;36:883-889.

  16. Simons K. Visual acuity and the functional definition of blindness. In: Tasman & Jaeger eds. Duane’s Clinical Ophthalmology. Philadelphia: Lippincott Williams & Wilkins; 1998. p. 5:51.1.

  17. Kuhn F, Pieramici DJ. Ocular Trauma, Principles and Practice. New York: Thieme; 2002. p. 29.

>Journals >Cirugía y Cirujanos >Year 2009, Issue 4

· Journal Index 
· Links 

Copyright 2019