Optic Nerve Injury in Srinagarind Hospital

Abstract

Background: Optic nerve  injury  can  occur  with  other injuries. It  cause  a  devastating  effect to  vision.

Objective: To study  causes  of  injury,  associated  injuries  and  management  of  patients  with  optic  nerve  injury  in  Srinagarind  Hospital.

Design: Descriptive study

Setting: Department of Ophthalmology,Srinagarind Hospital.

Subjects: Patients diagnosed as optic nerve injury between January 1987 to December 1996.

Intervention: Patients were treated with either intravenous dexamethasone or methylprednisolone for 72 hours.

Measurements : Best corrected visual acuities (BCVA) were determined with Snellen chart before and after treatment.

Results: 49 eyes from 48 patients, 44 male and 4 female, were diagnosed as optic nerve injury. Mean age was 24.52 ± 10.86 years. Median duration  of  injury  was  3  day. The most common cause  of  injury  was  motorcycle accident. Most frequent associated  ocular  injury  was lid ecchymosis. Associated head injury and maxillofacial injury were reported 58% and 16% respectively. Before treatment, no light perception  was detected in 61.22% of  studied eyes. After treatment, 39.58% of patients had better BCVA. Eyes treated with dexamethasone or methylprednisolone had better BCVA 39% and 50% respectively.

Conclusions: Optic nerve injury can occur with head injury and maxillofacial injury. Despite it caused a devastating effect to vision, it could be recovered after intravenous corticosteroid.

Key words: Optic nerve injury, Srinagarind Hospital