Traumatic Optic Neuropathy
A 44-year-old male sustained a fall with right brow injury about 3 weeks prior to admission to a local hospital for visual loss in the right eye. He received intravenous pulse steroid therapy for 3 days under the impression of traumatic optic neuropathy OD. His vision did not improve much after therapy. He came to our clinic for a second opinion. His best-corrected visual acuity was hand motion at 15 cm OD and 6/6 OS. Intraocular pressures and anterior segments were normal on exam. There was a relative afferent pupillary defect (RAPD) in the right eye. Ophthalmoscopic examination showed mild optic disc pallor in the right eye (Fig. 6.1). OCT showed mild thinning of the peripapillary retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GC-IPL) in the right eye when compared to the left eye (Fig. 6.2). One month later, his vision remained stable, but both the peripapillary RNFL and macular GC-IPL were shown to be moderately impaired (Fig. 6.3).
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