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David Shiple, Steven Newman; Traumatic Avulsion of the Optic Nerve. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2355.
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Traumatic avulsion of the optic nerve is an unusual form of traumatic optic neuropathy characterized by disruption of the axons at the level of the optic nerve due to penetrating or non-penetrating trauma. These patients generally have a poor prognosis and are often seen late with scarring. Recognition at the time of injury is often difficult because of associated damage to the anterior segment or blood within the vitreous.
Three patients with traumatic avulsion of the optic nerve are presented documenting the variable but usually poor visual result and the classical findings seen on funduscopy and B-scan.
Traumatic avulsion of the optic nerve is often recognized late with scarring over the discs but sometimes acutely with variable disruption of the vascular supply over the optic nerve head leading to local hemorrhage around the disc but also into the vitreous. Visual results remain poor and no therapeutic intervention has been successful. Incomplete avulsion may leave a clinically useful visual field. As the blood supply to the anterior segment is not usually disrupted in spite of traumatic reduction in afferent system function these patients usually maintain their globe unless there is additional associated injury.
Traumatic optic nerve avulsions are a rare syndrome associated with hemorrhage at the disc and into the vitreous leading to late scarring over the disc. Quantitative in vivo assessment better delineates the natural history of traumatic damage.
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