CT scan efficiency in emergency room diagnosis for optic neuropathy due to trauma

PURPOSE: To define radiological patterns for Traumatic Optic Neuropathy (TON), which is of special concern for patients suffering of poor awareness when exploration of visual function is needed. We also studied final visual acuity in connection with the early radiological findings. METHOD: 14 optic neuropathies due to trauma, with their emergency requested CT Scan and evolution of visual acuity are reported. RESULTS: 76.9% of the patients showed radiological findings suggesting a TON, 23% consisted in intraorbitary hematic collections, 15% comprised avulsions of optic disc, 15% showed intraorbitary bony fragments and only 15% showed optic canal fractures. CONCLUSIONS: We report the radiological findings suggesting a TON which concerns the polytraumatized patients. Together with the clinical exploration, CT Scan becomes the most important method for the assessment of TON in emergency settings. In cases of avulsion of the optic nerve, visual acuity was regarded as no light perception by the patients, while in others this perception varied.