Outcomes of optic nerve injuries in head trauma

The paper studies the natural course of the optic nerve (ON) injury in head trauma. The seria of 156 patients have been analyzed. In 129 (83%) cases there was one side ON injury, in 27 (17%) chiasm or both ON were involved. All patients were managed without high-dose steroids. Visual functions improvement was noted in 68 (39%) of 175 eyes with initial visual acuity ranged from amaurosis to 0.8. Of 76 eyes with initial visual acuity of light perception and more 46 (61%) improved, but of 99 amaurotic eyes only 22 (22%) did. Non-invasive transcutaneous ON electrostimulation (TONES) method was adopted for the treatment of 70 patients (81 eyes) in terms of 1 month - 8 years (average 13.2+/-2.3 months) after trauma. This resulted in further vision improvement in 42 (65%) of 65 eyes with visual acuity light perception and more. None of 16 amaurotic eyes improved. TONES is save and effective method for vision restoration in ON injury long after trauma.