Traumatic optic neuropathy

The optic nerve is vulnerable to indirect and direct trauma causing functional impairment of vision. Optic nerve injuries occur in the setting of head injury which is often a consequence of road traffic accidents or falls. The diagnosis of optic nerve injury may be delayed by the presence of other life-threatening injuries. The signs of trauma to the optic nerve are clinical and the examination of acutely injured patients poses difficulties for the clinician. In this article, I shall consider the diagnosis of optic nerve injuries and discuss the dilemmas of management that may arise.