Indirect injury to the optic nerves and optic chiasm

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Abstract
Twenty-five cases of indirect injury to the optic nerve or chiasm following blunt trauma to the head were retrospectively reviewed. Falls onto the head and road traffic accidents together accounted for most (88%) of the head injuries. Bony skull fractures were identified in 23 cases (92%), although in only five of these (20%) was one of the optic canals or anterior clinoid processes involved in a fracture. Visual loss was bilateral in 11 patients (44%). In eight of these bilateral cases the visual field defects suggested a lesion at or near the optic chiasm. In one case optic nerve function deteriorated after the initial assessment. This deterioration was reversed by treatment, which consisted of surgical drainage of an orbital haematoma and systemic corticosteroids.

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