ABSTRACT
PURPOSE: To inform rural healthcare providers about the early identification and management of traumatic optic neuropathy (TON). Specifically, we seek to legitimize expectant management as a viable approach to such cases. OBSERVATIONS: A 27-year-old female with direct posterior compressive TON with associated visual field and visual acuity deficit was managed expectantly without steroids or surgical intervention. In four months, her visual acuity improved from 20/400 to 20/50. CONCLUSTION AND IMPORTANCE: Although steroids and surgery have been common practice for treatment of TON, there is insufficient evidence to support their use in all cases. Existing research supports expectant management as a viable option. This could prove especially useful in rural settings where resources and surgical subspecialists are limited.
Subject(s)
Optic Nerve Injuries , Adult , Conservative Treatment , Female , Humans , Optic Nerve Injuries/diagnostic imaging , Optic Nerve Injuries/etiology , Optic Nerve Injuries/therapy , Orbit , Retrospective Studies , Visual AcuityABSTRACT
A 17-year-old girl presented with slow, progressive, painless visual deterioration in the left eye. Fundus examination and fluorescein angiography findings were consistent with combined hamartoma of the retina and retinal pigment epithelium. Spectral domain optical coherence tomography (SD-OCT) displayed a preretinal membrane, retinal disorganization, and thickened retina drawn into folds. Partial posterior vitreous detachment was noted. The higher-resolution scans delineated the transition between the tumor and normal retina. The higher resolution of SD-OCT allows detailed observation of the vitreoretinal interface abnormalities and retinal disorganization present in combined hamartomas of the retina and retinal pigment epithelium and aids in the differential diagnosis and management of pigmented fundus lesions.
