Abstract
There are different mechanisms of traumatic optic neuropathy, and the degree of disability varies. If the level of disability is high, improvement of visual acuity is not expected with conservative treatment. We report a case of optic canal fracture treated with endoscopic surgery. The patient was a 29-year-old male, who was injured after a fall of less than 8 meters while working on a ship. He was transported immediately to our hospital. He had open fractures to the thigh and elbow, and was admitted for Orthopedic Surgery. Since he complained of vision loss the following morning, he was introduced to ophthalmology and otolaryngology. His visual acuity was only at a hand motion level and his light reflexes had diminished. A CT scan revealed a fracture of the Lt. optic canal. These findings indicated the necessity of surgery and we performed endoscopic optic nerve decompression prior to steroid treatment on the night that this occurred. Visual acuity improved immediately after surgery to a level of being able to count fingers and finally to a level of 0.3. However, visual acuity was not fully recovered. While in this case there was no unified indication of optic canal decompression, it is important to quickly consider whether to perform surgery on a case by case basis. As well as this, Rhinologists who have techniques for endoscopic sinus surgery should take the initiative with regard to treatment, in cooperation with other departments.
