Optic Canal Decompression in Traumatic Optic Nerve Injury.

Surgical indications in traumatic optic nerve injury are controversial. Many report that patient with no light perception or light reflex immediately after trauma had no surgical indication. We reported 2 cases in which optic nerve decompression was useful in ameliorating traumatic optic nerve injury. Both subjects had been injured in traffic accidents. Three-dimensional CT scan (3D-CT) was useful in diagnosing optic canal fracture. Case 1: 72-year-old man. 3D-CT showed right optic canal fracture. On hospital day 7, we conducted optic canal decompression. Preoperative visual acuity of 0.04 improved to 0.08 after operation. Case 2: 41-year-old man. 3D-CT showed right optic canal fracture and he was diagnosed as blind in the right eye. After 2.5 half months, visual acuity improved to enable light perception. After optic canal decompression, the subject's visual acuity improved to where he could count fingers. 3D-CT is thus useful in diagnosing optic canal fracture. Optic nerve decompression should be considered even in patients having no light perception or light reflex.