[Late manifestations of the optic nerve damage after closed head trauma]

A follow-up assessment of the visual system in patients who had undergone close head injury and in whom simple atrophy of the optic nerve occurred several months after the trauma.

Among patients treated in Department of Ophthalmology in Białystok in the years 1984-1995 there were 2 women and 3 men, aged 19-61 years, who suffered from advancing simple atrophy of the optic nerve and who had undergone severe closed head trauma 3-5 months earlier. In one case the time interval between trauma and the visual sequelae amounted to 11 years.

The patients underwent a follow-up examination at 3 to 11 years after their initial treatment in the Department of Ophthalmology. Besides a conventional ophthalmologic examination, a static perimetry was performed as well as ultrasonography in projection B and Colour-Coded Doppler sonography (TCCD) of the orbital vessels.

When compared to the findings at discharge, in 2 patients visual acuity improved to 5/12, in the remaining 3 no improvement was noted. In all patients the optic discs were white, while other structures of the globe appeared within normal limits. Blood flow in the central retinal artery, ophthalmic artery and in the long posterior cilliary arteries remained undisturbed, as assessed with TCCD.

1. Lack of visual disturbances immediately after head injury does not preclude their development in the protracted period after the trauma. 2. The reason of the late development of visual sequelae after head trauma is not clear. Normal flow, found in the major vessels of the globe, might indirectly suggest disturbances of microcirculation within the optic nerve with a consequent optic atrophy.