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Neuro-ophthalmological findings in closed head trauma
N R Sabates1, M A Gonce, B K Farris
1Massachusetts Eye and Ear Infirmary, Boston.
Journal of Clinical Neuro-Ophthalmology
|December 1, 1991
Summary
Visual abnormalities are common after head trauma, with most patients experiencing improved vision through simple refraction or natural recovery. Proper safety measures like seat belts and helmets correlate with less severe head injuries.
Area of Science:
- Ophthalmology
- Neurology
- Trauma Care
Background:
- Visual abnormalities frequently occur after closed head trauma, impacting the entire visual pathway.
- Motor vehicle accidents are the leading cause of such injuries.
Purpose of the Study:
- To review visual complaints in patients with closed head trauma.
- To identify common visual deficits and their outcomes.
Main Methods:
- Retrospective review of 181 patients with visual complaints post-closed head trauma.
- Analysis of injury etiology, loss of consciousness, skull fractures, visual acuity, visual field defects, and cranial nerve palsies.
Main Results:
- Motor vehicle accidents accounted for 57% of trauma cases.
- 35% of patients had visual field defects, most commonly functional (tunnel) fields.
- 33% experienced cranial nerve palsy, with 75% resolving spontaneously. Most visual complaints resolved with refraction.
Conclusions:
- Visual pathway damage is a significant consequence of closed head trauma.
- Most visual deficits, including diplopia and acuity issues, resolve with conservative management or time.
- Severity of head injury is linked to inadequate safety equipment use.