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Open Angle Glaucoma: Treatment01:27

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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
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Updated: May 10, 2026

Optic Nerve Transection: A Model of Adult Neuron Apoptosis in the Central Nervous System
12:06

Optic Nerve Transection: A Model of Adult Neuron Apoptosis in the Central Nervous System

Published on: May 12, 2011

Surgery for traumatic optic neuropathy.

Patrick Yu-Wai-Man1, Philip G Griffiths

  • 1Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UK. patrick.yu-wai-man@ncl.ac.uk

The Cochrane Database of Systematic Reviews
|June 20, 2013
PubMed
Summary
This summary is machine-generated.

Surgical interventions for traumatic optic neuropathy (TON) lack robust evidence. Current research shows no clear benefit over spontaneous recovery, and surgery carries risks, making its use controversial.

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Area of Science:

  • Ophthalmology
  • Neurosurgery
  • Trauma Care

Background:

  • Traumatic optic neuropathy (TON) causes significant vision loss after head trauma.
  • Secondary retinal ganglion cell loss is attributed to optic nerve swelling or bone compression.
  • Surgical decompression and steroids are considered for improving visual prognosis in TON.

Purpose of the Study:

  • To evaluate the efficacy and safety of surgical interventions for managing traumatic optic neuropathy (TON).

Main Methods:

  • A systematic search of multiple databases (CENTRAL, MEDLINE, EMBASE, LILACS, mRCT, ClinicalTrials.gov, WHO ICTRP) was conducted.
  • Inclusion criteria focused on randomized controlled trials (RCTs) comparing surgical interventions (with or without steroids) to steroids alone or no treatment.
  • Two authors independently screened studies; no studies met the inclusion criteria.

Main Results:

  • No randomized controlled trials (RCTs) were identified that met the study's inclusion criteria.
  • The available evidence is limited to small, retrospective case series, hindering comparative analysis.

Conclusions:

  • There is no evidence that surgical optic nerve decompression offers additional benefit for traumatic optic neuropathy (TON) beyond spontaneous visual recovery.
  • Surgery for TON carries risks, including cerebrospinal fluid leak and meningitis, and its use remains controversial.
  • High-quality randomized controlled trials (RCTs) are urgently needed but present significant challenges in design and execution.