Clinical treatment of traumatic optic neuropathy in children: Summary of 29 cases

Clinical features and treatments for traumatic optic neuropathy (TON) in children are reported. Twenty-nine children were enrolled in the Affiliated Hospital of Qingdao University from April 1999 to May 2015 for retrospective analysis. Of these 29 patients, 5 received drug therapy, and 24 received drug therapy combined with surgical therapy. Among the patients who received surgical therapy, 23 received nasal endoscopic optic decompression under general anaesthesia, and 1 received nasal endoscopic orbital decompression under general anaesthesia. All the patients were followed up for at least 6 months. In 29 cases, 48.28% (14/29) had visual improvement. Of the 5 patients who received drug therapy, 3 showed improvement (60%). Of the 24 cases who received drug and surgical therapy, 11 showed improvement (45.83%). Of the 22 patients who lost visual sensitivity, 10 showed improvement (45.45%). Of the 7 cases with visual acuity above basic light sensitivity, 4 showed improvement (57.14%). In conclusion, TON in children can lead to poor diagnosis and prognosis because of the difficulty of examining children and their limited language expression ability. Early ophthalmologic examination is therefore essential for children with craniofacial injuries, and proper treatment should be undertaken as soon as possible.