Blindness after maxillofacial blunt trauma. Evaluation of candidates for optic nerve decompression surgery

Clinical and computerized tomography (CT) findings in 10 patients with post-traumatic blindness after maxillofacial blunt trauma were evaluated as potential candidates for optic nerve decompression surgery. The total number of blind eyes was 14. All patients suffered from midfacial fractures (isolated zygomatic fracture in 4 and Le Fort fracture in 6 cases) predominantly caused by road traffic accidents. CT scanning and clinical findings allowed location of damage to the optic nerve region in all patients. The most common CT finding was swelling of the optic nerve. Fracture in the optic canal wall was seen in only 3 cases. The clinical situations characteristic of this type of injury make diagnosis and early surgical intervention difficult. It was concluded that two of the 10 patients might have benefitted from optic nerve decompression.