Traumatic optic neuropathy

Abstract

Traumatic optic neuropathy (TON) is a clinical diagnosis, with imaging frequently adding clarification to the full nature/extent of the lesion(s) in question. Each pattern of injury carries its own unique prognosis and theoretical best treatment; however, the optimum management of patients with TON remains unclear. Observation, steroids, surgical measures, or a combination of these are current cornerstones of management, but statistically significant evidence supporting any particular approach for TON is absent from the literature. Hopefully, novel management strategies will emerge as more is understood about the converging pathways of various secondary and tertiary mechanisms of cell injury and death at play in TON. In the meantime, given our current deficiencies in knowledge regarding how to best manage TON, "primum non nocere" (first do no harm) is of utmost importance.