Central retinal artery occlusion is rarely associated with traumatic optic neuropathy, this case report details of one such case. The reported case is of a ten-year-old boy presenting after a fall from height with loss of vision in one eye. Vision was reduced to no perception of light and a CT scan revealed fractures of the medial orbital wall and roof and a diagnosis of traumatic optic neuropathy with central retinal artery occlusion was made. Surgical intervention was performed within 24 hours with optic canal decompression through a transorbital route. Postoperatively the child’s vision returned to 6/9 within one month, which was maintained at a five year follow-up. This highlights the possibility of a local decompression of the optic nerve using a transcaruncular-transorbital approach combined with direct fibrinolysis, which in this case provided an excellent visual outcome. 

Optic canal decompression and direct ophthalmic artery fibrinolysis for traumatic optic nerve neuropathy with central retinal artery occlusion.
Vaitheeswaran K, Kaur P, Garg S, Nadar M.
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Claire Howard

Salford Royal NHS Foundation Trust, Salford, UK.

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