1. What is traumatic optic neuropathy? Traumatic optic neuropathy (TON) is a fracture of the optic nerve canal and/or surrounding bones after craniofacial trauma that produces compression and pulling on the optic nerve, resulting in high-pressure damage to the canal segment of the optic nerve and varying degrees of visual impairment. The causes of severe visual impairment are primary injury: the instantaneous changes caused by external forces during trauma, including hemorrhage and tearing of the optic nerve; and secondary damage caused by edema and local vascular compression of the optic nerve after trauma. Secondary damage occurs after primary injury, and secondary damage further aggravates the primary injury, causing irreversible damage to vision. 2.Is it true that optic nerve damage can only occur in very serious trauma? No, it is not. The optic nerve extends from the skull to the back of the eye and is located deep in. According to the general thinking that only a serious eye rupture injury may appear optic nerve damage. In fact, not, most of the optic nerve injuries seen clinically are not combined with eye injuries, sometimes even very minor eye injuries, only subcutaneous bruising is seen, while the patient may also appear very serious optic nerve injury. 3, what circumstances should be alert to the possibility of optic nerve injury? Most of the patients are young and middle-aged, due to the impact of a car accident caused by the head and face on the ground, especially in the motorcycle or motorcycle riders, the speed of the car at the time of injury and there is no adequate protection measures, the impact of the patient’s head completely, so some patients can be combined with cranial trauma. Although optic nerve injuries vary, the post-injury signs can still give us some hints. If you encounter the following situations, you should be on high alert and have your vision checked as soon as possible: 1) one side of the face landed at the time of injury, accompanied by temporal skin or soft tissue injury; 2) the patient was in a coma after the accident, and CT examination revealed cranio-cerebral injury, especially skull base injury; 3) there was nasal bleeding or “clear fluid” out of the nose after the injury; 4) Subcutaneous hematoma at the arch and tail of the eyebrow. In the above cases, the patient’s family must be alert to the possibility of optic nerve injury and go to the hospital for examination as soon as possible. 4.Why is optic nerve injury easily ignored? (1) After trauma, patients may have eyelid bruising and edema, and often neglect to check the vision of the eye when the eyelid cannot be opened to see; (2) after injury, it is easy to ignore the reason for visual impairment and we usually see with both eyes, as long as we can see the object in front of us, the default is that both eyes can see, so we will not deliberately close one eye to check the vision of one eye; (3) when the patient is combined with serious cranial trauma, the patient himself is in When the patient is in a coma, the family members and doctors focus on saving lives and tend to ignore the examination of the optic nerve; when the patient is awake, they often unintentionally find that one eye has decreased or lost vision, and at this time the best time for treatment has been missed. 5.How should traumatic optic neuropathy be treated? Once the diagnosis is confirmed, high-dose hormone shock therapy is required; neurotrophic drugs and vasodilator drugs are used; the risk and prognosis of optic nerve canal decompression surgery are predicted by observing the recovery of vision. 6. There are two types of optic canal decompression surgery commonly used today: one is transnasal optic nerve canal decompression; the other is. Both are effective optic canal decompression methods, and both can open the orbital and cranial openings of the optic canal, with adequate decompression coverage. Transcranial optic nerve canal decompression is performed on the superior wall of the optic nerve canal, but the procedure is more invasive and the patient’s recovery is slower. Transnasal endoscopic optic nerve decompression is currently recognized as an effective and less invasive surgical procedure, and the area of decompression is the inner and lower wall of the canal, and the patient can move around on the second day after surgery. At present, the ophthalmology department of Jiu Hospital carries out computerized surgical navigation, which greatly increases the accuracy and safety of the surgery. 7.Is optic nerve decompression surgery dangerous? The risks of transnasal endoscopic optic nerve decompression surgery are greater than those of other surgeries: 1, because it is adjacent to the internal carotid artery, there is a possibility of damaging the internal carotid artery during surgery, but the use of endoscopic navigation system greatly reduces the risk. The risk of nasal leakage of cerebrospinal fluid and meningitis, which is present when the cranial opening of the optic nerve canal is opened, and the risk of damage to important structures at the orbital apex. Because of such risks associated with this procedure, patients and their families are urged to fully understand the risks of the procedure before surgery. Although the surgery may save some of the vision, it is not a “magic bullet”. 8.What is the success rate of optic nerve canal decompression surgery? First of all, it is important to distinguish that successful surgery and vision improvement are two different concepts. The success of the surgery is to decompress the canal sufficiently without serious complications. Visual acuity improvement depends on the degree of primary and secondary damage at the time of injury. Primary damage exists at the time of injury and cannot be reversed. The secondary damage changes over time, so it is closely related to the time of consultation, and the shorter the time, the better the effect. Therefore, it is recommended that once the patient is diagnosed, he or she should go to a hospital capable of completing this surgery, and the surgery should be combined with comprehensive drug treatment to strive for maximum recovery of vision. 9.Is the treatment completed after the surgery? No, the treatment of traumatic optic neuropathy should be combined with the process of comprehensive drug treatment. Early surgery combined with hormone impact, nerve growth drugs and supplemented with nerve nutrition, vasodilator drugs, hormone is a certain side effect, under the guidance of the doctor to gradually reduce the drug, can not suddenly stop. Therefore, patients are required to review regularly. 10.What do I need to do to avoid traumatic optic neuropathy? Traumatic optic neuropathy is caused by trauma, so it is crucial to avoid trauma as much as possible in life. Wearing a helmet can cushion you from falling when the speed is too fast and not easy to control.