Clinical observations on the isolated optic nerve injury.

The optic nerve can be injured indirectly by blunt trauma to the frontoorbital region. The mechanism of injury is related to trauma of the nerve in the tight, bony optic canal. Neurovisual transmission in the canal is interrupted by pressure on the nerve. The conventional management includes careful observation and supportive treatment. Recent interest in this unique clinical problem has prompted the development of new techniques to decompress the injured optic canal extracranially; these approaches have produced encouraging results. Another dividend of the method has been the mapping of the optic nerve region under magnification using the operating room microscope. Any gain of vision, partial or complete, is well appreciated by the patient and the physician.