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The optic nerve can be damaged when exposed to direct or indirect injury. Direct optic nerve injuries are caused by trauma to the head or orbit that crosses normal tissue planes and disrupts the anatomy and function of the optic nerve; e.g., a bullet or forceps that physically injures the optic nerve.
Ischemic injury to the optic nerve causes inflammation and swelling. Because the posterior optic nerve passes through the optic canal, a bony tunnel leading to the brain, swelling in this rigid space causes compression of the optic nerve. This compression worsens ischemia and perpetuates the cycle of injury, and swelling, and compression. [1]
[2] [3] Causes of a primary CSF leak are those of trauma including from an accident or intentional injury, or arising from a medical intervention known as iatrogenic. A basilar skull fracture as a cause can give the sign of CSF leakage from the ear, nose or mouth. [4] A lumbar puncture can give the symptom of a post-dural-puncture headache.
The orbital fat or the stretching of the nerve due to increased orbital volume may also lead to optic nerve damage. The patient experiences a loss of visual acuity, visual field defect, afferent pupillary defect, and loss of color vision. This is an emergency and requires immediate surgery to prevent permanent blindness. [citation needed]
The exact mechanism of optic nerve ischemia in these cases remains unclear, but contributing factors may include hypotension, anemia, hypoxia, and changes in the autoregulation of optic nerve arterial blood flow. The incidence of ischemic optic neuropathy leading to vision loss following general surgeries ranges between 0.1% and 0.002%.
The symptoms of nerve injury in the early 1900s were called nerve palsy (today neuropathy or neuritis are more common terms). [50] The concept of injuries causing nerve palsy was understood at that time. [49] For example, wrist fractures were known to be a cause of nerve palsy through compression, and this could be treated by liberating the nerve.
severe retinal disease, lesion of optic nerve anterior to chiasm: Gunn's pupillary phenomenon at Who Named It? Relative pupil dilatation when light swings to the affected side Markle's sign: George Bushar Markle IV: surgery: appendicitis (needed) RLQ pain on dropping from standing on toes to heels Massouh's sign: Farouk Massouh: surgery ...
The thickened and enhanced symptomatic nerve, as shown in recent MRI findings, might be indicative of the existence of structural nerve damage in RPON. [12] Therefore, neuropathy is suggested as the primary cause of RPON, [ 21 ] either induced by recurrent viral infections or immune-mediated inflammation . [ 22 ]
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