Walsh & Hoyt: Traumatic Optic Neuropathies: Management - Early Studies

Early reports concerning surgical decompression suggested it to be of little value in treating traumatic optic neuropathy. In these cases decompression was performed transcranially. Hooper operated on five patients with traumatic optic neuropathy. Two patients recovered vision, but only one patient had optic canal decompression. Hughes explored 8 cases in his series of 90 patients, with no visual improvement. Edmund and Godtfredsen operated on 6 patients in their series of 22 patients. The vision of only one patient improved following surgery, changing from no light perception to light perception. Based on this experience and the available pathologic material, Walsh felt that visual recovery was unlikely if amaurosis occurred at the moment of impact and advised against surgical intervention. He also cautioned against operating on unconscious patients. However, in cases of delayed visual loss, Walsh suggested that surgical decompression might be more promising.