An Objective Measure for Tracking Disease in Traumatic Optic Neuropathy: Ganglion Cell Layer Thickness

Traumatic optic neuropathy (TON) can result from direct or indirect insult to the optic nerve leading to decreased visual function and complete loss of vision. There are often legal implications that may increase the likelihood of malingering in those with occupational injuries or in cases where compensation may be at stake. A motivated patient can imitate ophthalmic disease in measures testing visual acuity, visual field, and visual evoked potentials and electroretinogram which can be consciously suppressed. Using optical coherence tomography (OCT), we have an objective measure of ganglion cell layer (GCL) thickness in TON and we show that this may detect and quantify damage early, as well as detect prognosis before any changes are noted in OCT of the retinal nerve fiber layer (RNFL).