Vision Loss: Light Perception Without Sight After Injury - Ophthalmology

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Having light perception but unable to see objects?


Hello, Doctor Gao.
My son is a fifteen-year-old middle school student who was involved in a car accident on April 30.
He has two facial fractures, one on his forehead and another on his nasal bridge.
Around May 7, an ophthalmologist examined my son's eyes in the intensive care unit and found that he had a light reflex, but mentioned only minor damage to the cornea.
Since then, no further examinations have been conducted.

Now that my son has been transferred to a general ward, I've noticed that his eyes appear somewhat vacant over the past couple of days.
I held my phone in front of him and asked if he could see anything, to which he replied no.
When I asked if he could see any light, he said yes.
I would like to inquire whether his vision has been impaired and if it can be treated.
For your reference, prior to the incident, his uncorrected vision was 0.2 and 0.3, and he is currently not wearing glasses in the ward.

Yu Bingchen, 40~49 year old female. Ask Date: 2021/06/10

Dr. Gao Pilin reply Ophthalmology


Hello Mr.
Yu: Based on your description, he may be able to perceive light, but I cannot determine if there is any visual impairment.
If there is a brain injury, a longer evaluation period is necessary.
A physician's examination is required to ascertain whether there is any damage to his vision.
Online responses can only serve as a reference; it is essential to seek medical attention at a healthcare facility.
I hope to have the opportunity to assist you.
Gao Pilin

Reply Date: 2021/06/10

More Info


Understanding vision loss, especially in the context of trauma, can be complex and concerning for both patients and their families. In your son's case, the fact that he can perceive light but cannot see objects suggests that there may be some level of visual function remaining, but it is likely compromised.
When assessing vision after an injury, it is essential to understand the different components of visual perception. Vision is not solely about seeing shapes or colors; it also involves the brain's ability to process visual information. In your son's situation, the ability to perceive light indicates that the photoreceptors in the retina are still functioning to some extent. However, the inability to see objects suggests that there may be damage to the optic nerve, visual pathways, or areas of the brain responsible for processing visual information.

The presence of facial fractures, particularly around the forehead and nasal area, raises concerns about potential trauma to the optic nerve or other structures involved in vision. The optic nerve can be affected by direct trauma or by swelling and bleeding in the surrounding areas, which can lead to vision loss. Additionally, if there was any impact to the brain, such as a concussion or more severe traumatic brain injury, this could further complicate visual processing.

Regarding the question of whether your son's vision can recover, it depends on several factors, including the extent of the injury, the specific areas affected, and the time elapsed since the injury. In some cases, vision can improve over time, especially if the damage is not severe and the brain has the capacity to heal. However, in other instances, the damage may be permanent, particularly if there is significant injury to the optic nerve or brain regions involved in vision.

It is crucial to have a comprehensive evaluation by an ophthalmologist or a neuro-ophthalmologist who specializes in vision problems related to neurological conditions. They can perform a series of tests to assess the integrity of the visual pathways, including visual field tests, imaging studies (such as an MRI), and other diagnostic assessments. These evaluations will help determine the extent of the injury and the potential for recovery.

In the meantime, it is essential to monitor your son's condition closely. If you notice any changes in his ability to perceive light or any other visual symptoms, it is important to seek medical attention promptly. Early intervention can be critical in managing vision loss and optimizing recovery.

In summary, while your son’s ability to perceive light is a positive sign, the inability to see objects indicates that there may be significant visual impairment. Recovery is possible, but it depends on the nature and extent of the injury. A thorough evaluation by a specialist is necessary to provide a clearer understanding of his condition and potential treatment options.

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