Optic Nerve Damage: Treatment Timelines and Recovery Insights

Q: Optic Nerve Damage: Treatment Timelines and Recovery Insights

Hello Mrs. <br>Lai： If you have already recovered about 70%, it is recommended that you visit a hospital with a specialized ophthalmology department for further examination. <br>Initially, due to the presence of bruising, a thorough examination was not possible, but now it may be

Optic nerve damage

Hello, my husband suffered a severe impact to his left eye socket on July 10 due to improper work operation.
He was taken to the emergency room where he was found to have significant hemorrhage inside the eye, resulting in complete loss of vision in the left eye.
The doctor assessed two possibilities: one is that the severe bleeding inside the eye is causing the loss of vision, and the other possibility is damage to the optic nerve.
For now, the only course of action is to apply eye drops and wait for the hemorrhage to resolve.
During a follow-up visit on July 12, his vision was approximately 0.1.
An examination with instruments revealed that there is still a large amount of hemorrhage inside the eye.
The doctor noted that although his vision has improved since July 10, due to the impact to the eye, the possibility of optic nerve damage cannot be ruled out.
Currently, we are just applying eye drops and will reassess after the hemorrhage resolves.
A follow-up appointment is scheduled for July 28.
I would like to ask about the six days since July 10.
My husband believes that his vision may still be somewhat blurred due to the hemorrhage, but he feels that he has regained about 70% of his original vision.
However, during the July 12 follow-up, the doctor emphasized that even though his vision is gradually improving, the possibility of optic nerve damage still exists.
Even if his vision improves day by day, it could potentially worsen due to optic nerve damage.
I saw in your previous responses a link regarding optic nerve damage and the importance of appropriate intervention within 14 days to prevent the nerve from drying out.
Is there indeed a "golden treatment period" of 14 days for optic nerve damage? Can any treatments be performed within these 14 days, or do we have to wait for the hemorrhage to resolve before considering further treatment? I am very concerned that my lack of understanding may lead to a delay in seeking medical attention or missing the so-called golden treatment period.
I know that there is currently no cure for optic nerve damage, but are there specific signs or symptoms that patients should be particularly aware of, or is it simply a matter of observation and waiting?

Lai Tai Tai, 50~59 year old female. Ask Date: 2022/07/15

Dr. Gao Pilin reply Ophthalmology

Hello Mrs.
Lai: If you have already recovered about 70%, it is recommended that you visit a hospital with a specialized ophthalmology department for further examination.
Initially, due to the presence of bruising, a thorough examination was not possible, but now it may be easier to diagnose, and you won't miss the opportunity for treatment.

Reply Date: 2022/07/15

More Info

Understanding optic nerve damage and its treatment is crucial, especially in cases involving trauma, such as your husband's recent injury. The optic nerve is responsible for transmitting visual information from the retina to the brain, and any damage to this nerve can significantly impact vision.
In your husband's case, the initial assessment indicated two potential causes for his vision loss: severe intraocular hemorrhage and possible optic nerve damage. The presence of blood in the eye can obscure vision and complicate the evaluation of the optic nerve's condition. As you noted, the doctor has recommended monitoring the situation until the blood clears, which is a common approach in such scenarios.

The Golden Period for Treatment
Regarding the "golden period" for treating optic nerve damage, it is often suggested that the first 14 days post-injury are critical for intervention. This timeframe is based on the understanding that early treatment may help preserve nerve function and potentially improve visual outcomes. During this period, the optic nerve is particularly vulnerable to secondary damage, such as ischemia (lack of blood flow) or further trauma.
However, the specific treatments available during this period can be limited. In many cases, the focus is on managing the immediate effects of the injury, such as controlling inflammation and ensuring that any bleeding is addressed. Once the blood has cleared, further assessments can be made to determine the extent of any nerve damage and the appropriate next steps.

Monitoring and Further Evaluation
It is essential to keep a close eye on your husband's condition. The gradual improvement in his vision is a positive sign, but the potential for optic nerve damage remains a concern. Regular follow-up appointments are crucial for monitoring his recovery. If there is any indication that his vision is deteriorating or not improving as expected, further imaging studies or consultations with specialists, such as a neuro-ophthalmologist, may be warranted.

Nutritional Support and Rehabilitation
While there is currently no definitive treatment to repair damaged optic nerves, some studies suggest that nutritional support, particularly with B vitamins, may aid in nerve health and recovery. The recommendation to take high doses of B vitamins is based on their role in nerve repair and function. However, this should be viewed as a supportive measure rather than a primary treatment.

Conclusion
In summary, while there is a recognized "golden period" for treating optic nerve injuries, the options for intervention are often limited to supportive care and monitoring. It is crucial to maintain regular follow-ups with healthcare providers to assess your husband's condition and make informed decisions about any necessary interventions. If you have concerns about his recovery or the adequacy of his treatment plan, do not hesitate to seek a second opinion or consult with a specialist in neuro-ophthalmology. Your vigilance and proactive approach to his care will be vital in navigating this challenging situation.

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