Vision Loss from Blood Clots Pressing on the Optic Nerve

Q: Vision Loss from Blood Clots Pressing on the Optic Nerve

Hello： I'm sorry to hear that your friend has suffered such an injury. <br>In cases where a blood clot is compressing the optic nerve, surgery may sometimes be performed to help remove the clot. <br>However, this depends on various factors, including the size of the clot, the deg

The optic nerve is compressed by a blood clot, resulting in blurred vision?

Hello doctor, my friend was hit in the face during training, resulting in a fracture below the orbital bone and near the nasal bone.
After a month, he is still experiencing intermittent pain and his vision has not improved.
He has now switched to a new doctor for examination.
The previous doctor did not take any significant action, and it has now been discovered that while the bone has healed, the eyeball is slightly sunken and there is a blood clot pressing on the optic nerve.
It is unclear if there are any bone fragments remaining, which may also be affecting his vision recovery.
The new doctor mentioned that it is too late for any corrective measures and that it is a matter of luck whether the blood clot will resolve on its own, along with the potential for vision recovery and pain relief.
Is there really nothing that can be done? Is there any possibility of surgery for the blood clot pressing on the optic nerve? How can we help the blood clot dissolve to relieve the pressure on the optic nerve? Is there a way to restore vision and alleviate the pain? Thank you.

Yin, 20~29 year old female. Ask Date: 2023/02/09

Dr. Gao Pilin reply Ophthalmology

Hello: I'm sorry to hear that your friend has suffered such an injury.
In cases where a blood clot is compressing the optic nerve, surgery may sometimes be performed to help remove the clot.
However, this depends on various factors, including the size of the clot, the degree of pressure it exerts on the optic nerve, and your friend's overall health condition.
Therefore, it is advisable to seek further professional opinions to determine the most appropriate treatment plan for your friend.
If the clot cannot be removed or cleared through surgery, your friend may require long-term treatment to alleviate pain, improve vision, and restore optic nerve function.
This may include therapies such as analgesics, physical therapy, and vision training.
Additionally, regular follow-up appointments are important to ensure that their condition is improving.

Reply Date: 2023/02/09

More Info

I'm sorry to hear about your friend's situation. Vision loss due to blood clots pressing on the optic nerve can be a serious condition, and it’s understandable that you are seeking clarity on possible treatments and outcomes.

When a traumatic injury occurs, such as the one your friend experienced, it can lead to various complications, including fractures of the orbital bones and the presence of hematomas (blood clots). These hematomas can exert pressure on the optic nerve, which is crucial for transmitting visual information from the eye to the brain. If the optic nerve is compressed, it can lead to vision impairment, pain, and other neurological symptoms.

In terms of treatment options, the management of a blood clot pressing on the optic nerve largely depends on several factors, including the size of the hematoma, the degree of pressure it exerts on the optic nerve, and the overall health of the patient. Here are some potential avenues for consideration:
1. Surgical Intervention: If the blood clot is large and causing significant pressure on the optic nerve, surgical intervention may be necessary. This could involve a procedure to evacuate the hematoma and relieve the pressure. However, the timing of the surgery is crucial; if too much time has passed since the injury, the risk of complications may increase, and the potential for recovery may diminish. It’s essential to consult with a neurosurgeon or an ophthalmic surgeon who specializes in such conditions to evaluate the feasibility of surgery.

2. Observation and Conservative Management: In some cases, if the hematoma is small and the pressure on the optic nerve is not severe, doctors may recommend a conservative approach. This involves monitoring the situation closely to see if the body can naturally reabsorb the blood clot over time. Regular follow-up appointments with imaging studies may be necessary to assess the status of the hematoma and the optic nerve.

3. Pain Management and Rehabilitation: Regardless of whether surgery is performed, managing pain and facilitating rehabilitation are important. This may include medications for pain relief, physical therapy, and possibly vision rehabilitation services to help your friend adapt to any changes in vision.

4. Supportive Care: Encouraging your friend to maintain a healthy lifestyle, including a balanced diet and adequate hydration, can support overall recovery. Additionally, avoiding activities that could exacerbate the condition, such as heavy lifting or straining, is advisable.

5. Consulting Specialists: It’s crucial for your friend to seek opinions from specialists, including an ophthalmologist, a neurologist, and possibly a neurosurgeon. They can provide a comprehensive evaluation and tailor a treatment plan based on the specific circumstances.

In conclusion, while the situation may seem dire, there are potential avenues for treatment that could help alleviate the pressure on the optic nerve and improve vision. It’s important to act quickly and consult with medical professionals who can provide the best course of action based on your friend’s unique condition. Regular follow-ups and monitoring will be key in managing this situation effectively.

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