Lost Eye Vision After Trauma to Head and Face?

Hi I lost my vision in my left eye after a trauma to my head and face, I know I had an orbital fracture, doctors here say there is no way to restore the vision in my eye, because there is alot of nerve damage behind my eye is there anything out there that could help me restore my vision. thankyou

Doctor Answers (2)

Traumatic optic neuropathy [TON]

+1

From your description, it sounds like you suffered a  traumatic optic neuropathy.

This is a complex question. First there are two types of TON. Direct vs Indirect. A direct injury involves the compression of the optic nerve, either by bone or foreign body. In this instance, the offending agent needs to be removed to decrease the pressure on the nerve. This type of injury is less common.

The most common type of TON is an indirect injury where nothing is compressing the nerve. Rather the force of the impact has been transmitted through bone to the bony optic canal, and either through microvascular damage or a shearing injury due to the force, the optic nerve is injured.

Treatment is a somewhat controversial area in Ophthalmology, though the controversy seems to be  settling. At one point, we thought that immediate treatment with very high dose IV steroids [within 48 hours of injury] could potentially have some beneficial effects. However, multiple studies have now shown that the improvements gained by those patients were likely unrelated to the steroids, but rather due to a spontaneous improvement.

Most Neuro-ophthalmologists no longer treat with high dose steroids, as the steroids themselves also have potential side effects, especially in older patients with other health problems.

At this point it seems that you are more than a few days out from injury. As such it is a moot point. Currently there is no treatment available. However, spontaneous improvement is still possible up to a year out from injury, though more than likely, the most dramatic improvement will happen within the first few weeks of injury.

I am quite sympathetic to your plight. My mother had a similar injury after a bad fall down the stairs and developed the same injury. Though her central vision returned, she had a dramatic loss of peripheral vision. This can cause significant psychological effect on a patient, which is normal. I would urge you to seek support, either through friends and family, or professionally. There are support groups for monocular [one eyed patients] that you can find on the internet.

If you haven't as of yet, I would consult a Neuro-ophthalmologist that can quantify the degree of visual loss with a visual field as well. This can give you a better idea of your deficit, and can potentially help your adjust and compensate, especially in tasks such as driving.

The good news is that many monocular patients lead very fulfilling lives. So don't lose hope!

Best of luck to you!!


Seattle Oculoplastic Surgeon
5.0 out of 5 stars 23 reviews

The eye is very complex.

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The retina is actually a tract of the brain.  This very delicate neural structure is encased in the tough wall of the eye known as the sclera.  The clear part of the eye, the cornea, functions as part of the lens system of the eye to let light into to be processed by the retina.  Unfortunately the eye is very sensitive to mechanical trauma.  Once the retina is disrupted, permanent visual loss is a very likely outcome.  This is probably one of the reasons that most animals evolved with two eyes.  With two eyes, very sensitive stereo vision permits amazing feats such as precisely pitching a fast ball or flying a jet fighter.  Many task do not require this level of visual detail.  For example it is possible to qualify to drive big rig trucks with just a single eye.

If your ophthalmologists have advised you that nothing further can be done to restore vision, they are most likely right.  Still, it is sometimes reassuring to seek a second opinion.  You might look for a retina specialist at a university setting for this type of opinion.  Researchers are working on this very issue and perhaps one day we will have a means of restoring some usable vision to the unsighted.  For now, much depends on the anatomic details of your eye injury and you doctors best know this situation.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 18 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.