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- W2105429260 abstract "Resumen Introduccion: La neuropatia optica traumatica puede ser dificil de diagnosticar en un primer contacto, por la ausencia de cambios en el disco optico o por la coexistencia de lesiones mas aparentes. Aunque existen datos funcionales que la sugieren, la falta de un parametro contralateral de comparacion puede limitar la deteccion. El objetivo fue analizar el caso de un paciente con neuropatia optica traumatica con afeccion bilateral asimetrica, para hacer enfasis en la necesidad de evaluar funcionalmente los ojos lesionados. Caso clinico: Hombre de 34 anos de edad con traumatismo craneoencefalico severo, perdida del estado de alerta y fractura facial tipo Lefort III por accidente automovilistico. A las 72 horas del accidente unicamente percibia luz y tenia un defecto pupilar aferente en el ojo izquierdo; el ojo derecho tenia deficiencia visual, no justificada por alteraciones del segmento anterior. El tratamiento se enfoco al ojo izquierdo, pero durante el seguimiento se identifico tardiamente afeccion del ojo derecho. Se analizo la evolucion del paciente y las causas que limitaron la deteccion temprana de la neuropatia traumatica en el ojo derecho. Conclusiones: La neuropatia optica traumatica debe buscarse mediante la evaluacion funcional en todos los ojos lesionados. La ausencia de alteraciones en el fondo del ojo no la descarta, particularmente si existe deficiencia visual. Es necesario identificar los pacientes con pupila positiva durante la evaluacion inicial y referirlos oportunamente al especialista, quien identificara los casos atipicos e implementara tempranamente el tratamiento. Palabras clave: Atrofia optica, neuropatia optica traumatica, trauma ocular. Summary Background: Diagnosis of traumatic optic neuropathy is difficult during primary care as a result of the absence of optic disk changes or coexisting injuries that may be more apparent. Although there are functional signs that suggest its presence, the lack of a comparison parameter may further prevent its detection. A case of bilateral traumatic optic neuropathy is analyzed to emphasize the need for functional evaluation in the injured eye. Clinical case: A 34-year-old male presented with severe head trauma, loss of consciousness and type III Lefort facial fracture as a result of a vehicular accident. Seventy two hours after the accident, the left eye had only light perception and an afferent papillary defect. The right eye had visual deficiency not explained by anterior segment injuries. Therapy was aimed at the left eye and, during follow-up, involvement of the right eye was identified very late. The patient’s evolution is analyzed, as well as the causes that prevented early detection of traumatic optic neuropathy in the right eye. Conclusions: Functional evaluation must be used to search for traumatic optic neuropathy in every eye injury. The absence of ocular fundus abnormalities does not rule out the disease, especially when visual deficiency exists. Detection of patients with a positive pupil during initial evaluation of trauma is required in order to refer the patient in a timely manner to the ophthalmologist. The specialist should identify atypical cases and therapy should be initiated as early as possible." @default.
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- W2105429260 date "2009-07-01" @default.
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- W2105429260 title "Neuropatía óptica traumática bilateral asimétrica. Informe de un caso" @default.
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