Neuro-ophthalmic manifestations of head trauma

J Neuroophthalmol. 2001 Jun;21(2):112-7. doi: 10.1097/00041327-200106000-00012.


Objective: To describe the neuro-ophthalmic findings in a group of patients with head trauma.

Materials and methods: A retrospective chart review of all patients given a diagnosis code of head trauma in the neuroophthalmology unit at Emory University between 1991 and 1999.

Results: A total of 326 consecutive patients were reviewed (203 [63%] men and 123 [37.0%] women). Age ranged from 2 to 86 years, with a mean of 30 years. Motor vehicle accident was the most common cause of head trauma, occurring in 195 (59.8%) patients. An abnormal neuro-ophthalmic examination was noted in 185 of 326 patients (56.7%). Loss of consciousness was not associated with any outcome, but the presence of a neuroimaging abnormality, particularly intracranial hemorrhage, was significantly associated with specific neuroophthalmic deficits.

Conclusions: Head trauma causes a number of neuroophthalmic manifestations. The afferent and efferent pathways are vulnerable to traumatic injury, although the efferent system is more commonly affected. Loss of consciousness may not be a reliable predictor of specific neuro-ophthalmic outcomes, but neuroimaging abnormalities may.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Blindness / etiology
  • Brain Injuries / complications*
  • Brain Injuries / diagnosis
  • Child
  • Child, Preschool
  • Diplopia / etiology
  • Eye Diseases / diagnosis
  • Eye Diseases / etiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nervous System Diseases / diagnosis
  • Nervous System Diseases / etiology*
  • Retrospective Studies
  • Risk Factors