1267 Neuro-Ophthalmic Manifestations in Traumatic Brain Injury: A Hospital-Based Study From Western Nepal

INTRODUCTION: Traumatic brain injury often leads to neuo-ophthalmologic deficits, which are often ignored and thus lead visual field defects and even permanent visual disability. METHODS: A hospital-based cross-sectional study was carried out among patients admitted to our center with a diagnosis of traumatic brain injury for a period of six months from August 2020 through January 2021. Glasgow Coma Score was used to grade the severity of the head injury. Detailed ophthalmological examinations were documented in predesigned proforma. Descriptive statistics were used to describe the outcomes. RESULTS: A total of 377 head injury patients underwent neuro-ophthalmic examination- 271 (71.9%) were males and 106 (28.1%) were females. The age ranged from 3 to 85 years, mean age being 38.6±16.8 years. Time from injury to ophthalmologic examination ranged from 30 minutes to 12 days post-injury, the mean duration being 24.2 hours. Road traffic accidents were the commonest cause of head injury (53.8%). 38 (10.1%) patients had neuro-ophthalmic manifestations- 16 (42.0%) had afferent pathway deficits and 22 (57.9%) had efferent pathway deficits. The most frequently encountered neuro-ophthalmic abnormality was optic neuropathy in 14 (36.8%) followed by trochlear, oculomotor, abducens nerve, and chiasmal injury. The presence of brain contusion was associated with traumatic optic neuropathy while skull fractures were associated with trochlear nerve palsy, these associations being statistically significant (P<0.05). CONCLUSIONS: Neuro-imaging abnormalities, particularly brain contusion and skull fractures were significantly associated with neuro-ophthalmic deficits.