A case of injury to right brow due to a fall from scooter present with sudden loss of vision in the right eye.The pupil shows absent direct reflex but a normal consensual pupillary reflex is present. The fundus is normal. The treatment of choice is-
High-Yield Explanation
Sudden loss of vision, absent Ipsilateral direct light reflex and normal ipsilateral consensual light reflex suggest the diagnosis of optic nerve injury.
Within 8 hours of injury megadose of iv steroid (methylprednisolone) should be given. If there is no response or deterioration, optic canal decompression should be done. If vision is improving, steroids should be tapered gradually. If on tapering steroids, vision deteriorates, optic canal decompression is indicated.