A woman lost her sight after falling, and experts from Zhejiang and Hubei provinces helped her regain her sight through "decompression" surgery

The bone around the optic nerve is carefully removed within a few millimeters to "loosen" the compressed optic nerve and restore the "lost" vision. Recently, at the Aier Eye Hospital affiliated to Wuhan University, experts from Zhejiang and Hubei provinces jointly performed endoscopic optic nerve decompression surgery on 62-year-old Ms. Zeng (pseudonym).

A week ago, 62-year-old Ms. Zeng from Suizhou accidentally tripped while picking tea in the mountains, and her right forehead hit the ground. She was bleeding, her forehead was swollen, it was difficult to open her eyes, and her eyes kept crying. Ms. Zeng went to the local health center for treatment, but the symptoms did not improve. Later, due to obvious swelling on the right side of her face, Ms. Zeng came to the local hospital for treatment again. After examination, it was found that Ms. Zeng's right eye vision had completely lost, so Ms. Zeng came to the Aier Eye Hospital affiliated to Wuhan University for treatment.

Examination revealed that Ms. Zeng's pupils were dilated, her light reflex disappeared, and her vision was no longer sensitive to light. After completing the orbital CT scan, it was found that Ms. Zeng had multiple fractures in the right zygomatic arch, the right forearm and outer lower wall of the maxillary sinus, the right lateral wall of the orbit, and the anterior lower edge of the greater wing of the sphenoid bone. She was eventually diagnosed with right optic nerve damage, right orbital bone fracture, and right eyelid contusion.

Zhang Jiang, director of the hospital's tear duct/eye and nose related department, said that traumatic optic nerve damage is an emergency and critical illness. If the fractured fragments of the optic canal are not cleaned in time and the compressed optic nerve is not relieved, Ms. Zeng's right eye will be blind forever.

"Optic nerve repair surgery is extremely difficult. Ms. Zeng suffered traumatic optic nerve damage and multiple fractures of the optic nerve and orbit. Therefore, any mistake during the 'decompression' process could result in cerebrospinal fluid rhinorrhoea at the very least, or even internal carotid artery rupture and bleeding, which could be life-threatening. The surgery needs to be performed as quickly as possible to minimize damage to the optic nerve," said Zhang Jiang.

Afterwards, Zhang Jiang urgently connected with Wu Wencan, the director of the Eye and Optometry Hospital affiliated to Wenzhou Medical University. After reviewing the films online and assessing the patient's condition, the two experts agreed that optic canal decompression surgery should be performed as soon as possible to save vision.

Under the guidance of the anesthesiologist, Zhang Jiang's team and Dr. Wu Wencan's team performed endoscopic optic nerve decompression on Ms. Zeng. After more than an hour of full treatment, the operation was successfully completed. On the first day after the operation, Ms. Zeng's right eye regained light perception and is still recovering.

"Under normal circumstances, the optic canal protects the optic nerve, which is equivalent to an 'outer protective layer'. But when the optic nerve is injured and swollen, this 'outer protective layer' becomes a 'tightening curse', tightly clamping the optic nerve and making the injury more and more serious. Therefore, it is necessary to 'decompress' the 'optic nerve' as soon as possible, remove the bony canal of the optic nerve, and relieve the local swelling of the optic nerve before recovery is possible." Zhang Jiang introduced that in the past, optic nerve damage usually required craniotomy, which was more traumatic, had a high risk of postoperative infection, and slow healing and recovery of patients. With the development of endoscopic technology, optic canal opening and optic nerve decompression under nasal endoscopy has become a new method for treating traumatic optic nerve damage in recent years.