Grades for Traumatic Optic Neuropathy

Description

Cook et al used a grading system to classify patients with traumatic optic neuropathy following head injury. This was used to help compare outcomes from different interventions. The authors are from the University of Washington in Seattle, the University of Wisconsin in Madison and the Massachusetts Eye and Ear Infirmary.

Parameters used for grading:

(1) injury to bone

(2) visual acuity after the injury

Injury to bone:

(1) no fracture

(2) fracture to anterior orbital structures (limited to the anterior two thirds of the orbit)

(3) posterior orbital fracture (fractures to the posterior one third of the orbit, optic canal, anterior clinoid and superior sphenoid sinus), nondisplaced

(4) posterior orbital fracture, displaced

Visual acuity:

(1) better than 20/200

(2) 20/200 to light perception only

(3) no light perception

Injury to Bone	Visual Acuity	Grade
no fracture	better than 20/200	1
	20/200 to light perception only	2
	no light perception	3
fracture to anterior orbital structures	better than 20/200	1
	20/200 to light perception only	2
	no light perception	3
posterior orbital fracture, nondisplaced	better than 20/200	3
	20/200 to light perception only	3
	no light perception	3
posterior orbital fracture, displaced	better than 20/200	3
	20/200 to light perception only	3
	no light perception	4

Stated in rules:

If displaced posterior orbital fracture and no light perception, then Grade 4.

Else if posterior orbital fracture, then Grade 3.

If not posterior orbital fracture and no light perception, then Grade 3.

If not posterior orbital fracture and visual acuity better than 20/200, then Grade 1.

Else Grade 2.

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Description

Specialty

Objective

ICD-10

Grades of Cook et al for Traumatic Optic Neuropathy

Purpose: To evaluate a patient for traumatic optic neuropathy using the grading scheme of Cook et al.

Description

Specialty

Objective

ICD-10