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We appreciate Dr Perry's keen interest in our study. The IONTS was transformed into an observational study because of insufficient eligible patients. The authors observed that their study lacks standardization of visual acuity testing, has a bias of timing of initial visual examination, and includes the patients who were not seen immediately after injury.¹

Although the role of steroids in the management of traumatic optic neuropathy is controversial, clinical studies to validate the role of steroids or to prove their harmful effects in such cases are not available.² The steroids are known to help in maintenance of tissue blood flow, aerobic energy metabolism, improvement of reversal of extracellular calcium, reduction of neurofilament degradation, and enhancement of neuronal excitability and synaptic transmission.³ So some form of treatment is better than no treatment.

In our series, 40% of cases had optic nerve compression by the fractured bone fragments without disruption . . . [Full Text of this Article]

Ashok K. Gupta, MS, MNAMS

Correspondence: Dr Gupta, Department of Otorhinolaryngology, Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India (akgpgi@hotmail.com).

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Treatment of Traumatic Optic Neuropathy Remains Controversial
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