AIM:  The aim of the study was to emphasize the importance of T–ONTT (Traumatic Optic Neuropathy Treatment Trial) in the management of traumatic optic neuropathy and assessment of visual outcome at the end of treatment.

BACKGROUND: Optic neuropathy is a potentially blinding complication of head or orbital trauma. In this study, we tried to emphasize the importance of TONTT (traumatic optic neuropathy treatment trial) in patients with traumatic optic neuropathy.

 MATERIALS AND METHODS:  This hospital–based prospective study was conducted for a period of 1 year in Government Stanley medical college hospital. All patients admitted with history of facial or head injury in trauma ward with RAPD (RELATIVE AFFERENT PUPILLARY DEFECT) on examination were included and they underwent complete ocular examination including visual acuity testing, grading of RAPD by swinging flash light test, colour desaturation, visual fields, flash VEP and detailed fundus evaluation along with CT scan of orbit with optic nerve cuts. Patients were treated according to T–ONTT (Traumatic Optic Neuropathy Treatment Trial) and their visual prognosis were analysed at the end.

 RESULTS: A total of 20 eyes of 20 patients, with the age group of 17–48 years were examined and included in the TONTT trial. The correlation between RAPD and vision, VEP changes and vision were made. Out of 20 patients, the most common RAPD grading was found to be grade 2+. It was found that RAPD grading and VEP changes well correlated with visual acuity. All patients received treatment according to TONTT (Traumatic Optic Neuropathy Treatment Trial). Out of 20 patients, 90% patients showed improvement in terms of visual acuity by 2 snellen’s line at the end of treatment.

CONCLUSION: The effectiveness of methyl prednisolone in traumatic optic neuropathy was found to be effective if instituted early as possible irrespective of the presenting visual acuity.