PREDICTING SEVERITY AND VISUAL OUTCOMES OF EYE TRAUMA FOLLOWING TREATEMENT, USING OCULAR TRAUMA SCALE
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Abstract:
Objective: To predict the severity and visual outcomes following treatment in patients sustaining eye trauma using ocular trauma scale.
Study Design: Retrospective case series.
Place and Duration of Study: Armed Forces Institute of Ophthalmology Rawalpindi, from Jan 2015 to Jan 2017.
Methodology: A total of 50 patients with eye trauma were included. Injuries were classified according to 'Birmingham Eye Trauma Terminology System‟. „Ocular trauma scale' was used to predict the visual outcome. We analyzed the data by using Statistical Package for Social Sciences version 22.
Results: Patients‟ mean age was 30 ± 5.632 years. Forty-nine (98%) had open globe injury and 01 (2%) had closed globe injury. Primary & secondary repair was performed and pars plana vitrectomy in 28 (56%), patients was most commonly performed procedure. Based on best-corrected visual acuity vision of 4 (8%) patients significantly improved. Twenty (40%) were bilaterally blind while 16 (32%) were unilaterally blind in right eye and 10 (20%) were blind in left eye.
Conclusion: Open globe injuries of grade IV and V on Ocular trauma scale were found to be severe with the worst visual and anatomical outcomes. Use of protective eye equipment in high-risk individuals including welders, and sportsmen etc would have an invaluable role in reducing the incidence of ocular trauma and its severity.Keywords:
Eye injuries
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Background: Major ocular trauma is an injury with potential blindness in ophthalmology. The aim of this study was to evaluate the demographic and etiologic factors of major ocular trauma in a tertiary hospital in Northern Taiwan. Subjects and Methods: A retrospective review of patients who suffered from open globe injuries and underwent management in a tertiary hospital between January 1, 2005, and December 31, 2014, was conducted. Patients with prior ocular trauma, preexisting ocular conditions affecting the visual acuity (VA) and those with a history of previous intraocular or refractive surgery was excluded from this study. Results: Totally 199 eyes of 195 patients were enrolled in this study. Open globe injury occurred more frequently in males than in females (136 vs. 63 patients, P < 0.0001). Workplace is the most common place of injury (56.3%), followed by home (23.1%). Among patients younger than 18-year-old, domestic-related injury was the predominant cause (78.6%), while among those aged above 18 years, occupational injuries were the most common cause (62.0%). Compared with VA measured on admission, final VA was improved in 38.6%, unchanged in 48%, and worse in 13.4%. The visual outcome was found to be significantly associated with the initial VA, posterior extent injury, length of wound, and presence of vitreous prolapse. Conclusions: Unfavorable prognostic factors for final visual outcome in these patients are related to initial VA, posterior extent injury, length of wound, and presence of vitreous prolapse. Results of this study help predict visual outcomes of open globe-injured patients in emergent counseling.
Eye injuries
Tertiary level
Posterior vitreous detachment
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Aims and Objectives: The aim and objective of this study was to assess the visual prognosis in open globe injury patients using the "Ocular Trauma Score (OTS)." Methodology: A prospective study of 100 patients with open globe injury attending a tertiary referral eye care center, Chennai, was carried out for a period of 12 months from February 1, 2018, to February 1, 2019. Results: The mean age of presentation was 40 years. Males (75%) were more commonly injured compared to females (11%). The right eye (65%) was more commonly injured than the left eye (35%). Out of the 100 patients, 96 patients underwent surgical management and 4 patients were managed conservatively. Out of the 96 patients, 26% had globe ruptures, 11% had relative afferent pupillary defect, 10% had perforating injuries, 8% had retinal detachment, and 4% had endophthalmitis. OTS was 1 in 9% of patients, 2 in 30%, 3 in 35% patients, 4 in 15% patients, and 5 in 11% patients, indicating that most of the patients had poor visual acuity at the time of presentation with an OTS value of 1–3. At the end of 6 weeks, 18% of the patients had a vision of no perception of light, 21% had a vision of percentage of light/hand movements, 25% had 1/200–19/200, 18% had 20/200–20/50, and 18% had >20/40. Majority of the patients had a visual acuity between 1/200 and 19/200. The results were analyzed with the OTS value chart. Conclusion: OTS is a comprehensive score to predict final visual outcome in patients with open globe injury, which can be widely used for counseling ocular trauma victims. OTS calculated at the initial evaluation has predictive value in patients with open globe injury.
Tertiary care
Trauma Center
Center (category theory)
Eye care
Globe
Tertiary level
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Purpose: To evaluate cases of paediatric ocular trauma at a tertiary eye hospital in central Saudi Arabia and determine the demographics, causes, ocular injuries and visual status before and after management.Methods: A retrospective review was performed of health records of children younger than 16 years with ocular trauma managed from January 1998 to December 2019. Data were collected on patient demographics, eye involved, cause of trauma, the presenting and final vision and the duration of follow up. Best-corrected visual acuity (BCVA) at the last follow up was compared between open and closed eye injury groups. The Birmingham Eye Trauma Terminology (BETT) was used to classify the ocular injuries.Results: Among 1,003 patients, 728 (72.6%) had open globe and 275 (27.4%) had closed globe injuries. The main causes of trauma were, unsafe playing-related activities (394 patients;39.3%), unsafe home environment (158 patients;15.8%) and injury by metallic objects (166 patients;16.6%). Gunshot-related ocular trauma was noted in 62 (6.2%) children. Presenting vision <20/400 was noted in 292 (40.1%) eyes with open globe injuries and 110 (40%) eyes with closed globe injuries. ( P =0.4). After a median follow up of 13.3 months, BCVA was 20/20 to 20/200 in 393 (53%) eyes with open globe injuries and 137 (49.8%) eyes with closed globe injuries. ( P =0.03).Conclusions: Despite being very well-managed, Saudi children seem to be at risk of visual disability due to ocular trauma. The risk factors for ocular trauma require preventative action through public health education that could reduce the incidence of childhood blindness.Funding: None to declareConflict of Interest: None to declare. Ethical Approval: This study was approved by the Hospital Institutional Review Board (1310-R).
Etiology
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Background: Although ocular trauma is preventable public health problem throughout the world it is still one of the common causes of ophthalmic morbidity and monocular blindness. There are no published studies on pattern and severity of ocular trauma in Uttarakhand. The present study analyzes the pattern and visual outcome of ocular trauma in this region. Methods: Study design: Prospective hospital-based study. Settings: Patients of ocular trauma presenting to Ophthalmology OPD and emergency department of Himalayan Institute of Medical Sciences, Dehradun. Participants: All ocular injury patients seen for the first time during the period January to December 2008. Results: A total of 88 patients, and 103 eyes, were studied. Men had two fold higher rate of ocular injury than women. The mean age of presentation was 31.2 + 13.6 years (range: 6 - 80 years). The predominant age group of patients was 21-40 years, 55.29 % (n = 47). Eye injuries related to road traffic accident were seen in 37.86% of eyes. Industrial workers were more frequently involved in ocular trauma (23.86%). Closed globe injuries were noted in 55 eyes (53.39%) and open globe injuries were noted in 40 eyes (38.83%). Eight eyes (7.76%) suffered from chemical injuries. The initial presenting visual acuity of patients with blunt ocular trauma was better than penetrating injury. Eye with better visual acuity at presentation had better visual prognosis at 6 months. Conclusion: Ocular injuries were common in young males. Road traffic accidents related eye injuries were noted in significant number of cases. Strict implementation of traffic rules, health education and preventive strategies may help to decrease the occurrence of ocular injuries.
Eye injuries
Blunt trauma
Presentation (obstetrics)
Penetrating Trauma
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Objectives: This present study was to evaluate the clinical and socio-demographical study in cases of paediatrics ocular injuries.
Methods: A detail assessment and relevant investigations were performed to all paediatrics OCT. And globe injuries were recorded according to the BETT. Occular injury was examined by using equipment model OCT 2000 by TOPCON at IGIMS, Patna. Treatment was given depending on type and severity of injuries. Patients were followed up on day 1, day 7, 1 month, and at 6 months. Initial best corrected visual acuity was evaluated on first day of follow up. And final best corrected visual acuity (BCVA) was evaluated on last day of follow up after 6 months.
Results: Data was analysed by using simple statistical methods with the help of MS-office software. All data was tabulated and percentage was calculated.
Conclusions: Age group 0-10 years and males were more prone to ocular trauma. Stick, stone RTA and fall were more causative risk for OCT. School, home, Road traffic accident were the common places for ocular trauma. Open globe injury and close globe injury were commonly seen in ocular trauma cases. Close globe injury patients were shows the better BCVA with respect to OGI, lids and lacrimal apparatus injury and non-mechanical injury. Hence, we should aware the parents and family members about the common modes of trauma, the need of supervision of the objects of play. Self-protection should be taught to children to prevent possible ocular injuries. Houses, playgrounds and schools must be made safe and common items of trauma such as sharp objects, household lime, acids must be kept out of reach of children. Intensive campaign may be done before festival seasons about safety measures to increase public awareness. Ocular trauma is a frequent reason for emergency room visits. Evaluation of eye injuries should start with visual acuity and continue with prompt referral to an ophthalmologist as indicated.
Key words: Ocular trauma, clinical profile, open globe injury, close globe injury, BCVA
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Hyphema
Vitreous hemorrhage
Eye injuries
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Most patients with open globe eye injury are brought to hospital as emergency patients and usually require admission for emergency surgery. We analyzed the visual outcome in patients with open globe eye injury at our hospital over a 4-year period.This study reviewed 40 eyes of 40 patients with open globe eye injury who were presented to Juntendo University Shizuoka Hospital and required emergency surgery during the 4 years from January 2010 to December 2014. Retrospective evaluation of the visual outcome was performed using data from the medical records, including assessment of the influence of sex, side of the eye injury, cause of injury, and site/severity of injury.The mean age (SD) at the time of the injury was 58.9 years (±25.1 years). There were 28 males (70.0%) and 12 females (30.0%). Statistically significant improvement in visual acuity after treatment was noted in the males (P=0.0015, Wilcoxon test), but not in the females. Twenty-five patients had injury to the right eye (62.5%) and 15 had injury to the left eye (37.5%). A significant improvement in visual acuity was achieved after treatment of injury to the right eye (P=0.021), but not the left eye (P=0.109). The most frequent cause of injury was an accident (15 eyes; 37.5%). The second most frequent cause was work-related injury (14 eyes; 35.0%), which only occurred in males, and the third cause was accident due to negligence (eleven eyes; 27.5%). Two patients developed sympathetic ophthalmia and one patient developed postoperative endophthalmitis.The majority of patients with open globe eye injury were male workers in Japan. The visual outcome of work-related injury was better than that of injury due to other causes. The visual outcome was also better if the right eye was injured compared with the left eye. Patients with injuries due to negligence were older than the other groups, and this finding might be characteristic of an aging society.
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Pediatric trauma can lead to serious visual impairment as a result of the trauma itself or secondary to amblyopia. Precise data on epidemiological characteristics and visual outcomes of pediatric ocular injuries are valuable for the prevention of monocular blindness. A total of 268 cases of pediatric ocular trauma admitted to the Department of Ophthalmology of the Lithuanian University of Health Sciences Hospital from January 2008 to December 2013 were retrospectively reviewed. Data analysed included age, sex, cause, type and treatment of injury, initial and final visual acuity (VA) and tissues involvement. Eye injuries were classified by Birmingham Eye Trauma Terminology (BETT) and Ocular Trauma Classification System (OTCS). The age of children ranged from 6 months to 17.5 years. Boys were more likely to suffer ocular injury than girls. Home was the leading place of eye injury (60.4%), followed by outdoors (31.7%), school (5.2%) and sporting area (2.2%). The highest percentage of eye injuries in children were caused by blunt (40.3%) and sharp objects (29.9%), followed by burns (9.3%), falls (6.7%), explosions (4.5%), fireworks (4.1%), gunshots (1.9%) and traffic accidents (0.7%). Closed globe injury (CGI) was the most common type of eye injury (53.4%). CGI were noted to be higher in children aged 13–18 years, while open globe injury (OGI) were higher in the pre-school age group. Injury of grade 4 and grade 5 were more common in OGI, while grade 1 and grade 2 predominated in cases of CGI. Hypotony, traumatic cataract, iris laceration, vitreous prolapse and uveitis were the most common presentations of OGI, while hyphema, secondary glaucoma and retinal edema were significantly related with CGI. Final diagnoses contributing to poor final visual outcome such as corneal scar corneal opacity, hypotony, aphakia, and retinal detachment were statistically significant related only with OGI. Overall, 65.63% of children regained good visual acuity (VA ≥ 0.5), but for 18.4% of them, the trauma resulted in severe visual impairment (VA ≤ 0.1). Ocular trauma in children still remains an important preventable cause of ocular morbidity. This study provides data indicating that ophthalmological injuries are a significant cause of visual impairment in children.
Eye injuries
Blunt trauma
Visual Impairment
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To analyze the clinical characteristics and visual prognoses of patients with ocular trauma treated in Shandong Eye Hospital.The inpatient data of patients with eye injuries hospitalized in our institution from January 2014 to December 2018 were retrospectively reviewed, including demographic information, types of trauma, causes of injury, treatment, and initial and final visual acuities.A total of 1,425 patients (1,622 eyes), aged 39.5 ± 18.5 years, were included. The ratio of male to female was 5.3 : 1. Of the mechanical eye injuries, there were 490 (34.4%) open-globe injuries and 454 (31.9%) closed-globe injuries. Nonmechanical eye injuries had 426 patients (29.9%), while 55 patients (3.9%) had adnexal injuries. Over a half of the traumas were work-related (51.1%, 728 patients). Most patients were treated with surgical intervention (1,404 eyes, 87.9%). There were significant differences in the final visual acuities between open-globe injuries and closed-globe injuries (P < 0.001), as well as between mechanical injuries and nonmechanical injuries (P < 0.001). The final visual acuity was closely correlated with the initial visual acuity (Spearman's correlation coefficient = 0.618, P < 0.001) and the OTS score (Spearman's correlation coefficient = 0.691, P < 0.001).Ocular trauma usually occurs in young and middle-aged men and in the workplace in Shandong Province. The proportion of nonmechanical injuries is high, and the prognosis is poor. A comprehensive understanding of the characteristics of ocular trauma is useful for blindness prevention and treatment.
Eye injuries
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OBJECTIVES:
To review the epidemiological profile, nature and type of ocular trauma caused by fireworks. To characterize the visual outcome and prognosis in patients with ocular trauma due to fireworks.
METHODS: It is an observational retrospective and prospective study. Study population included all patients who came with history of ocular trauma due to firecrackers. Sample size calculated was 96. Patients recruited for the study were interviewed using a detailed questionnaire regarding the mode of injury and underwent ocular examination including visual acuity at presentation. Following which they were either treated conservatively or surgically according to the type of injury. Follow up of these patient at six months was done to determine the final visual acuity. Chi square test was done to obtain the factors which led to poor visual outcome.
RESULTS:
According to this study, young males, upper lower class and bystanders formed the major proportion of those who were injured. Bombs and cone fountain caused most of the injuries and ground spinner being the least. Corneal epithelial defect was the most common injury among closed globe whereas corneal tear in open globe. 7 eyes had blindness due to firecracker injury. Based on this study, it was concluded that factors for poor visual outcome after firecracker injury were poor initial visual acuity (p=0.046) and open globe injury (p<0.001)
Eye examination
Eye injuries
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