To analyse the outcomes of ocular trauma on the basis of zone of injury

Abstract

   Purpose: To analyze the outcome of ocular trauma based on the zone of injury.

   Material and Method: A total of 244 patients with eye injuries were included in this study. The study was conducted at Department of Ophthalmology, General Hospital Lahore in Lahore from January 1 2016, to September 30 2018, and data was collected through pre-designed Proforma. Data about age, sex, causes, affected ocular zone, and visual acuity (VA) before and after treatment were recorded. Patients were grouped into 3 groups: Zone 1, 2, and 3 according to the damaged ocular area.

   Results: This study included a total of 244 patients having ocular trauma. Zone 1 group included 136 patients. VA before treatment ranged from light perception (LP) to 6/60 in 130 patients, 4 patients had 6/36 to 6/12, and 2 patients had 6/9 to 6/6. VA after treatment was between LP and 6/60 in 128 patients, 5 patients had 6/36 to 6/12, and 3 patients had 6/9 to 6/6. Zone 2 group included 76 patients. VA before treatment ranged from LP to 6/60 in 52 patients, 18 patients had 6/36 to 6/12, and 6 patients had 6/9 to 6/6 . VA after treatment was between LP and 6/60 in 46 patients, 25 patients had 6/36 to 6/12, and 7 patients had 6/9 to 6/6. Zone 3 injury group included 32 patients with VA between LP to 6/60 before treatment VA after treatment was between LP and 6/60 in 31 patients, and 1 patient between 6/36 and 6/12.

   Conclusion: Improvement in VA after ophthalmic care is directly dependent upon the extent of ocular damage and VA before the treatment.

Keywords

• trauma,vision,zone,open glob

References

1. 1. Négrel A.-D., Thylefors B. The global impact of eye injuries. Ophthalmic Epidemiology. 1998;5(3):143–69.
2. 2. Al-Bdour M. D., Azab M. A. Childhood eye injuries in North Jordan. International Ophthalmology. 1998;22(5):269–73.
3. 3. de Bustros S., Michels R. G., Glaser B. M. Evolving concepts in the management of posterior segment penetrating ocular injuries. Retina. 1990;10(supplement 1): S72–5.
4. 4. Wong TY, Klein BEK, Klein R. The prevalence and 5-year incidence of ocular trauma. The Beaver Dam Eye study. Ophthalmology. 2000;107(12):2196–202.
5. 5. Bauza AM, Emami P, Soni N, Holland BK, Langer P, Zarbin M, Bhagat N. A 10-year review of assault-related open-globe injuries at an urban hospital. Graefe's Archive for Clinical and Experimental Ophthalmology. 2013;251(3):653–59.
6. 6. De Juan E, Sternberg P, Michels RG. Penetrating ocular injuries. Types of injuries and visual results. Ophthalmology. 1983;90(11):1318–1322. doi: 10.1016/s0161-6420(83)34387-6.
7. 7. Sudhalkar A, Chhablani J, Jalali S, Narayanan R. Traumatic vitreous hemorrhage in children-clinical features and outcomes. Eye Science. 2014;29(2):63–69.
8. 8. Zhu L, Wu Z, Dong F, Feng J, Lou D, Du C, Ren P. Two kinds of ocular trauma score for paediatric traumatic cataract in penetrating eye injuries. Injury. 2015;46(9):1828-33.

9. 9. Spiegel D., Nasemann J., Nawrocki J., Gabel V.-P. Severe ocular trauma managed with primary pars plana vitrectomy and silicone oil. Retina. 1997;17(4):275–85.
10. 10. Cekic O., Batman C. Severe ocular trauma managed with primary pars plana vitrectomy and silicone oil. Retina. 1998;18(3):287–8.
11. 11. iu X, Liu Z, Liu Y, Zhao L, Xu S, Su G, Zhao J. Determination of visual prognosis in children with open globe injuries. Eye (Lond). 2014;28(7):852-6
12. 12. Teixeira S. M., Bastos R. R., Falcão M. S., Falcão-Reis F. M., Rocha-Sousa A. A. Open-globe injuries at an emergency department in Porto, Portugal: clinical features and prognostic factors. European Journal of Ophthalmology. 2014;24(6):932–9.
13. 13. Agrawal R., Wei H. S., Teoh S. Prognostic factors for open globe injuries and correlation of ocular trauma score at a tertiary referral eye care centre in Singapore. Indian Journal of Ophthalmology. 2013;61(9):502–6. 14. Yalcin Tök O, Tok L, Eraslan E, Ozkaya D, Ornek F, Bardak Y. Prognostic factors influencing final visual acuity in open globe injuries. J Trauma. 2011;71(6):1794-800.
14. 15. Esmaeli B, Elner SG, Schork MA, Elner VM. Visual outcome and ocular survival after penetrating trauma: a clinicopathologic study. Ophthalmology. 1995;102(3):393–400.
15. 16. Gilbert CM, Soong HK, Hirst LW. A two-year prospective study of penetrating ocular trauma at the Wilmer Ophthalmological Institute. Ann Ophthalmol. 1987;19(3):104-6.
16. 17. Pieramici DJ, MacCumber MW, Humayun MU, Marsh MJ, de Juan E Jr. Open-globe injury. Update on types of injuries and visual results. Ophthalmology. 1996;103(11):1798-803.
17. 18. Pieramici DJ, Au Eong KG, Sternberg P Jr, Marsh MJ. The prognostic significance of a system for classifying mechanical injuries of the eye (globe) in open-globe injuries. J Trauma. 2003;54(4):750-4.
18. 19. Sternberg P Jr, de Juan E Jr, Michels RG, Auer C. Multivariate analysis of prognostic factors in penetrating ocular injuries. Am J Ophthalmol. 1984;98(4):467-72.
19. 20. Rahman I, Maino A, Devadason D, Leatherbarrow B. Open globe injuries: factors predictive of poor outcome. Eye (Lond). 2006;20(12):1336-41.
20. 21. Schmidt GW, Broman AT, Hindman HB, Grant MP. Vision survival after open globe injury predicted by classification and regression tree analysis. Ophthalmology. 2008;115(1):202-9.
21. 22. Han SB, Yu HG. Visual outcome after open globe injury and its predictive factors in Korea. J Trauma. 2010 Nov;69(5):E66-72.
22. 23. Agrawal R, Rao G, Naigaonkar R, Ou X, Desai S. Prognostic factors for vision outcome after surgical repair of open globe injuries. Indian J Ophthalmol. 2011;59(6):465-70.
23. 24. McGwin G, Xie A, Owsley C. Rate of Eye Injury in the United States. Arch Ophthalmol. 2005; 123 (7): 970-6.
24. 25. Dang S. Eye injuries at work. American Academy of Ophthalmology [online.] February 22, 2016.
25. 26. Soliman MM, Macky TA. Pattern of ocular trauma in Egypt. Graefes Arch Clin Exp Ophthalmol. 2008;246(2):205-12.
26. 27. McCormack P. Penetrating injury of the eye. Br J Ophthalmol. 1999;83(10):1101-2.
27. 28. Esmaeli B, Elner SG, Schork MA, Elner VM. Visual outcome and ocular survival after penetrating trauma. A clinicopathologic study. Ophthalmology. 1995;102(3):393-400.
28. 29. Kim JH, Yang SJ, Kim DS, Kim JG, Yoon YH. Fourteen-year review of open globe injuries in an urban Korean population. J Trauma, 2007; 62 (3): 746–9.
29. 30. Tielsch JM, Parver L, Shankar B. Time trends in the incidence of hospitalized ocular trauma. Arch Ophthalmol. 1989; 107: 519-23.
30. 31. Joanne K et al. Ocular Trauma in the United States. Arch Ophthalmol. 1992; 110 (6): 838-42.
31. 32. Gilbert CM, Soong HK, Hirst LW. A two-year prospective study of penetrating ocular trauma at the Wilmer ophthalmological institute. Annals of Ophthalmology, 1987;19(3):104-6.
32. 33. Shokunbi MT, Agbeja AM. Ocular complications of head injury in children. Child's Nerv Syst 1991; 7:147−9.
33. 34. Nash EA, Margo CE. Patterns of emergency department visits for disorders of the eye and ocular adnexa. Arch Ophthalmol. 1998; 116: 1222-1226.
34. 35. Roh S, Patron ME. Images in clinical medicines. Ocular Trauma Due to a Water-Bottle Cap. N Engl J Med 2008; 358 (21): 2265.
35. 36. Blanch RJ, Good PA, Shah P, Bishop JR, Logan A, Scott RA. Visual outcomes after blunt ocular trauma. Ophthalmology. 2013;120(8):1588-91.
36. 37. Eagling, EM. Ocular damage after blunt trauma to the eye. Its relationship to the nature of the injury. Br J Ophthalmol. 1974; 58: 126–40.
37. 38. Jones NP, Hayward JM, Khaw PT, Claoué CM, Elkington AR. Function of an ophthalmic "accident and emergency" department: results of a six month survey. Br Med J (Clin Res Ed). 1986 ;292(6514):188-90.
38. 39. Shoja MR, Miratashi AM. Pediatric ocular trauma. Aeta Medica Iranica 2006. 2006; 44 (2): 125–30.
39. 40. Cillino S, Casuccio A, Di Pace F, Pillitteri F, Cillino G. A five-year retrospective study of the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in a Mediterranean area. BMC Ophthalmol. 2008;8:6.
40. 41. Brophy M, Sinclair SA, Hostetler SG, Xiang H. Pediatric eye injury-related hospitalizations in the United States. Pediatrics. 2006; 117 (6): e1263–71.