Abstract
BackgroundOpen globe injury (OGI) is one of the most devastating form of ocular trauma. The aim of the study is to identify the epidemiology and predict visual outcomes in traumatic open globe injuries using ocular trauma score (OTS) and correlate with final visual acuity (VA) at 3 months.MethodsPatients older than 5 years, presenting to B.P. Koirala Lions Centre for Ophthalmic Studies (BPKLCOS) from March 2016- March 2017 with OGI that met inclusion criteria were evaluated. Patient profile, nature and cause of injury, and time to presentation were recorded. Patients were managed accordingly and followed up to 3 months. An OTS score for each patient was calculated and raw scores were categorized accordingly. The VA after 3 months were compared to the predicted OTS values.ResultsSeventy-three eyes of 72 patients were examined. 76 % were male, and the mean age was 26.17 years (median, 23.5 years). The mean time from injury to presentation was < 6 hours (30 patients, 41 %). Thirty-seven eyes (51 %) had zone I trauma, followed by twenty eyes (27 %) with zone II, and sixteen eyes (22 %) with zone III trauma. Sixty-five patients (90 %) were managed surgically, and fifty (68 %) received intravitreal antibiotics with steroid. When compared, the projected VA as per OTS were able to predict actual final visual outcomes in 60 % of the eyes with OGI of various zones.ConclusionsOTS can be an accurate predictive tool for final visual acuity even with a short follow up period of 3 months; with poor presenting visual acuity, delayed presentation, posterior zones of injury, need for intravitreal injections, endophthalmitis, and globe rupture associated with poorer prognosis.
Highlights
Open globe injury (OGI) is one of the most devastating form of ocular trauma
All diagnosed cases of OGI, irrespective of gender, laterality, duration of presentation, and other chronic systemic illness, that presented to BPKLCOS and the Tribhuvan University Teaching Hospital (TUTH) emergency department between March 2016 – March 2017 were included in the study
Epidemiology Between March 2016- March 2017, a total of 95 patients presented with OGI
Summary
Open globe injury (OGI) is one of the most devastating form of ocular trauma. The aim of the study is to identify the epidemiology and predict visual outcomes in traumatic open globe injuries using ocular trauma score (OTS) and correlate with final visual acuity (VA) at 3 months. Ocular trauma is one of the leading causes of ocular morbidity and monocular blindness in the world, with open globe injury (OGI) constituting a major portion of trauma related vision loss [1]. A major ocular injury can result in both severe physical damage and psychological trauma for patients and relatives. 750,000 cases of ocular trauma are hospitalized each year, with 203,000 open globe injuries per year worldwide [3, 4]. Males are six times more likely to be affected than females, and a recent report showed a shift from workplace to home as the place of injury [3, 7,8,9,10,11]
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