Abstract
Purpose of Review: The management of eye injuries is both difficult and argumentative. This study attempts to highlight the management of ocular trauma using currently available information in the literature and author experience. This review presents a workable framework from the first presentation, epidemiology, classification, investigations, management principles, complications, prognostic factors, final visual outcome and management debates. Review Findings: Mechanical ocular trauma is a leading cause of monocular blindness and possible handicap worldwide. Among several classification systems, the most widely accepted is Birmingham Eye Trauma Terminology (BETT). Mechanical ocular trauma is a topic of unsolved controversy. Patching for corneal abrasion, paracentesis for hyphema, the timing of cataract surgery and intraocular lens implantation are all issues in anterior segment injuries. Regarding posterior segment controversies, the timing of vitrectomy, use of prophylactic cryotherapy, the necessity of intravitreal antibiotics in the absence of infection, the use of vitrectomy vs vitreous tap in traumatic endophthalmitis is the issues. The pediatric age group needs to be approached by a different protocol due to the risk of amblyopia, intraocular inflammation, and significant vitreoretinal adhesions. The various prognostic factors have a role in the final visual outcome. B scan is used to exclude R.D, Intraocular foreign body (IOFB), and vitreous haemorrhage in hazy media. Individual surgical strategies are used for every patient according to the classification and extent of the injuries. Conclusion: This article examines relevant evidence on the management challenges and controversies of mechanical trauma of the eye and offers treatment recommendations based on published research and the authors’ own experience.
Highlights
Ocular trauma is a common, preventable cause of visual impairment
This review presents a workable framework from the first presentation, epidemiology, classification, investigations, management principles, complications, prognostic factors, final visual outcome and management debates
The pediatric age group needs to be approached by a different protocol due to the risk of amblyopia, intraocular inflammation, and significant vitreoretinal adhesions
Summary
Ocular trauma is a common, preventable cause of visual impairment. Several questions like cause of the trauma, extent of the trauma, initial visual acuity, time of starting treatment, need of multiple surgery, association of endophthalmitis, counselling and realistic outcome of the management will be discussed. Over the last 30 years, developments in our understanding of the pathogenesis and management of ocular trauma, together with advances in ocular surgery apparatus and procedures, have enhanced the success of the final visual outcome. Mechanical eye injuries have a deep impact on the patient’s life as well as to the family and society. It can be avoidable with social awareness and some protective measure. This review article will focus on the measure, that should be taken to avoid mechanical eye trauma, and we believe it will give the trauma surgeons overall guidance
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