Ocular injuries and visual status before and after their management in the tribal areas of Western India-A historical cohort study

Abstract

The authors present the epidemiology of ocular trauma and visual status before and after their management from 2003 to 2005 at a hospital in a tribal area of India. This was a historical cohort study. Persons exposed to open and closed globe types of injuries were reviewed. Ophthalmologists examined patients with the help of bio-microscope and also noted their visual acuity. Ocular Injuries were classified according to Birmingham Eye Trauma Terminology System (BETTS). Epidemiological profile, causes of injury, ocular status and visual gain after management were noted. Percentage scattergrams were plotted for both groups of injuries to evaluate visual gains. Binary logistic regression analysis was carried out to determine the predictors of visual outcomes following ocular trauma management. Of the 2,607 persons with ocular trauma, 'open globe' and 'closed globe' types of injuries were found in 451 and 2,156 persons respectively. Within 24 hours of injury, only 1,355 patients (52%) had consulted ophthalmologists. Improvement in vision following management was noted in 133 persons (29.4%) with 'open globe' injuries and 217 persons (48.1%) with 'closed globe' injuries. In 845 patients (39.5%), vision could be retained at same level after management. Agents and activities responsible for ocular injuries in our study differed from those reported in the industrialized countries. Late presentation was very common in our tribal area. Management improved the vision in eyes with trauma, but eyes with 'closed globe' type of ocular injuries had better results than 'open globe' type.