Validation of a modified Birmingham Eye Trauma Terminology classification for mechanical eye injuries

Abstract

Introduction Criticisms have been levelled at the widely accepted Birmingham Eye Trauma Terminology (BETT) classification of mechanical ocular trauma, as it is not specific enough. Alternative modifications to the BETT have been proposed and this study aimed to assess these newer classifications. Methods A prospective cohort study of all patients presenting to the outpatient department between January 2005 and December 2014, who were examined and categorised based on the BETT. Cases which did not comply with the BETT system were placed in additional categories, and documented for each type of injury. Results A total of 4721 eyes suffered mechanical injuries and 1060 (22.4%) could not be classified with BETT, including 368 globe injuries (7%) associated with orbital/ocular adnexa injury; 692 eyes (14.6%) with ocular surface foreign body (OSFB) or ocular wall foreign body (IWFB). There were 77 eyes (1.6%) with contusion, 9 eyes (0.19%) with lamellar laceration-associated OSFB or OWFB, 29 eyes (0.6%) with globe rupture-associated OSFB, OWFB or intraocular foreign body (IOFB) and 60 eyes (1.4%) with laceration-associated OSFB or OWFB. Conclusion The BETT needs modification to be fully applicable to the wide range of ocular trauma seen across the world.