Ocular Trauma Classification Research Articles

A System for Classifying Mechanical Injuries of the Eye (Globe)

To develop a classification system for mechanical injuries of the eye. The Ocular Trauma Classification Group, a committee of 13 ophthalmologists from seven separate institutions, was organized to discuss the standardization of ocular trauma classification. To develop the classification system, the group reviewed trauma classification systems in ophthalmology and general medicine and, in detail, reports on the characteristics and outcomes of eye trauma, then established a classification system based on standard terminology and features of eye injuries at initial examination that have demonstrated prognostic significance. This system classifies both open-globe and closed-globe injuries according to four separate variables: type of injury, based on the mechanism of injury; grade of injury, defined by visual acuity in the injured eye at initial examination; pupil, defined as the presence or absence of a relative afferent pupillary defect in the injured eye; and zone of injury, based on the anteroposterior extent of the injury. This system is designed to be used by ophthalmologists and nonophthalmologists who care for patients or conduct research on ocular injuries. An ocular injury is classified during the initial examination or at the time of the primary surgical intervention and does not require extraordinary testing. This classification system will categorize ocular injuries at the time of initial examination. It is designed to promote the use of standard terminology and assessment, with applications to clinical management and research stud ies regarding eye injuries.

Mechanical ocular trauma.

Mechanical ocular trauma remains a leading cause of visual loss and blindness and often affects young individuals. Approximately 75% of people with trauma-induced visual impairment are monoculary blind. Furthermore, the human, social, and economic consequences of eye injuries are enormous in all parts of the world. Because most eye injuries are preventable, efforts could be spent much more effectively on preventing eye injuries rather than treating them. It is important to make the public aware of the benefits of using protective equipment, which is almost universally available, and was the main concern of most of the authors reporting on ocular trauma in the past year. Of great importance seems to be the introduction of an international standardized classification of ocular trauma.

A standardized classification of ocular trauma.

No internationally standardized classification of ocular trauma terminology has existed heretofore. Despite a growing interest in eye injuries, the absence of a common language continues to impede both clinical care and research. A classification was initially developed based on the authors' extensive personal experience. It then under-went repeated reviews over a 3-year period by international ophthalmic specialists. Written and oral suggestions from respondents in 19 countries and from selected ocular trauma experts were considered and incorporated. By always using the entire globe as the tissue of reference, the new classification is unambiguous, consistent, simple, and comprehensive. It provides definitions for the terms commonly used in eye trauma and creates a logical system of injury types. In addition to widespread international acceptance by professionals, the new classification has been endorsed by the International Society of Ocular Trauma, the United States Eye Injury Registry, the American Academy of Ophthalmology, the Hungarian Eye injury Registry, the Vetreous Society, and the Retina Society. It can be reasonably expected that the system will ultimately become the standardized international language of ocular trauma.

A Standardized Classification of Ocular Trauma

No internationally standardized classification of ocular trauma terminology has existed previously. Despite a growing interest in eye injuries, the absence of a common language continues to impede both clinical care and research. A classification has been developed initially based on the authors' extensive personal experience. It then has undergone repeated reviews over a 3-year period by international ophthalmic audiences, incorporating suggestions from respondents in 13 countries and selected ocular trauma experts. By always using the entire globe as the tissue of reference, the new classification is unambiguous, consistent, and simple. It provides definitions for the commonly used eye trauma terms within the framework of a comprehensive system. The new classification has been endorse by the Board of Directors of the International Society of Ocular Trauma, the United States Eye Injury Registry, the Hungarian Eye Injury Registry, the Vitreous Society, the Retina Society, and the American Academy of Ophthalmology. It can be reasonable expected that the system eventually will become the standardized international language of ocular trauma. The authors urge ophthalmologists to begin using this terminology in both clinical practice and research.