Clinical Spectrum and Prognostic Evaluation of Ocular Trauma Using Ocular Trauma Score in a Tertiary Care Hospital of Uttarakhand

Saurabh Rawat; Vatsala Vats; Monika Jain; Tarannum Shakeel

doi:10.51168/sjhrafrica.v7i2.2640

Autori

Saurabh Rawat Resident, Department of Ophthalmology, SGRRIM&HS
Vatsala Vats Professor and Head, Department of Ophthalmology, SGRRIM&HS
Monika Jain Associate Professor, Department of Ophthalmology, SGRRIM&HS
Tarannum Shakeel Professor, Department of Ophthalmology, SGRRIM&HS

DOI:

https://doi.org/10.51168/sjhrafrica.v7i2.2640

Cuvinte cheie:

Ocular trauma, Ocular Trauma Score, Open globe injury, Closed globe injury, Visual prognosis, BETT classification

Rezumat

Background

Ocular trauma is an important cause of preventable monocular blindness and visual morbidity worldwide and contributes significantly to ocular morbidity, particularly in developing countries.³˒¹¹˒²¹ The Ocular Trauma Score (OTS) is a validated prognostic tool used to predict final visual outcome following ocular injury.¹˒²⁵

Aim

To evaluate the clinical spectrum of ocular trauma and assess the prognostic significance of the Ocular Trauma Score in patients presenting to a tertiary care hospital in Uttarakhand.

Materials and Methods

This hospital-based observational study included 110 patients presenting with ocular trauma to a tertiary care center in Uttarakhand. Injuries were classified according to the Birmingham Eye Trauma Terminology System (BETT).²˒⁴˒²⁵ OTS was calculated for each patient and correlated with type of injury, posterior segment involvement, and visual outcome.

Results

Closed globe injuries constituted 80.9% of cases, while open globe injuries accounted for 19.1%. Road traffic accidents were the most common mode of injury. OTS Category 3 was the predominant category (62.7%). Significant associations were observed between OTS category and type of injury, visual outcome, and posterior segment involvement (p < 0.001).

Conclusion

The OTS demonstrated strong prognostic value in predicting severity and visual outcome following ocular trauma. Routine use of OTS can aid in prognostication, management planning, and patient counseling.¹˒¹⁶˒¹⁷

Referințe

Kuhn F, Maisiak R, Mann L, Mester V, Morris R, Witherspoon CD. The Ocular Trauma Score (OTS). Ophthalmol Clin North Am. 2002;15(2):163-165. https://doi.org/10.1016/S0896-1549(02)00007-X

Kuhn F, Morris R, Witherspoon CD, Heimann K, Jeffers JB, Treister G. A standardized classification of ocular trauma. Ophthalmology. 1996;103(2):240-243. https://doi.org/10.1016/S0161-6420(96)30710-0

Négrel AD, Thylefors B. The global impact of eye injuries. Ophthalmic Epidemiol. 1998;5(3):143-169.

https://doi.org/10.1076/opep.5.3.143.8364

Pieramici DJ, Sternberg P Jr, Aaberg TM Sr, Bridges WZ, Capone A Jr, Cardillo JA, et al. A system for classifying mechanical injuries of the eye (globe). Am J Ophthalmol. 1997;123(6):820-831. https://doi.org/10.1016/S0002-9394(14)71132-8

Agrawal R, Shah M, Mireskandari K, Yong GK. Controversies in ocular trauma classification and management: review. Int Ophthalmol. 2013;33(4):435-445. https://doi.org/10.1007/s10792-012-9698-y

Cao H, Li L, Zhang M. Epidemiology of patients hospitalized for ocular trauma in the Chaoshan region of China, 2001-2010. PLoS One. 2012;7(10):e48377. https://doi.org/10.1371/journal.pone.0048377

Sharma HE, Sharma N, Kaur A. Pattern of ocular trauma in the hilly region of Northern India. Indian J Ophthalmol. 2005;53(2):134-135.

Bhartiya P, Sharma RP, Kumari N. Ocular trauma: epidemiological profile and visual outcome at a tertiary eye care center in North India. Indian J Clin Exp Ophthalmol. 2017;3(4):512-516.

Esmaeli B, Elner SG, Schork MA, Elner VM. Visual outcome and ocular survival after penetrating trauma: a clinicopathologic study. Ophthalmology. 1995;102(3):393-400.

https://doi.org/10.1016/S0161-6420(95)31009-3

May DR, Kuhn FP, Morris RE, Witherspoon CD, Danis RP, Matthews GP, et al. The epidemiology of serious eye injuries from the United States Eye Injury Registry. Graefes Arch Clin Exp Ophthalmol. 2000;238(2):153-157.

https://doi.org/10.1007/PL00007884

Thylefors B. Epidemiological patterns of ocular trauma. Aust N Z J Ophthalmol. 1992;20(2):95-98.

https://doi.org/10.1111/j.1442-9071.1992.tb00718.x

Vats S, Murthy GV, Chandra M, Gupta SK, Vashist P, Gogoi M. Epidemiological study of ocular trauma in an urban slum population in Delhi, India. Indian J Ophthalmol. 2008;56(4):313-316.

https://doi.org/10.4103/0301-4738.41413

MacEwen CJ. Eye injuries: a prospective survey of 5671 cases. Br J Ophthalmol. 1989;73(11):888-894.

https://doi.org/10.1136/bjo.73.11.888

Khatry SK, Lewis AE, Schein OD, Thapa MD, Pradhan EK, Katz J. The epidemiology of ocular trauma in rural Nepal. Br J Ophthalmol. 2004;88(4):456-460. https://doi.org/10.1136/bjo.2003.030700

Gyasi M, Amoaku W, Adjuik M. Epidemiology of hospitalized ocular injuries in the Upper East region of Ghana. Ghana Med J. 2007;41(4):171-175.

Rahman I, Maino A, Devadason D, Leatherbarrow B. Open globe injuries: factors predictive of poor outcome. Eye (Lond). 2006;20(12):1336-1341. https://doi.org/10.1038/sj.eye.6702099

Fujikawa A, Mohamed YH, Kinoshita H, Matsumoto M, Uematsu M, Tsuiki E, et al. Visual outcomes and prognostic factors in open-globe injuries. BMC Ophthalmol. 2018;18(1):138. https://doi.org/10.1186/s12886-018-0804-4

Andreoli MT, Andreoli CM. Surgical rehabilitation of the open globe injury patient. Am J Ophthalmol. 2012;153(5):856-860. https://doi.org/10.1016/j.ajo.2011.10.013

Nirmalan PK, Katz J, Tielsch JM, Robin AL, Thulasiraj RD, Krishnadas R, et al. Ocular trauma in a rural south Indian population. Ophthalmology. 2004;111(9):1778-1781. https://doi.org/10.1016/j.ophtha.2004.02.012

https://doi.org/10.1016/S0161-6420(04)00535-4

Chiapella AP, Rosenthal AR. One year in an eye casualty clinic. Br J Ophthalmol. 1985;69(11):865-870.

https://doi.org/10.1136/bjo.69.11.865

Desai P, MacEwen CJ, Baines P, Minassian DC. Incidence of cases of ocular trauma admitted to the hospital and incidence of blinding outcome. Br J Ophthalmol. 1996;80(7):592-596. https://doi.org/10.1136/bjo.80.7.592

Punnonen E, Laatikainen L. Epidemiology and social characteristics of perforating eye injuries. Acta Ophthalmol (Copenh). 1989;67(5):492-498. https://doi.org/10.1111/j.1755-3768.1989.tb04098.x

Alfaro DV III, Jablon EP, Rodríguez Fontal M, Villalba SJ, Morris RE, Grossman M, et al. Fishing-related ocular trauma. Am J Ophthalmol. 2005;139(3):488-492. https://doi.org/10.1016/j.ajo.2004.10.011

Mela EK, Dvorak GJ, Mantzouranis GA, Georgakopoulos CD. Ocular trauma in a Greek population: review of 899 cases resulting in hospitalization. Ophthalmic Epidemiol. 2005;12(3):185-190.

https://doi.org/10.1080/09286580590964801

Kuhn F, Morris R, Witherspoon CD. Birmingham Eye Trauma Terminology (BETT): terminology and classification of mechanical eye injuries. Ophthalmol Clin North Am. 2002;15(2):139-143.

https://doi.org/10.1016/S0896-1549(02)00004-4

Wong TY, Tielsch JM. A population-based study on the incidence of severe ocular trauma in Singapore. Am J Ophthalmol. 1999;128(3):345-351. https://doi.org/10.1016/S0002-9394(99)00167-1

Serrano JC, Chalela P, Arias JD. Epidemiology of childhood ocular trauma in a northeastern Colombian region. Arch Ophthalmol. 2003;121(10):1439-1445. https://doi.org/10.1001/archopht.121.10.1439

McGwin G Jr, Xie A, Owsley C. Rate of eye injury in the United States. Arch Ophthalmol. 2005;123(7):970-976.

https://doi.org/10.1001/archopht.123.7.970

Hoskin AK, Philip SS, Yardley AM, Mackey DA. Eye injury prevention for the pediatric population. Clin Exp Optom. 2015;98(6):526-530.

Soliman MM, Macky TA. Pattern of ocular trauma in Egypt. Graefes Arch Clin Exp Ophthalmol. 2008;246(2):205-212. https://doi.org/10.1007/s00417-007-0720-4