Shah Md Rajibul Islam¹*, Omar Jafarullah², Golam Rabbani³ and Shah Md Bulbul Islam⁴

¹Assistant Professor, HOD, Department of Ophthalmology, Armed Forces Medical College and Hospital Jashore, Bangladesh
²Consultant, Bangladesh Eye Hospital Mirpur, Bangladesh
³Registrar, Department of Ophthalmology, Holy Family Red Crescent Medical College and Hospital, Bangladesh
⁴Professor of Ophthalmology, Ibn Sina Medical College and Hospital, Bangladesh

*Corresponding Author: Shah Md Rajibul Islam, Assistant Professor and HOD, Department of Ophthalmology, Armed Forces Medical College and Hospital Jashore, Jashore, Bangladesh.

Received: May 24, 2021; Published: June 23, 2021

Abstract

Introduction: Trauma is one of the leading cause of ocular morbidity worldwide. More common in young male. This study aims to outline the seriousness of the condition.

Methods: This cross sectional observational study was done from the imaging room (B Scan USG) of all the patients with ocular trauma that had been advised for a BScan USG. It was done from July 2019 up to June 2020. Age and sex was noted, causative agent was identified, BScan USG findings were noted.

Results: Out of 2653 patients, 82% were male. Mean age was 29 ± 10.4 (06 - 72) years. 68% were open globe injury and 32% were closed globe. High speed projectile was the highest 30% followed by blunt trauma 20%, Sharp kitchen objects 18%, RTA 10%, toy 12%, Stationary 5%, Fight 3% and Vegetative trauma 2%. Traumatic cataract resulted in 42% followed by vitreous hemorrhage 38%, endophthalmitis 18%, retinal detachment and lens dislocation 12% and hyphema 10%.

Conclusion: A large number ocular trauma can be avoided if proper safety equipment is used and precautions taken. Large number of ocular morbidity occurs in young males every year resulting in socio-economic burden. We as clinicians should advocate strong legislation to prevent work related ocular injury.

Keywords: Ocular Trauma; B Scan USG; Work Related Ocular Injury

Introduction

  Ocular trauma accounts for one of the most common cause of uniocular blindness [1-3]. The age distribution is bimodal where the maximum occurrence is in the young age group and a later peak in the elderly [4-6]. Studies conclude predominance in males [7-9]. The males playing the active role in the society being a key factor. In the elderly, falling down plays a major role with little gender predisposition. Ocular trauma not only causes visual impairment, additionally it results in socio-economic burden. The developing and under developed countries taking the largest toll [10-12]. The spectrum of injuries vary from very minor non sight threatening to serious potentially blinding condition. Not only the injury itself, but the complications following can lead to visual impairment. Complications may result from the initial injury itself, repair of injury or from delayed intervention. In the industrialized countries, work related ocular injury is more common. Vegetative injuries are noticed commonly in the rural setting during harvesting season. Apart from these, domestic violence, social and political unrest that leads to brawl can result in ocular injuries [13-16].

Materials and Methods

  This cross sectional observational study was done from the imaging room (B Scan USG) of all the patients with ocular trauma that had been advised for a B Scan USG. Study was conducted from July 2019 up to June 2020. Age and sex was noted, causative agents were identified, B Scan USG findings were noted.

Results and Discussion

  2653 patients were referred for B Scan USG within the study period. Out of which the majority, 82.02% were male. The rest 17.98% were female. Mean age was 29 ± 10.4 (06 - 72) years. The most affected age group was from 20 - 39 years, 37.01% as shown in table 1. 68% were open globe injury and 32% were closed globe. High speed projectile was the highest 30% followed by others as shown in table 2. Most of the trauma occurred at place of work, few at home and rest during movement. As shown in figure 1 the effects of trauma varied considerably. Traumatic cataract being the most prevalent in 42%.

Figure 1: Effects of ocular trauma in the patients.

Table 1: Demographics.

Table 2: Type of injury and factors in ocular injury.

  The cause of injury varied from gunshot wounds to playing with toys. Work related injuries were more common. Domestic violence and stationary objects were also significant. Unattended children playing with sharp objects, throwing toys, stones at each other caused a considerable amount of injury. Almost all of the work related injuries were due to not using protective wear.

Figure 2: Pie chart depicting the causes of ocular injuries.

  Similar results were also observed in other studies. Younger, males were predominant in all the studies. It is due to the socio-economic nature of males being the major active work force. It is also found common in different studies that many of the work related injuries occurred due to not following protective wear protocol.

Limitations

  The study was conducted depending on a single imaging modality (B Scan USG). A good portion of patients that did not need the investigation, could not be included in the study. Detailed Ophthalmic examination was not done by the authors. Many of the cases were not taken into account as injury repair was completed more than one week ago. Management of cases were not taken into account i.e. conservative or intervention. Follow up was not possible in almost all of the cases.

Conclusion

  A large number ocular trauma can be avoided if proper safety equipment is used and precautions are taken. Large number of ocular morbidity occurs in young males every year resulting in socio-economic burden. We as clinicians should advocate for strong legislation to prevent work related ocular injury.

Conflict of Interest

No financial interest or any conflict of interest to declare.

Acknowledgement

Department of Retina, Ispahani Islamia Eye Institute and Hospital.

References

1. Canavan YM., et al. “A 10-year survey of eye injuries in Northern Ireland, 1967-76”. British Journal of Ophthalmology 64 (1980): 618-625.
2. Chua D., et al. “The Prevalence and Risk Factors of Ocular Trauma: The Singapore Indian Eye Study”. Ophthalmic Epidemiology4 (2011): 164-170.
3. Soylu M., et al. “Eye injury (ocular trauma) in southern Turkey: epidemiology, ocular survival, and visual”. International Ophthalmology 30 (2010): 143-148.
4. Negrel AD and Thylefors B. “The global impact of eye injuries”. Ophthalmic Epidemiology 5 (1998): 143-169.
5. Glynn RJ., et al. “The incidence of eye injuries in New England”. Archives of Ophthalmology 106 (1988): 785-789.
6. Desai P., et al. “Epidemiology and implications of ocular trauma admitted to hospital in Scotland”. Journal of Epidemiology and Community Health 50 (1996): 436-441.
7. Schein OD., et al. “The spectrum and burden of ocular injury”. Ophthalmology 95 (1988): 300-305.
8. Mac Ewen CJ. “Eye injuries: a prospective survey of 5671 cases”. British Journal of Ophthalmology 73 (1989): 888-894.
9. Katz J and Teilsch JM. “Lifetime prevalence of ocular injuries from the Baltimore Eye Survey”. Archives of Ophthalmology 111 (1993): 564.
10. Teilsch JM and Parver LM. “Determinants of hospital charges and length of stay for ocular trauma”. Ophthalmology 97 (1990): 231-237.
11. Umeh RE and Umeh OC. “Causes and visual outcome of childhood eye injuries in Nigeria”. Eye4 (1997): 489-495.
12. Ilsar M., et al. “Ocular injuries in Malawi”. British Journal of Ophthalmology 66 (1982): 145-148.
13. Wisse RP., et al. “Ocular firework trauma: a systematic review on incidence, severity, outcome and prevention”. British Journal of Ophthalmology 94 (2010): 1586-1591.
14. Jones NP. “One year of severe eye injuries in sport”. Eye5 (1988): 484-487.
15. Mac Ewen CJ. “Sports associated eye injuries: a casualty department survey”. British Journal of Ophthalmology 71 (1987): 701-705.
16. Groessl S., et al. “Assault - related penetrating ocular injury”. American Journal of Ophthalmology 116 (1993): 26-33.

Citation

Citation: Shah Md Rajibul Islam., et al. “Ocular Morbidity from Trauma; A One Year Survey".Acta Scientific Ophthalmology 4.7 (2021): 25-28.

Copyright

Copyright: © 2021 Shah Md Rajibul Islam., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.