A Clinical Study of Ocular Trauma: Etiology, Pattern, Management and Visual Outcome
Bhim B Rai1*, Anshu Sahai2, Winnie Gangwal3, Monisha Sahai2 and Ted Maddess1
1John Curtin School of Medical Research, College of Health and Medicine, Australian National University, Acton, Australia
2Department of Ophthalmology, Sahai Hospital and Research Centre, Jaipur, Rajasthan, India.
3Department of Ophthalmology, K.C. Memorial Hospital, Jaipur, Rajasthan, India
*Corresponding Author: Bhim B Rai, John Curtin School of Medical Research, College of Health and Medicine, Australian National University, Acton, Australia.
October 20, 2022; Published: October 28
Purpose: To understand the profile of ocular trauma presenting to a tertiary hospital in Rajasthan, India.
Study Design: Prospective, case-series study.
Methods: We included ocular injury patients attending Sahai Hospital and Research Centre. Questionnaires based on India Eye Injury Registry were used. Mechanical and chemical injuries were classified as per Ocular Trauma Classification Group (OTCG), and Ropar-Hall Classification, respectively.
Results: Of 405 patients (411 eyes), majority were male (77.9%). None of the patients was using eye protective device (EPD). The most commonly affected group was aged 21-30 years, farmers (25.3%), and rural patients (51.1%). More urban patients presented within 12 hours, 29.9% c. f. 6.2%. Presentation after 24 hours had poorer best corrected visual acuity (BCVA) (p = 0.001), and it declined with increasing interval (p = 0.001). Majority of injuries were mechanical (395, 96.1%) with hammer-chisel works (20.4%). Close-globe injury (CGI) out-numbered open globe injury (OGI) (306,74.4% c. f. 89, 21.6%). Contusion in CGI (52.9%), and penetrating injury in OGI (61.8%) were the most common types. Cornea was the most common tissue injured (69.6%) and corneal opacity the most common complication. In CGI, zone of injury was the single most important visual prognostic factor (p = 0.001). In OGI, type (p = 0.002), grades (p = 0.004), and zones (p = 0.004) of injury determined visual prognosis.
Conclusions: Patients presenting within 24 hours had good prognosis. In OGI, higher grade and more posterior entry site had poor prognosis. In CGI, zone was the only significant prognostic factor. Most of the injuries were avoidable. We recommend compulsory use of EPDs while on work.
Keywords: Eye Injury; Golden Hour; Mechanical Injury; Ocular Trauma; OTCG
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