Acta Scientific Ophthalmology (ISSN: 2582-3191)

Research Article Volume 5 Issue 11

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.

Received: October 20, 2022; Published: October 28

Abstract

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

References

  1. Iftikhar M., et al. “Changes in the Incidence of Eye Trauma Hospitalizations in the United States From 2001 Through 2014”. JAMA Ophthalmology1 (2019): 48-56.
  2. Chen Z and Li S-M. “Trauma of the globe: State of art in global and in China”. Chinese Journal of Traumatology6 (2016): 317-318.
  3. MacEwen CJ. “Ocular injuries”. The Royal College of Surgeons of Edinburgh 5 (1999): 317-323.
  4. Gupta H. “Updates on drug bioavailability and delivery to posterior segment of eye”. Journal of Pharmacy and Bioallied Sciences 3 (2013): 173-174.
  5. Pieramici DJ., et al. “A system for classifying mechanical injuries of the eye (globe). The Ocular Trauma Classification Group”. American Journal of Ophthalmology6 (1997): 820-831.
  6. Dannenberg AL., et al. “Penetration eye injuries in the workplace. The National Eye Trauma System Registry”. Archives Ophthalmology6 (1992): 843-848.
  7. Pratt B., et al. “Occupational injuries in Canadian youth: an analysis of 22 years of surveillance data collected from the Canadian Hospitals Injury Reporting and Prevention Program”. Health Promotion and Chronic Disease Prevention in Canada 5 (2016): 89-98.
  8. Kuhn F., et al. “A standardized classification of ocular trauma”. Ophthalmology2 (1996): 240-243.
  9. Mozingo DW., et al. “Chemical burns”. Journal of Trauma5 (1988): 642-647.
  10. Frank DH., et al. “The early treatment and reconstruction of eyelid burns”. Journal of Trauma10 (1983): 874-877.
  11. Dua HS., et al. “A new classification of ocular surface burns”. British Journal of Ophthalmology11 (2001): 1379-1383.
  12. Xu T., et al. “Prevalence and causes of vision loss in China from 1990 to 2019: findings from the Global Burden of Disease Study 2019”. Lancet Public Health12 (2020): e682-e691.
  13. Schein OD., et al. “The Spectrum and Burden of Ocular Injury”. Ophthalmology3 (1988): 300-305.
  14. Hoskin AK., et al. “Eye Injury Prevention for the Pediatric Population”. The Asia-Pacific Journal of Ophthalmology (Phila) 5.3 (2016): 202-211.
  15. Vasu U., et al. “Occupational open globe injuries”. Indian Journal of Ophthalmology1 (2001): 43-47.
  16. Singh S., et al. “Epidemiology, clinical profile and factors, predicting final visual outcome of pediatric ocular trauma in a tertiary eye care center of Central India”. Indian Journal of Ophthalmology11 (2017): 1192-1197.
  17. Khatry SK., et al. “The epidemiology of ocular trauma in rural Nepal”. British Journal of Ophthalmology4 (2004): 456.
  18. Ng HR., et al. “The Epidemiological Profile of Open Globe Injuries and Prognostic Factors in a Tertiary Care Centre”. Cureus 6 (2021): e15846-e.
  19. Rai BB., et al. “Pattern of vitreo-retinal diseases at the national referral hospital in Bhutan: a retrospective, hospital-based study”. Bmc Ophthalmology1 (2020).
  20. Maurya RP., et al. “The epidemiology of ocular trauma in Northern India: A teaching hospital study”. Oman Journal of Ophthalmology2 (2019): 78-83.
  21. Saxena R., et al. “Pattern of pediatric ocular trauma in India”. Indian Journal of Pediatrics10 (2002): 863-867.
  22. Upadhyay MP., et al. “The Bhaktapur eye study: ocular trauma and antibiotic prophylaxis for the prevention of corneal ulceration in Nepal”. British Journal of Ophthalmology4 (2001): 388-392.
  23. Omar R., et al. “Characteristics of eye injuries, medical cost and return-to-work status among industrial workers: a retrospective study”. BMJ Open1 (2022): e048965-e.
  24. Wong TY., et al. “Ocular trauma in the United States Army: hospitalization records from 1985 through 1994”. American Journal of Ophthalmology5 (2000): 645-650.
  25. Economy of Rajasthan (2021).
  26. Shock JP and Adams D. “Long-term visual acuity results after penetrating and perforating ocular injuries”. American Journal of Ophthalmology5 (1985): 714-718.
  27. AlDahash F., et al. “Pediatric openglobe injury in a university-based tertiary hospital”. European Journal of Ophthalmology2 (2020): 269-274.
  28. Georgouli T., et al. “Prevalence of ocular and orbital injuries in polytrauma patients”. European Journal of Trauma and Emergency Surgery 2 (2011): 135-140.
  29. Dandona R and Dandona L. “Review of findings of the Andhra Pradesh Eye Disease Study: policy implications for eye-care services”. Indian Journal of Ophthalmology4 (2001): 215-234.
  30. Malik ., et al. “A study on pattern of ocular injuries in Delhi”. All India Ophthalmological Society 4 (1968): 178-182.
  31. Bourke L., et al. “Clinical outcomes and epidemiology of intraocular foreign body injuries in Cork University Hospital, Ireland: an 11-year review”. Irish Journal of Medical Science 3 (2021): 1225-1230.
  32. Campbell EA and Wilbert CD. “Foreign Body Imaging”. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright © 2022, StatPearls Publishing LLC (2022).
  33. Rai BB., et al. “Retained intraocular metallic foreign body causing retinal detachment”. Bhutan Health Journal1 (2017).
  34. Jain BS and Soni SR. “Ocular injuries: an analytical study in a teaching general hospital”. Indian Journal of Ophthalmology3 (1987): 112-116.
  35. Lee EJ., et al. “Role of Pseudomonas aeruginosa ExsA in penetration through corneal epithelium in a novel in vivo model”. Investigative Ophthalmology and Visual Science 12 (2003): 5220-5227.
  36. Ahmed F., et al. “Corneal Abrasions and Corneal Foreign Bodies”. Prime Care3 (2015): 363-375.
  37. Allen RS., et al. “Long-Term Functional and Structural Consequences of Primary Blast Overpressure to the Eye”. Journal of Neurotrauma17 (2018): 2104-2116.
  38. Shakin JL and Yannuzzi LA. “Posterior segment manifestations of orbital trauma”. Advances in Ophthalmic Plastic and Reconstructive Surgery 6 (1987): 115-135.
  39. Boparai M and Sharma R. “Ocular war injuries”. Indian Journal of Ophthalmology5 (1984): 277-279.
  40. Agarwal A., et al. “Cataract surgery in the setting of trauma”. Current Opinion in Ophthalmology 1 (2010): 65-70.
  41. Nizamoglu M., et al. “The tenyear experience of firework injuries treated at a uk regional burns & plastic surgery unit”. Annals of Burns and Fire Disasters 1 (2018): 13-16.
  42. Parija S., et al. “Firework related ocular injuries in Eastern India - A clinico-epidemiological analysis”. Indian Journal of Ophthalmology12 (2021): 3538-3544.
  43. Kurien NA., et al. “Spectrum of Ocular Injuries and Visual Outcome Following Firework Injury to the Eye”. Journal of Emergencies, Trauma, and Shock 1 (2020): 39-44.
  44. Shiuey EJ., et al. “Assessment of Firework Related Ocular Injury in the US”. JAMA Ophthalmology6 (2020): 618-623.
  45. Nirmalan PK., et al. “Ocular trauma in a rural south Indian population: the Aravind Comprehensive Eye Survey”. Ophthalmology9 (2004): 1778-1781.
  46. Krishnaiah S., et al. “Ocular trauma in a rural population of southern India: the Andhra Pradesh Eye Disease Study”. Ophthalmology7 (2006): 1159-1164.
  47. Northey LC., et al. “Eye trauma epidemiology in regional Australia”. Ophthalmic Epidemiology4 (2014): 237-246.
  48. Voon LW., et al. “The epidemiology of ocular trauma in Singapore: perspective from the emergency service of a large tertiary hospital”. Eye (Lond)1 (2001): 75-81.
  49. Thompson GJ and Mollan SP. “Occupational eye injuries: a continuing problem”. Occupational Medicine (Lond) 2 (2009): 123-125.

Citation

Citation: Bhim B Rai., et al. “Traumatic Flap Dislocation and Management After 17 Years of Lasik Surgery".Acta Scientific Ophthalmology 5.10 (2022): 20-29.

Copyright

Copyright: © 2022 Bhim B Rai., 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.




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Acceptance rate35%
Acceptance to publication20-30 days
ISI- IF1.042
JCR- IF0.24

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