Evaluation of epidemiological aspects and prognostic factors determining final visual outcome in patients of blunt ocular trauma: A prospective study of 250 patients

Lanjewar Shruti

Volume : IX, Issue : VI, June - 2019

Evaluation of epidemiological aspects and prognostic factors determining final visual outcome in patients of blunt ocular trauma: A prospective study of 250 patients

Lanjewar Shruti

Abstract :

Aim: To analyze the epidemiological factors, study clinical aspects and different factors affecting final visual outcome in blunt ocular trauma in Indian setup. Patients and methods: This prospective study included 300 eyes in 250 patients who sustained blunt ocular trauma and visited casualty/ OPD in Department of Ophthalmology of our institution. These patients were appropriately treated and followed at regular intervals to assess their visual outcome. Results: Out of 667 cases of mechanical ocular trauma reporting to our institution, blunt trauma accounted for 44.97% of cases. The majority of the patients were between 21 and 40 years old (63.15%) with male preponderance (83.6%). Most of them were laborers and industrial workers (35.6%). The principal cause of injuries was assault with stone (45%). Most important cause of bilateral injuries seen in 50 cases was RTA (72%). Majority of grievous injuries with Ocular trauma score of 1and 2 were caused by stone and iron rod. Most of the patients (69.66%) presented within 24 hours of injury. Lids and adnexa involvement was seen in 75.33% eyes in form of edema and ecchymosis. Most common anterior segment involvement findings were conjunctival congestion and chemosis (71.33%) followed by traumatic uveitis (27%) and corneal edema (13.33%). Commotion retinae (10.33%) was most common posterior segment finding Visual impairment less than 20/200 at time of presentation was more frequently associated with ruptures of the globe, traumatic cataract, commotio retinae, retinal detachment, vitreous hemorrhage and endophthalmitis. Poor visual outcome statistically correlated with poor initial visual acuity [chi sq = 92.58, degree of freedom=2, p<0.000], patients having OTS grade of 1 and 2 [chi sq = 106.23, degree of freedom=2, p<0.0001], delay in onset of treatment [chi sq = 50.99, degree of freedom = 2, p< 0.0001] and with ocular conditions like globe rupture, subluxated lens with secondary glaucoma, posterior segment involvement and endophthalmitis. Conclusions: Our study shows that final visual outcome predominantly depends upon mode of injury, initial vision after injury, nature of ocular damage and grades of OTS. We conclude that timely intervention holds the crux for determining the final visual outcome