Jagadish Prasad Rout1, Sahu Soni2, Swati Samikshya3, Pramod Kumar Sharma4, Kanhei Charan Tudu5, Jayashree Dora6
Usually, young adults are the common victims of ocular trauma in their productive age. Severe ocular trauma most often leads to poor vision, at times total loss of vision, which is not only burden to their family, but also to the entire nation. Proper evaluation of severity of ocular trauma at the time of initial examination may help in planning for skillful management and help in prevention of severe visual morbidity.
The aim of the study is to study the prevalence of ocular trauma and the visual outcome after one year of its emergency management and secondary management in selected cases in a tertiary care center.
MATERIALS AND METHODS
89 cases of ocular trauma who presented to our tertiary care center of different age groups were studied prospectively from July 2016 to July 2017. Evaluation of all ocular trauma case was done primarily by slit-lamp examination, indirect ophthalmoscopy and 90D biomicroscopy, x-ray orbit, B-scan and CT scan orbit. All patients who required immediate admission and emergency management were included in the study and old cases of ocular trauma or underwent previous ocular surgical procedure and had ocular infections or any ocular pathology were excluded. All the subjects were managed either conservatively or surgically as and when required. Primary management like repair of lacerated lid injuries, corneal laceration and penetrating injury with or without iris prolapse, corneoscleral tear suturing, scleral tear suturing and removal of IOFB were done on emergency basis. Secondarily, patients were taken up for surgery for traumatic cataract extraction, posttraumatic glaucoma surgery, vitreoretinal surgery for vitreous haemorrhage, retinal haemorrhage and retinal detachment.
Out of 89 cases, 69 were males and 20 were females. Agricultural injury was the leading cause of ocular trauma in which injury from vegetative matter were the most common causative aetiology followed by objects like knife and axes used in agriculture. Industrial injury is the second most common cause followed by accidental ocular traumas. Mode of injury to eye could be inferred by our study, which revealed that penetrating eye injury cases were maximum in number. In anterior segment, anterior lens capsular rupture, traumatic mydriasis, hyphaema, corneal injury, traumatic cataract and corneal FB are most commonly found in the traumatised eye. Similarly, the traumas found in posterior segment were most commonly in the form of retinal haemorrhage, retinal detachment and Berlin’s oedema. Ocular trauma was most commonly found in anterior segment overall. Primary and secondary repair of the ocular injuries could salvage the visual acuity to a great extent in our study, although VA of anterior segment injury was better than that of posterior segment injuries.
Incidence of ocular trauma was most common in males due to more exposure and mostly in working age group. Anterior segment injuries had better visual outcome. Cases undergoing only primary repair had better visual outcome than patients who required secondary management. Patients who presented with endophthalmitis, RD and extensive vitreous haemorrhages had poor outcome.
Ocular Trauma, Penetrating Injury, Agricultural Injury, Corneal Injury.