Title: Demographical Factors and Complications in Open Globe Injuries

Authors: Dr Veena Pilli, Dr Gayatri

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i5.97

Abstract

Aim:  To study demographical factors and complications frequently encountered in open globe injuries.

Method: Retrospective charts review conducted in a tertiary care center, Sankar Foundation Eye Hospital, Visakhapatnam. Total 35 Open globe injury (OGI )case records from 1 January 2012 to 31 December 2013 identified, Case notes examined to determine demographic data, mechanisms of injury, pre operative vision, location of injury, procedures carried out, post operative vision (day  1, post 3 months), Snellen chart used to record visual acuity, slit lamp examination for recording anterior segment clinical signs and B- scan done for posterior segment findings

Results: Almost 1/3rd of patients are below 15yrs, mostly men (75%) encountered injury – attributed to their life style. Type A (rupture) mechanism of injury is common – due to blunt trauma, 66% injuries are in zone 1 – anterior.

Visual acuity (grade D) gaurded in 60 % cases, Almost 75% of cases had afferent pupillary defect. Hyphaema, Traumatic cataract, choroidal detachment, retinal detachment, vitreous haemorrhage - common complications for less vision. Uveal tissue prolapse is more prone for infection. In zone 1 injuries, 5 cases (17 %) did not turn up for review at 3 months, of the patients who turned up 31% had improvement in vision, In zone 1+2 injuries  2 (25%) patients were lost to follow up, Out of remaining 50% had improvement in vision. This emphasis the need for patient motivation, only 3% of case were operated within 24 hours of presentation. 58% of cases were operated between 24 to 48 hours, 39 % of cases were operated after 48 hours. This shows problem of logistics and finances involved with such sudden events.

References

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2.      Scott R. The Ocular Trauma Score. Community Eye Health. 2015;28(91):44-5.

3.      Thompson JT, Parver LM, Enger CL, et al. Infectious endophthalmitis after penet-rating injuries with retained intraocular foreign bodies. National Eye Trauma Sys-tem. Ophthalmology 1993;100:1468-74.

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Further Reading

1)      Kuhn F, Maisiak R, et al. The Ocular Trauma Score (OTS). Ophthalmol Clin North Am 2002;15(2): 163–165, vi. [PubMed]

2)      Schmidt GW, Broman AT, et al. Vision survival after open globe injury predicted by classification and regression tree analysis. Ophthalmology 2008;115(1): 202–209. [PubMed]

3)      Scott R. The injured eye. Philos Trans R Soc Lond B Biol Sci 2011;366(1562): 251–260. [PMC free article] [PubMed]

Corresponding Author

Dr Veena Pilli

MBBS MS, Asst. Professor of Ophthalmology

Gitam Institute of Medical Science and Research, Gitam University