A Clinical Study of the Pattern of Ocular Trauma and Its Visual Outcome among Road Traffic Accident Cases in a Tertiary Care Teaching Institute

2021 ◽  
Vol 8 (03) ◽  
pp. 141-145
Author(s):  
Vinay Kumar Dawson ◽  
Manasvi Dawson

BACKGROUND Ocular injuries due to road traffic accidents (RTA) is one of the important causes of ophthalmological morbidity and cause of unilateral blindness. Some of the injuries also result in cosmetic disfigurement. Increased usage of vehicles for transport in recent times has increased the incidence of cases. The primary objective of this study was to understand the epidemiology and pattern of ocular trauma in RTA cases and their visual outcome. METHODS A total of 75 cases was included in the study following the inclusion and exclusion criteria. A detailed history was taken which included information regarding time, location, type and mechanism of injury, use of spectacles, car safety belts, and helmets. The time interval between injury and reporting was recorded. Test of visual acuity was done, ophthalmic examination included the examination of all patients with the slit lamp, 90 D examination, and indirect ophthalmoscopy were done. Ultrasound B scan was done in cases where unclear media prevented fundus examination. RESULTS Ecchymosis of the lids was the commonest type of ocular injury. Out of 15 eyelid laceration cases, 10 cases were with mild partial-thickness tears present and 5 had severe lid tears which required suturing. Most of the patients recovered with good vision in 6 months post-treatment and a few fair results. Analysis of variance (ANOVA) comparison between conservative management and surgical management at the end of 4 months post treatment was done. The P-values were > 0.05 hence, not significant. It indicated that the outcomes were independent of the method of management adopted. CONCLUSIONS The incidence of RTAs is increasing due to an increase in the number of vehicles used by the public. Ocular injuries are more often seen in young men especially those driving two-wheelers without safety devices like helmets. Open globe injuries and cases with previous ocular problems have poor outcomes. KEYWORDS Ocular Trauma, Road Traffic Accidents [RTA], Visual Outcome

2021 ◽  
Author(s):  
Rajendra prakash Maurya ◽  
Rajendra Prakash Maurya ◽  
Virendra Pratap Singh ◽  
Syeed Mehbub Ul Kadir ◽  
Jayant Kumar Das ◽  
...  

Abstract Purpose This study aimed to determine the frequency, sociodemographic profile, clinical presentation, patterns of injury, treatment and outcomes of cases of simultaneous bilateral ocular trauma. Methods This retrospective study was conducted from May 2015 to April 2019. The medical records of patients presenting with bilateral ocular injuries were reviewed. Results Among the 402 patients presenting with ocular injuries, 34 (8.46%) had simultaneous bilateral ocular trauma. The majority were male (70.59%) and the mean age was 26.82 ± 15.86 years (range: 2–70 years).Most injuries occurred away from home (64.71%), mainly in roads (32.36%) or playgrounds (14.71%), and the vast majority (91.18%) were non-occupational in nature. Mechanical injuries were most frequent (47.05%), followed by cracker (17.65%), chemical (17.65%) and thermal (11.76%) injuries. Most cases occurred due to assault (26.47%), road traffic injury(20.59%) or sports/recreational activities (17.65%). The majority of victims were not using protective devices at the time of injury (82.35%) and had associated polytrauma (58.82%).Closed and open globe injuries accounted for 29.41% and 14.71% of cases, respectively, mostly involving zones I (55.00%) and II (40.00%). Orbital fractures occurred in 27.94% of eyes. Category I and II ocular trauma scores were noted in 5.88% and 7.35% of eyes, respectively. Overall, 13.24% were blinded as a result of the trauma. Conclusion Simultaneous bilateral ocular trauma is rare and occurs mostly following traffic accidents, assault or recreational activities. In particular, younger males are more prone to bilateral ocular injuries, the majority of which are severe and associated with poor outcomes.


Author(s):  
B. S. Puzari ◽  
R. K. Das ◽  
Indira Pegu

Background: Ocular injuries in road traffic accidents (RTA) constitute a major but preventable cause of visual morbidity worldwide and so it is of public health importance. Aim of the study was to assess the visual outcome in patients attending tertiary care hospital with ocular injuries following RTA and compare various associated risk factors.Methods: A prospective study was done with 60 cases of ocular injuries following road traffic accidents in Assam Medical College and Hospital to find out the visual outcome and compare various risk factors .Detailed history and clinical evaluation was done with follow up at 1st and 3rd week.Results: Maximum cases were seen in the age group of 30-40 years, more in males (76.66%); with 78.33% in two wheelers. Out of the 60 cases, 38.33% occurred at night, 21.66% was under the influence of alcohol. 15.27% of patients presented with diminished vision, out of which 15% cases reported with severe ocular morbidity like vitreous haemorrhage, lens dislocation, sclera-corneal tear etc.Conclusions: Younger age group was mostly affected with male preponderance, alcohol and two wheelers being quite important risk factors. Early treatment of ocular injuries and use of protective wear result in better visual outcomes.


Author(s):  
Shubhra Das ◽  
Dipak Bhuyan ◽  
Sujit Addya

Background: Ocular trauma is a well-known cause of blindness and visual impairment and in industrialised nations it has become the reason for extended hospitalization of ophthalmologic patients. Anually, there are in excess of 2 million cases of ocular trauma, with more than 40,000 individuals sustaining significant visual impairment on a permanent basis. The aim of the present study was to study the pattern of ocular involvement in variety of road traffic accidents, attending the emergency department of Gauhati Medical College and Hospitals; analyse and correlate various factors playing roles in etiology and evaluate the final visual outcome. Methods: The study was conducted at a tertiary care centre in which retrospective analysis of 500 cases, who sustained injury involving any part of eye due to road traffic accidents attending emergency department from 1st January 2014 to 31st December 2016, was performed. Results: The predominant age group was between 21-30 years of age with males (75.2%) dominating over female (24.8%). Lid injury in the form of abrasions, lacerations, oedema to full thickness tear, is the commonest presentation in majority of the studies. RTA is more common in rainy and winter months and during the daytime. Two (2) wheelers is the common type of vehicle involved. Final visual outcome in the present study is good and comparable to other studies. Conclusions: Driving under the influence of alcohol is an important etiology in Northeast India. A significant section of the patients were driving two-wheelers and not following the safety precautions as advised, which calls for rigorous implementation of traffic rules. Last but not the least, it is often said that the prevention is the best way to minimise such unwanted events. Public sensitisation, strict adherence to traffic rules and improved roads are some of the few steps that can go a long way to reduce such events. 


2022 ◽  
Vol 7 (4) ◽  
pp. 642-647
Author(s):  
Anubha Bhatti ◽  
Arushi Kakkar ◽  
Shakeen Singh

To study the epidemiology and clinical profile of ocular trauma patients presenting to tertiary care centre. Prospective study. All patients of ocular trauma in OPD/Emergency were assessed for detail between 1/1/17 to 31/6/18 and data on demographic profile was established as per guidelines of Ocular Trauma Society of India. Patients were categorized in different segments and assessed/followed for visual impairment in particular. A total of 246 cases were examined out of which 87% were males. The most common mode of ocular injury was Road Traffic Accidents. Pediatric eye trauma constituted 16.7% of the total cases. 26.8% cases arrived to our centre between 4-24 hours and 62.6% cases presented after 24 hours. Amongst 131 cases of Road Traffic Accidents, none of them were using protective measures like helmets or goggles. Of these, 17.1% were under the influence of alcohol. 28.5% were involved in medicolegal proceedings. Majority of the cases comprised of monocular trauma (78.1%). Closed globe injuries constituted 88.94% of the total cases of which most cases presented with lid edema and ecchymosis. Chemical injuries were reported in 4.5% cases. 9 patients lost vision completely and 71 cases had vision from light perception to 6/18. Ocular trauma is one of the common causes of ocular morbidity. It has been seen predominantly in male population. Public needs to be educated about safety measurements and education about prompt need to specialised care to reduce ocular trauma related visual morbidity.


2020 ◽  
Vol 7 (11) ◽  
pp. 5063-5069
Author(s):  
Sandeep Jawade ◽  
Rahul Dagwar ◽  
Ravi Chauhan

Introduction: Ocular trauma is a major cause of visual morbidity and Visual impairment leading to injury of the globe, optic nerve and adnexa ranging from superficial to vision-threatening complications. Objective: To study the factors leading to blunt ocular trauma, its characteristics, presentation and Outcome. Methods: Hospital-based prospective study conducted at the tertiary care centre of central India. The patient was assessed and if required, admitted. They were followed up on 1st week,1st month,6th month and were assessed for visual outcome and complications. Results: Male constituted 66% and female 34% of all patients. This study had patients of age ranging from 3 to 90 years. Most of the patients were found in the age group of 31-40 years(20.3%). In our study which included 103 cases, there were 20% cases of RTA and 80% cases of non-RTA. 85(82.5%) had lid oedema with chemosis of conjunctiva.87(84.4%) patients had a sub-conjunctival haemorrhage.16 patients (15.5%) presented with a corneal abrasion.32 patients(31.06%) presented with traumatic hyphaema.2 patients(1.9%) had traumatic optic neuropathy.7 patients(6.7%) presented with Berlin’s oedema and 8(8.1%) presented with angle recession glaucoma. Final visual outcome of patients was,1 patient(0.97%)had no perception of light,4 patients(3.8%) had visual acuity of perception of light and projection of rays inaccurate. 7 patients(6.7%) had vision perception of light and projection of rays accurate.45(43.68%) patients regained visual acuity of 6/6 Conclusion: Blunt trauma was more common in males. Most common age group was 4th decade. Road traffic accidents constituted a large number of blunt injuries. Road traffic accidents had a high rate of visual loss due to optic nerve injury.                                                                                                            


2013 ◽  
Vol 11 (2) ◽  
pp. 40-43
Author(s):  
Sagar Rajkarnikar ◽  
Ramesh Raj Bist ◽  
Anu Gurung ◽  
Ram Shrestha

Introduction: Ocular trauma is a major cause of monocular blindness and visual impairment throughout the world. It is estimated that more than 2 million people suffer from ocular trauma annually and 40,000 become visually handicapped permanently. The aim of this study was to evaluate the visual outcome in open globe injury patients. Methods: This study was conducted in Nepal Eye Hospital. All the cases of admitted open globe injuries were examined and managed in the hospital were included in this study. The detail history of trauma and visual acuity was recorded. Clinical diagnosis was made after detail examination of anterior and posterior segment.  Patient was treated according to the type of injury. Visual recovery and the cause of poor vision at the time of discharge was also noted. Data was analyzed using the SPSS 11 program. Results: Out of the 100 cases enrolled in the study work related injury was the most frequent injury, metal was the most common causative agent. Males of 20-50 years of age are more vulnerable to open globe injury. Vision improved in 48%, same vision in 39% and deteriorated vision in 13% cases was recorded. Conclusions: Present study reveals that open globe injury can present in varying severity and though the overall prognosis is grave, prompt surgical intervention can result in better visual outcome. The visual outcome in mild to moderate ocular injury was satisfactory but poor in severe injuries.Medical Journal of Shree Birendra Hospital; July-December 2012/vol.11/Issue2/40-43 DOI: http://dx.doi.org/10.3126/mjsbh.v11i2.7909  


2012 ◽  
Vol 45 (03) ◽  
pp. 498-503 ◽  
Author(s):  
Darshan Kumar A. Jain ◽  
Praveen Bhardwaj ◽  
Hari Venkataramani ◽  
S. Raja Sabapathy

ABSTRACT Background: Epidemiological studies on traumatic brachial plexus injuries are few and these studies help us to improve the treatment, rehabilitation of these patients and to allocate the resources required in their management. Epidemiological factors can vary in different countries. We wanted to know the situation in an Indian centre. Materials and Methods: Data regarding age, sex, affected side, mode of injury, distribution of paralysis, associated injuries, pain at the time of presentation and the index procedure they underwent were collected from 304 patients. Additional data like the vehicle associated during the accident, speed of the vehicle during the accident, employment status and integration into the family were collected in 144 patients out of the 304 patients. Results: Road traffic accidents accounted for 94% of patients and of the road traffic accidents 90% involved two wheelers. Brachial plexus injury formed a part of multitrauma in 54% of this study group and 46% had isolated brachial plexus injury. Associated injuries like fractures, vascular injuries and head injuries are much less probably due to the lower velocity of the vehicles compared to the western world. The average time interval from the date of injury to exploration of the brachial plexus was 127 days and 124 (40.78%) patients presented to us within this duration. Fifty-seven per cent had joined back to work by an average of 8.6 months. It took an average of 6.8 months for the global brachial plexus-injured patients to write in their non-dominant hand.


2019 ◽  
Vol 185 (5-6) ◽  
pp. e799-e803 ◽  
Author(s):  
Soner Guven ◽  
Ali Hakan Durukan

Abstract Introduction Empty bullet-related ocular injuries (EBOI) are rare and may result in unfavorable visual outcomes due to both open globe and closed globe injuries. To our knowledge, no reports of such injuries in terms of outcomes have been previously described in the literature. The aim of this study was to describe the treatment performed and ocular outcomes of such injuries. Materials and Methods EBOI of 23 cases were reviewed who were referred to Gulhane School of Medicine Department of Ophthalmology between January 1998 and January 2018. Patient demographics, ocular signs (initial and final), injury types, type and number of interventions, and ocular trauma scores were recorded. Results In total, 23 eyes of the 23 patients with an average age of 22.3 ± 4.54 years (range, 20–41 years) were included in the study. All of the patients were male, and all injuries were due to empty bullets during shooting training. None had ocular protection at the time of ocular injury. Fourteen patients (60.9%) were open globe injuries, whereas nine (39.1%) of them were closed globe injuries. Mean ocular trauma scores category of the cases was 2.52 ± 1.03. The baseline and final visual acuity was 20/200 or better in 21.7% and 69.5% of eyes, respectively. Nineteen eyes (82.7%) had undergone a total of 31 surgeries with a 1.34 ± 0.88 surgery average. Conclusions The prognosis of EBOI is unpredictable and is dependent on the severity of ocular damage. The best treatment option is prevention of EBOI with protective eyewear.


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