Clinical presentation and visual outcome of broomstick ocular injury in 120 eyes of children at a tertiary eye care in India

2020 ◽  
Author(s):  
Abhishek Gupta ◽  
Prabhakar Singh ◽  
Richa Gupta ◽  
Vidya Bhushan ◽  
Shivani Sinha ◽  
...  
Keyword(s):  
Ocular Trauma ◽  
Hand Movement ◽  
Visual Outcome ◽  
Ocular Injury ◽  
Eye Injuries ◽  
Early Presentation ◽  
Open Globe ◽  
Regional Institute ◽  
Open Globe Injuries

Abstract Background Eye injuries are a serious health problem globally. Ocular trauma accounts for 5% of blindness cases. In India broomstick injury is very common. But only few studies are published regarding the nature and outcome of broomstick ocular injuries. The aim of this study is to determine the frequency, mode of presentation, complications and surgical results with a view to offering solutions to reduce this trend. Methods This retrospective study was conducted at Regional Institute of Ophthalmology, Patna. The records of all patients presenting to the Eye OPD and Emergency clinic with ocular trauma from broomstick injury between March2017 and April 2020 were reviewed. A total of 120 cases were identified. Patient’s age, gender, interval between injury and presentation to eye OPD, mechanism of injury, activity at time of injury, visual acuity at presentation, anterior and posterior segment findings, diagnosis, complications, treatments offered and follow-up events were documented. Data were analysed statistically. Results The mean age of presentation was 8.10 ± 4.93 years. All were children < 15 years old. 80% patients sustained trauma from broomstick shot as an arrow. 70% had presenting vision < Hand movement. 90% of the cases were open globe injuries. Most of them had multiple complications such as corneal perforation (80%), traumatic cataract (27%), endophthalmitis (68%), retinal detachment (12.5%), panophthalmitis 8 (7%) and orbital cellulitis (6%). Culture was positive in 20%. Pseudomonas aeuroginosa was the most common organism isolated. Therapeutic vitrectomy was performed in 67% eyes. Only 12% eyes gained ambulatory vision (VA > 3/60) after vitrectomy. Conclusion Broomstick shot as an arrow causes devastating and multiple complications resulting in rapid and immediate loss of vision. Overall prognosis is bad and early presentation to the hospital does not appear to improve the prognosis. Such injuries often affect younger, male children. Primary prevention is the only way to control blindness occurring from such injuries. Primary health education should be given in school to highlight these risk factors.

scholarly journals Profile of Ocular Trauma Patients presenting to the National Eye Referral Hospital, Asmara, Eritrea

2021 ◽  
Author(s):  
Oluwafemi Adekunmi Ibrahim ◽  
Danait Michael ◽  
Hermela Misghna ◽  
Amir Ibrahim ◽  
Rut Russom
Keyword(s):  
Ocular Trauma ◽  
Visual Outcome ◽  
Referral Hospital ◽  
Ocular Injury ◽  
Trauma Patients ◽  
Open Globe Injury ◽  
Eye Injuries ◽  
Cross Sectional ◽  
Open Globe ◽  
At Home

Abstract Background Ocular trauma is a significant disabling health problem and a leading cause of visual impairment and loss worldwide. These injuries have many diverse costs including human suffering, long term disabilities, loss of productivity and economic hardship. Therefore, assessing the profile of ocular trauma, the etiology and its outcome is critical to the prevention of ocular injuries Methods This cross-sectional study was conducted on ocular trauma patients presenting to Berhan Ayni National Eye Referral Hospital from August – November, 2018. Data on demography, presenting visual acuity, type of injury and visual outcome were collected using a standardized questionnaire. The types of injuries were classified according to Birmingham Eye Trauma Terminology System. Pearson Chi-Square test (χ2)/or Fisher’s exact test in the Crosstab procedure was used to evaluate the relationship between specific variables. Logistic regression models were constructed to assess risk factors associated with blindness. Result 280 patients were seen with ocular trauma in the hospital during the study period. Males were 198 (70.7%) and peak age was 18–40 years. Ocular injury commonly occurred at home (31.8%), street and high way (31.4%) and workplace (28.9%). 24.7% of the injury was work-related. Common causes of injury were blunt objects (37.5%), sharp objects (31.1%) and fall (12.5%). 27.8% had open globe injury (OGI). Blindness was associated with rural residence (p < 0.0001), presentation greater than 24 hours (p = 0.04), non-use of eye protection goggles (p = 0.007), open globe injury (p = 0.018), posterior segment involvement (p < 0.0001) and hospitalization (p < 0.0001). Conclusion Immediate and comprehensive medical care is mandatory for ocular trauma patients. Educating the public especially at home and workplace is essential to prevent eye injuries.

scholarly journals Visual Outcome in Open Globe Injury

2013 ◽  
Vol 11 (2) ◽  
pp. 40-43
Author(s):  
Sagar Rajkarnikar ◽  
Ramesh Raj Bist ◽  
Anu Gurung ◽  
Ram Shrestha
Keyword(s):  
Ocular Trauma ◽  
Visual Outcome ◽  
Ocular Injury ◽  
Open Globe Injury ◽  
Poor Vision ◽  
Work Related ◽  
Open Globe ◽  
History Of ◽  
Visually Handicapped ◽  
Type Of Injury

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  

scholarly journals Microbial contamination in open globe injury

1970 ◽  
Vol 4 (1) ◽  
pp. 84-89 ◽  
Author(s):  
S Bhala ◽  
S Narang ◽  
S Sood ◽  
C Mithal ◽  
AK Arya ◽  
...  
Keyword(s):  
Visual Outcome ◽  
Bacillus Species ◽  
Open Globe Injury ◽  
Open Globe ◽  
A Prospective Study ◽  
Culture Positive ◽  
Initial Contamination ◽  
Final Visual Outcome ◽  
Open Globe Injuries

Introduction: Endophthalmitis is the most dreaded complication of ocular trauma and knowledge of the microbial contaminants is essential to start empirical antibiotic therapy. Purpose: To determine incidence of contamination after open globe injuries (OGI) in our setup and to identify the spectrum of microorganisms contaminating open globe injuries. Material and methods: A prospective study including 50 consecutive eyes of open globe injury over a period of two years was conducted. Intra-operatively, 4 - 5 samples were taken from the inferior conjunctival sac and anterior chamber at the beginning and end of the open globe injury repair. Any abscised tissue or foreign body was also sent for culture sensitivity. A vitreous tap was taken from eyes with posterior segment trauma with signs of endophthalmitis. Results: Microbial cultures were positive in13 eyes (26 %). The microbial spectrum included Aspergillus species in 45.6 %, Alternaria in 15.2 %, Curvularia in 15.2 %, Staphylococcus aureus in 7.6 %, Bacillus species in 7.6 %, and Streptococcus pneumoniae in 7.6 %. Of these 13 eyes, nine eyes developed clinically evident frank endophthalmitis during follow-up. Overall, endophthalmitis developed in 20 eyes (40 %). There was a significant association between the initial contamination and development of endophthalmitis (p < 0.05). 53 % of culture positive cases achieved ambulatory vision compared to 73 % of culturenegative cases. Conclusion: Initial contamination was seen in 26 % of OGI cases. Aspergillus (fungus) was the commonest contaminant. There was a strong correlation between the initial contamination and development of endophthalmitis. Culture-negative cases had a trend towards better final visual outcome than culture-positive cases. Close follow up of cases showing contamination following OGI is recommended. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5857 NEPJOPH 2012; 4(1): 84-89

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
Keyword(s):  
Traffic Accidents ◽  
Ocular Trauma ◽  
Road Traffic ◽  
Visual Outcome ◽  
Post Treatment ◽  
Time Interval ◽  
Ocular Injury ◽  
Road Traffic Accidents ◽  
Open Globe ◽  
Ocular Injuries

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

Blunt ocular trauma in patients over 70: Clinical characteristics and prognosis

2020 ◽  
pp. 112067212094657
Author(s):  
Orit Vidne-Hay ◽  
Miri Fogel Levin ◽  
Shahar Luski ◽  
Joseph Moisseiev ◽  
Elad Moisseiev
Keyword(s):  
Chart Review ◽  
Ocular Trauma ◽  
Retrospective Chart Review ◽  
Functional Results ◽  
The Elderly ◽  
Additional Surgery ◽  
Female Predominance ◽  
Open Globe ◽  
Open Globe Injuries

Purpose: To describe the mechanisms and outcomes of open globe injuries (OGIs) in patients 70 years or older. Methods: A retrospective chart review of patients from two large academic centers in Israel who were underwent surgery for OGI. Data was collected from surgical and clinic charts. Anatomical and functional results were recorded as well any additional surgeries and complications. Results: Thirty-two eyes of 32 patients were included. The mechanism of OGI consisted of blunt trauma with ocular rupture secondary to falls. All eyes underwent immediate primary closure of the corneal and scleral lacerations. Additional surgeries were performed in 34.3% of cases. In 31.2% of cases additional surgery was not required, and in 21.9% of cases the damage was so devastating that additional procedures were not recommended. Four patients (12.5%) chose not to undergo additional surgery. Mean visual acuity at presentation was 2.24 ± 0.72 logMAR and it improved to 1.92 ± 0.89 logMAR at final follow-up ( p = 0.002). VA at presentation was significantly correlated to final VA ( p < 0.001). Conclusions: OGI in the elderly represents a unique group. It is mostly related to falls, with a female predominance and a poor visual prognosis. In this patient population, general health concerns and increased risks of anesthesia require special attention. Care should be taken to educate elderly patients and their caretakers on how to avoid falls.

scholarly journals Evaluation of surgical outcome in open globe injuries in a tertiary ophthalmological centre

2014 ◽  
Vol 9 (2) ◽  
pp. 9-14
Author(s):  
Polina Dahal ◽  
RN Byenju
Keyword(s):  
Surgical Outcome ◽  
Primary Repair ◽  
Visual Outcome ◽  
Ocular Injury ◽  
Surgical Interventions ◽  
Lens Extraction ◽  
Open Globe ◽  
Secondary Procedures ◽  
Type Of Injury ◽  
Open Globe Injuries

Aims: To evaluate the clinical presentations and surgical outcome in patients with open globe injuries in a tertiary ophthalmological centre in Bharatpur Eye Hospital, Bharatpur. Methods: Seventy nine patients with ocular injury who underwent surgery were included in the study. The type of injury, surgical interventions and final visual outcome were recorded. The period of study was from 2012 May to 2013 May. Results: Injury was mild in 48 (60.8 %), moderate in 17 (21.5 %) & severe in 14 (17.7 %) cases (International Ocular Trauma Classification). Forty six (58.2 %) cases had only primary repair, 27 (34.2 %) had associated lens extraction, 12(15.2 % )had vitrectomy, 2 (2.5 %) had retinal detachment surgery, one (1.3 %) had intra-ocular foreign body removal, one (1.3 %) evisceration. Thirteen 16.5 %) cases underwent secondary procedures. Final vision was 6\18 or better in 20 (25.3 %), 6\18-6\60 in 14 (17.7 %) and <6\60 in 15 (18.9 %) cases. 10 (12.7 %) cases developed phthisical changes. Conclusion: Present analysis reveals that open globe injuries can present in varying severity &though the overall prognosis is grave, prompt surgical intervention can result in better visual outcome. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-2, 9-14 DOI: http://dx.doi.org/10.3126/jcmsn.v9i2.9678

scholarly journals Profile of pediatric ocular trauma in mid western hilly region of Nepal

1970 ◽  
Vol 4 (1) ◽  
pp. 134-137 ◽  
Author(s):  
S Dulal ◽  
JB Ale ◽  
YD Sapkota
Keyword(s):  
Medical Records ◽  
Ocular Trauma ◽  
Ocular Injury ◽  
Hilly Region ◽  
Open Globe ◽  
History Of ◽  
Ocular Injuries ◽  
The Himalaya ◽  
Open Globe Injuries ◽  
Conjunctival Hemorrhage

Introduction: Majority of blinding ocular injuries can be prevented. Objective: To describe the epidemiology of ocular trauma in children. Material and methods: A retrospective review of medical records of the patients aged below 16 years who attended the Himalaya Eye Hospital, Pokhara with history of ocular injury. Results: Of 6,829 pediatric patients, 554 (8.1 %) had ocular trauma. The ocular trauma was more prevalent (38.1 %) in the age group of 5 – 10 years followed by 10-15 years (16.6 %). The boys (62 % vs 38 %) were more prone to ocular trauma than girls (RR = 1.7 and 95 % CI = 1.41 - 2.02). Of 554 ocular injuries, 32 (5.8 %) were open globe injuries. Sub-conjunctival hemorrhage was the commonest presenting finding in 96 (17.3 %) subjects. Forty-seven (8.5 %) of them attended the hospital after 15 days of injury. Home was the most common place for trauma (n =204, 36.8%), followed by playground (n = 140, 25.3 %). Conclusion: Children between the ages of 5-10 years are most vulnerable to ocular trauma. Home is the commonest place for ocular injury followed by playground. By adopting some common safety factors or by reducing the ocular injury risks factor, ocular trauma can be greatly reduced. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5865 NEPJOPH 2012; 4(1): 134-137

scholarly journals Characteristics and visual outcome of ocular trauma patients at Queen Elizabeth Central Hospital in Malawi

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0246155
Author(s):  
Thokozani Zungu ◽  
Shaffi Mdala ◽  
Chatonda Manda ◽  
Halima Sumayya Twabi ◽  
Petros Kayange
Keyword(s):  
Rural Areas ◽  
Ocular Trauma ◽  
Adult Population ◽  
Visual Outcome ◽  
Outcome Variable ◽  
Ocular Injury ◽  
Central Hospital ◽  
Female Ratio ◽  
Open Globe ◽  
Queen Elizabeth Central Hospital

Background To describe the epidemiology and visual outcome of patients with ocular trauma treated at Queen Elizabeth Central hospital in Malawi. Methods A prospective, observational study was undertaken from September 2017 to December 2017. Data on socio-demographic features, aetiology of trauma, type of ocular injury pre-referral pathway and treatment of ocular trauma was collected as the exposure variables. The main outcome variable was best corrected visual acuity at 8 weeks following initial visit. Results A total of 102 patients (103 eyes) with ocular trauma were recruited with loss of follow up of 11 participants at 8 weeks following recruitment. The most affected age group were children under 11 years old (35.3%), followed by young adults of age between 21–30 years (22.5%). The male-to-female ratio for ocular injury was 2.8:1. Most participants had closed globe injuries (n = 72, 70.6%), with over half the population injured by blunt objects (n = 62, 60.8%). Furthermore, among the adult population, majority (n = 19 38%) were injured on the road during assaults (n = 24, 48%), while most paediatric injuries (n = 32, 61.5%) occurred at home during play. The incidence of monocular blindness was 25.3% at eight weeks after the first presentation. Factors that were associated with monocular blindness on multivariate analysis were living in rural areas and open globe injuries. Conclusion Ocular trauma led to monocular blindness in a quarter of the study population. There is need for preventive education of ocular injuries at both family and community level.

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