The Ocular Trauma Score as a Method for the Prognostic Assessment of Visual Acuity in Patients with Close Eye Injuries

Abstract: Of the many ocular blunt traumas, trauma due to typical buffalo attack thrrough leverage has not been reported. We reported a 65-year-old man attacked by a buffalo on his left eye. The patients complained of pain of his left eye associated with swelling, bleeding, and blurred vision. Eye examination revealed that visual acuity of the left eye was classified as hand motion (HM), limited ocular motility, blepharospasm, and a crescent-shaped anterior lamella laceration with lateral canthal involvement. Anterior segment examination revealed bullous subconjunctival hemorrhage, corneal edema, and rosette-shaped opacification (RSO) of the lens. Head-CT showed traumatic cataract and periorbital haemorrhage; no abnormalities in the right eye. Ovular trauma score (OTS) of the patient was three indicating that the possible visual prognosis was 2% as no light perception (NLP), 11% as light perception (LP) or hand motion (HM), 15% as 1/200-19/200, 31% as 20/200-20/50, and 41% as >20/40. Literature data showed that the visual sensitivity of OTS prediction in NLP, 20/200-20/50, and 20/40 was 100%. The specificity of OTS in predicting vision in LP/HM 1/200-19/200 was 100%. After a recovery period of approximately two months and the sutured wound healed, the patient came to the eye clinic of Prof. Dr. R. D. Kandou Hospital Manado. After a cataract surgery was performed on the left eye of the patient, his visual acuity improved to 20/40.Keywords: ocular trauma, buffalo attack, ocular trauma score (OTS) Abstrak: Dari sekian banyaknya trauma tumpul, trauma akibat rudapaksa tipikal serangan kerbau yang menggunakan gaya ungkit belum pernah dilaporkan. Kami melaorkan seorang laki-laki berusia 65 tahun yang mendapat serangan kerbau pada mata kiri dengan keluhan nyeri disertai pembengkakan, pendarahan, dan penglihatan kabur. Pemeriksaan mata menunjukkan ketajaman visual mata kiri dengan gerakan tangan, motilitas okular terbatas, blefarospasme, dan laserasi lamela anterior berbentuk bulan sabit dengan keterlibatan kantal lateral. Pemeriksaan segmen anterior menunjukkan perdarahan subkonjungtiva bulosa, edema kornea, dan rosette-shaped opacification (RSO) pada lensa. Hasil CT-kepala menunjukkan katarak traumatik dan perdarahan periorbital, tanpa kelainan pada mata kanan. Skor trauma okular pasien (OTS) ialah tiga yang menandakan kemungkinan prognosis pada visual pasien ialah 2% menjadi no light perception (NLP), 11% menjadi light perception (LP) atau hand motion (HM), 15% menjadi 1/200-19/200, 31% menjadi 20/200-20/50, dan 41% menjadi >20/40. Penggunaan OTS pada kasus ini karena data literatur menunjukkan bahwa sensitivitas penglihatan prediksi OTS di NLP, 20/200-20/50, dan 20/40 ialah 100%. Kekhususan OTS dalam memrediksi visi di LP/HM 1/200-19/200 ialah 100%. Setelah masa pemulihan sekitar dua bulan dan luka penjahitan sembuh, pasien datang kontrol ke poliklinik mata RSUP Prof. Dr. R. D. Kandou Manado. Setelah dilakukan operasi katarak pada mata kiri didapatkan tajam penglihatan mata kiri pasien 20/40.Kata kunci: trauma mata, serangan kerbau, ocular trauma score (OTS)

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A prospective study to evaluate the predictive value of ocular trauma score in cases of mechanical eye injuries in a tertiary care hospital

Indian Journal of Clinical and Experimental Ophthalmology ◽

10.18231/j.ijceo.2021.103 ◽

2021 ◽

Vol 7 (3) ◽

pp. 523-527

Author(s):

Arvind Kumar ◽

Rupali Verma ◽

Abha Shukla

Keyword(s):

Predictive Value ◽

Ocular Trauma ◽

Tertiary Care ◽

Common Source ◽

Care Hospital ◽

Eye Injuries ◽

Tertiary Care Centre ◽

Ocular Trauma Score ◽

Globe Rupture ◽

Trauma Score

Ocular trauma score (OTS) was proposed to predict the visual outcome of patients after ocular trauma, which estimates visual function (visual acuity) after 6 months of ocular trauma. This OTS scale is useful for guiding the treatment and rehabilitation of the patients with eye injury and to provide the valuable information and advice. Aim of this study was to evaluate the predictive value of OTS in cases of mechanical ocular trauma. A prospective interventional study was carried out in a tertiary care centre over a period of 2 years; August 2017 to July 2019. Patients with mechanical eye trauma were included in the study. OTS score was calculated and recorded for each eye at the time of injury. Proper treatment given to each case and followed for six months. Results obtained were compared with standard OTS with respect to final VA. Out of 50 patients mean age was 28.46 years, with majority between 21 to 50 years of age. There were 78% males and 22% were females. Metallic objects were the common source of injury in 27 cases (54%) like iron rod and nail. In cases (fifty eyes) the distribution of OTS variables was; globe rupture 86% (43 eyes), retinal detachment 6% (3 eyes), relative afferent pupillary defect (RAPD) 6% and endophthalmitis 2% (1 eye) respectively. The final visual acuities in OTS categories in our study groups were similar to those in the OTS study group, except for some categories. OTS helps treating ophthalmic team to assess evidence based prognosis of a traumatized eye in advance. With the guidance of OTS the patient and their family can be counselled for further management.

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Factors Affecting Final Functional Outcomes in Open-Globe Injuries and Use of Ocular Trauma Score in Nepalese population

10.21203/rs.3.rs-86664/v1 ◽

2020 ◽

Author(s):

Saurav Man Shrestha ◽

Casey Leigh Anthony ◽

Justin A. Grant ◽

Madhu Thapa ◽

Jyoti Baba Shrestha ◽

...

Keyword(s):

Visual Acuity ◽

Ocular Trauma ◽

Final Visual Acuity ◽

Delayed Presentation ◽

Ocular Trauma Score ◽

Visual Outcomes ◽

Open Globe ◽

The Mean ◽

Trauma Score ◽

Open Globe Injuries

Abstract Background: Open globe injury (OGI) is one of the most devastating form of ocular trauma. The aim of the study is to identify the epidemiology and predict visual outcomes in traumatic open globe injuries using ocular trauma score (OTS) and correlate with final visual acuity (VA) at 3 months. Methods: Patients older than 5 years, presenting to B.P. Koirala Lions Centre for Ophthalmic Studies (BPKLCOS) from March 2016- March 2017 with OGI that met inclusion criteria were evaluated. Patient profile, nature and cause of injury, and time to presentation were recorded. Patients were managed accordingly and followed up to 3 months. An OTS score for each patient was calculated and raw scores were categorized accordingly. The VA after 3 months were compared to the predicted OTS values. Results: Seventy-three eyes of 72 patients were examined. 76% were male, and the mean age was 26.17 years (median, 23.5 years). The mean time from injury to presentation was <6 hours (30 patients, 41%). Thirty-seven eyes (51%) had zone I trauma, followed by twenty eyes (27%) with zone II, and sixteen eyes (22%) with zone III trauma. Sixty-five patients (90%) were managed surgically, and fifty (68%) received intravitreal antibiotics with steroid. When compared, the projected VA as per OTS were able to predict actual final visual outcomes in 60% of the eyes with OGI of various zones (p<0.05). Conclusion: OTS can be an accurate predictive tool for final visual acuity even with a short follow up period of 3 months; with poor presenting visual acuity, delayed presentation, posterior zones of injury, need for intravitreal injections, endophthalmitis, and globe rupture associated with poorer prognosis.

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Comment on a new ocular trauma score in pediatric penetrating eye injuries

Eye ◽

10.1038/eye.2011.131 ◽

2011 ◽

Vol 25 (9) ◽

pp. 1240-1240 ◽

Cited By ~ 8

Author(s):

H E Sharma ◽

N Sharma ◽

A Kipioti

Keyword(s):

Ocular Trauma ◽

Eye Injuries ◽

Ocular Trauma Score ◽

Trauma Score

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Two kinds of ocular trauma score for paediatric traumatic cataract in penetrating eye injuries

Injury ◽

10.1016/j.injury.2015.04.024 ◽

2015 ◽

Vol 46 (9) ◽

pp. 1828-1833 ◽

Cited By ~ 13

Author(s):

Lili Zhu ◽

Zhencheng Wu ◽

Feng Dong ◽

Jia Feng ◽

Dinghua Lou ◽

...

Keyword(s):

Ocular Trauma ◽

Traumatic Cataract ◽

Eye Injuries ◽

Ocular Trauma Score ◽

Trauma Score

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Pediatric Traumatic Retinal Detachment: Clinical Features, Prognostic Factors, and Surgical Outcomes

Journal of Ophthalmology ◽

10.1155/2018/9186237 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Dilek Yaşa ◽

Zeynep Gizem Erdem ◽

Ufuk Ürdem ◽

Gökhan Demir ◽

Ali Demircan ◽

...

Keyword(s):

Visual Acuity ◽

Prognostic Factors ◽

Retinal Detachment ◽

Surgical Outcomes ◽

Ocular Trauma ◽

Ocular Trauma Score ◽

Visual Outcomes ◽

The Mean ◽

Trauma Score

Purpose. We report the clinical characteristics, prognostic factors, and surgical outcomes for 23-gauge pars plana vitrectomy (23-G PPV) in pediatric cases of traumatic retinal detachment (RD). Methods. Medical records of pediatric patients who underwent 23-G PPV to treat traumatic retinal detachment were retrospectively reviewed. These patients underwent a follow-up examination at least 1 year following surgery. Associations between various preoperative factors and anatomical and visual outcomes were analyzed. An Ocular Trauma Score (OTS) and a Pediatric Ocular Trauma Score (POTS) were calculated for each patient. Raw scores were converted to their corresponding OTS and POTS categories. Final visual acuities by categories were compared with those in the OTS and POTS studies. Results. The mean age of the patients was 9 ± 4 years, and the male-to-female ratio was 4.7 : 1. The mean follow-up time was 23 ± 14 months. Anatomical success was achieved in 72% of the eyes, and functional success (>5/200) was achieved in 37% of the eyes. Functional success was less common among patients with visual acuities less than hand motion, macula-off retinal detachment, proliferative vitreoretinopathy at presentation, and recurrent retinal detachment during follow-up. When we compared the categorical distribution of final visual acuities in all categories, our results were significantly different than those suggested by OTS and POTS. Conclusions. Visual outcomes are poorer compared to anatomical outcomes. OTS and POTS do not provide reliable prognostic information if the patient has RD. Presenting visual acuity, the presence of macula-off RD, and PVR are all important predictors of final visual acuity.

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Optimal timing of vitrectomy for severe mechanical ocular trauma: A retrospective observational study

Scientific Reports ◽

10.1038/s41598-019-54472-9 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Honghua Yu ◽

Jianhua Li ◽

Ying Yu ◽

Guodong Li ◽

Dongli Li ◽

...

Keyword(s):

Visual Acuity ◽

Ocular Trauma ◽

Visual Outcome ◽

Optimal Timing ◽

Trauma Patients ◽

Ocular Trauma Score ◽

Post Operation ◽

Group A ◽

Group B ◽

Trauma Score

AbstractMechanical ocular trauma could lead to disastrous visual outcomes. There has been a controversy regarding the timing of vitrectomy for such cases. This study aimed to find out the optimal timing of vitrectomy for severe mechanical ocular trauma. Patients with severe mechanical ocular trauma who had undergone vitrectomy were enrolled and followed up for at least 6 months. Clinical data were collected including ocular trauma score (OTS), the timing of vitrectomy upon injury, visual acuity, vitrectomy results, post-operation complications and etc. All cases were classified according to the timing of vitrectomy upon injury into 3 groups: group A 1–7 days, group B 8–14 days, group C more than 14 days. A total of 62 cases were enrolled, including 20 eyes in group A, 25 eyes in group B, and 17 eyes in group C. No significant differences were shown of the gender, age or OTS among the 3 groups. Both functional success rate and visual outcome were optimal in group B, then in group A, and worst in group C. These results suggested that the best timing of vitrectomy for severe mechanical ocular trauma is 8–14 days upon injury; second best is 1–7 days; worst is after 14 days.

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Factors affecting final functional outcomes in open‐globe injuries and use of ocular trauma score as a predictive tool in Nepalese population

BMC Ophthalmology ◽

10.1186/s12886-021-01819-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Saurav M. Shrestha ◽

Casey L. Anthony ◽

Grant A. Justin ◽

Madhu Thapa ◽

Jyoti B. Shrestha ◽

...

Keyword(s):

Visual Acuity ◽

Ocular Trauma ◽

Final Visual Acuity ◽

Predictive Tool ◽

Ocular Trauma Score ◽

Visual Outcomes ◽

Open Globe ◽

The Mean ◽

Trauma Score ◽

Open Globe Injuries

Abstract Background Open globe injury (OGI) is one of the most devastating form of ocular trauma. The aim of the study is to identify the epidemiology and predict visual outcomes in traumatic open globe injuries using ocular trauma score (OTS) and correlate with final visual acuity (VA) at 3 months. Methods Patients older than 5 years, presenting to B.P. Koirala Lions Centre for Ophthalmic Studies (BPKLCOS) from March 2016- March 2017 with OGI that met inclusion criteria were evaluated. Patient profile, nature and cause of injury, and time to presentation were recorded. Patients were managed accordingly and followed up to 3 months. An OTS score for each patient was calculated and raw scores were categorized accordingly. The VA after 3 months were compared to the predicted OTS values. Results Seventy-three eyes of 72 patients were examined. 76 % were male, and the mean age was 26.17 years (median, 23.5 years). The mean time from injury to presentation was < 6 hours (30 patients, 41 %). Thirty-seven eyes (51 %) had zone I trauma, followed by twenty eyes (27 %) with zone II, and sixteen eyes (22 %) with zone III trauma. Sixty-five patients (90 %) were managed surgically, and fifty (68 %) received intravitreal antibiotics with steroid. When compared, the projected VA as per OTS were able to predict actual final visual outcomes in 60 % of the eyes with OGI of various zones. Conclusions OTS can be an accurate predictive tool for final visual acuity even with a short follow up period of 3 months; with poor presenting visual acuity, delayed presentation, posterior zones of injury, need for intravitreal injections, endophthalmitis, and globe rupture associated with poorer prognosis.

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Comparison of the Ocular Trauma Score and Pediatric Ocular Trauma Score as Two Prognostic Models in Pediatric Open Globe Injuries

Klinische Monatsblätter für Augenheilkunde ◽

10.1055/a-1194-5104 ◽

2020 ◽

Author(s):

Dusica Pahor ◽

Tomaz Gracner

Keyword(s):

Visual Acuity ◽

Ocular Trauma ◽

Final Visual Acuity ◽

Prognostic Models ◽

Ocular Trauma Score ◽

Open Globe ◽

Significant Difference ◽

Trauma Score ◽

Pediatric Ocular Trauma ◽

Open Globe Injuries

Abstract Aim To compare the ocular trauma score (OTS) and the pediatric ocular trauma score (POTS) as prognostic models of visual outcome after open globe injury in children during a period of 19 years. Patients and Methods A retrospective study of 36 open globe injuries in 36 patients younger than 18 years was conducted from January 2000 to January 2019. For each case, OTS and POTS points were calculated. Results Significant differences were observed in our patients using the two models regarding categories 1 to 4. One third of the cases were in categories 1 and 2 using the OTS model, and nearly 60% using the POTS model. Nearly 60% of our patients were in categories 3 and 4 using the OTS model and 30.6% using the POTS model. In category 5, no difference was observed between the two models. The comparison of distribution of the percentage of final visual acuity between OTS and POTS model in each category revealed a significant difference in category 1 in final visual acuity 20/40 or more (25 vs. 50%) as well as in final visual acuity 20/20 (0 vs. 30%). In category 2, final visual acuity was not significantly different in 20/40 or more between the two models; however, there was a significant difference in final visual acuity 20/20 – 12.5% in the OTS model and 45.5% in the POTS model. In category 3, significant differences were revealed between the two models. Using the OTS model, final visual acuity 20/40 or more was observed in more than 60% and using POTS model in 100%; final visual acuity 20/20 was observed in 36.3% using OTS model and in 50% using POTS model. In category 4 and 5, no differences were observed between OTS and POTS models. Conclusion Our study did not confirm the benefit of POTS. The distribution of our cases among OTS categories demonstrated a significant difference between the two models with more cases distributed in lower categories in POTS group. In the POTS group, the prognosis for final visual acuity was significantly better in the first three categories than in the OTS group, probably as a result of a lower calculation for POTS points. In our opinion, the OTS model is easier to use, has a higher prognostic accuracy, and should be further used in counselling of paediatric cases.

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