A DESCRIPTIVE STUDY OF CLOSED GLOBE INJURIES WITH HYPHAEMA
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 41
Abstract
BACKGROUND Eye injuries still remain one of the most common causes of unilateral blindness worldwide. In addition to the physical and psychological trauma to the patient, the direct and indirect costs to the society are enormous. Blunt eye injuries commonly result in traumatic hyphaema and are not an infrequent cause of presentation to the emergency units of many eye clinics. Aims of this study were- 1. To study the cause, clinical presentation, complications and visual outcome of closed globe injury with hyphaema. 2. To know the association between mode of injuries and associated lesions and visual outcome. MATERIALS AND METHODS Study Design and Statistical Analysis- A descriptive case series study was conducted at Regional Institute of Ophthalmology, Thiruvananthapuram for a period of one year, from October 2010 to September 2011, in all patients coming to the institute with hyphaema due to closed globe injury and willing to participate in the study. Patients with pre-existing ocular diseases were excluded. Data were analysed using computer software, Statistical Package for Social Sciences (SPSS) version 10. Data are expressed in its frequency and percentage. To elucidate the associations and comparisons between different parameters, Chi square ( 2 ) test was used as a nonparametric test. For all statistical evaluations, a two-tailed probability of value, < 0.05 was considered significant. RESULTS Sixty patients who completed the 6-month followup were taken for the analysis. 31.7% were between the age group of 10-19 years and 80% were male. Play and sports injury constituted 35% and work site injuries constituted about 21.7% of the total injuries. 60% had only grade 1 hyphaema and 43.3% had angle recession. Those who had initial VA >6/60 either maintained that vision or improved. Only 10% of the study population had corneal blood staining. Majority of those who had initial hyphaema <1/3rd , had normal initial intraocular pressure. Of the total 36 patients who had initial hyphaema less than 1/3rd, 29 (80.6%) had normal intraocular pressure on presentation. Of the 36 patients with initial hyphaema <1/3rd, 28 (77.8%) had normal intraocular pressure at 3rd day. Those who had lenticular and posterior segment injury had poor visual outcome. In our study, initially only 15% had vision better than 6/12, but at the end of 180 days of followup, 81.7% had vision better than 6/12. At initial presentation, only 66.7% had normal intraocular pressure but at the end of 180 days of followup, 100% of the study population had normal intraocular pressure. So, even though the initial vision and intraocular pressure were not favourable, majority improved over 6 months with treatment and close followup. CONCLUSION In this study, males and school going children in the age group of 10-20 were the major group. Work site injuries and play and sports injuries were associated with significant ocular morbidity. Majority of the patients had grade 1 hyphaema on initial presentation, and most of these patients had normal intraocular pressure on presentation and better final visual outcome. Corneal blood staining was found to be significantly associated with grade of hyphaema. Those who had total and near total hyphaema were at increased risk for corneal blood staining and they had poor final visual outcome. Although angle recession was common, significant angle recession was less. There was no significant correlation between angle recession and final visual outcome. In this study, those who had initial good vision and normal intraocular pressure either maintained the condition or improved. Poor final visual outcome was significantly associated with lenticular and posterior segment injuries.
Authors and Affiliations
Susan Philip, Rejina Mohan P. T
Keywords
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- EP ID EP219690
- DOI 10.18410/jebmh/2017/494
- Views 92
- Downloads 0
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