Ocular Manifestations in Head Injury Patients - A Prospective Study
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 8
Abstract
Introduction: Ophthalmic findings are often ignored in patients of head injury leading to delay in their proper management resulting in permanent visual impairment. This prospective study aims to evaluate various ocular manifestations in cases of head injury patients ,correlate them with the patients neurological status and to analyse any association between them . Material and methods: A detailed ophthalmological examination was carried out in 86 patients with closed head injury within 6 hours of admission in the Intensive care unit of our institute. Glasgow Coma Scale (GCS) was applied to grade the severity of head injury. Ocular neurological signs like abnormal pupillary reactions and abnormal extraocular muscle (EOM) movements and GCS were then correlated to prognosticate the visual outcome and survival rate of the. Patients were managed by a multidisciplinary approach. Results: Out of 86 enrolled patients of head trauma,74 (86.04%) were males and 12 (13.91%) were females in the age range 5-74 years and mean of 28.68 years. Ocular complications occurred in 58 (67.44%) patients . Young adult males (21-30 years) were more vulnerable to head injury. Road traffic accident was the most common cause of head injury in 52 cases (60.46%) leading to soft-tissue injuries to the globe and adnexae in maximum no. of patients. The most frequently encountered neuro-ophthalmic manifestation was pupillary involvement as relative affarent pupillary defect (RAPD) in 27 (31.39%) cases, followed by extraocular muscle (EOM) affection in 21(24.41%) cases and disc edema in 14(16.27%)cases. Conclusion; Pupillary involvement has a significant association with severity of head injury but there was an insignificant co-relation of the GCS, neurodeficit and the ocular signs with the outcome. RAPD being most common and best early indication to post-traumatic reduced vision does not has much bearing in determining the final visual outcome.
Authors and Affiliations
Rashmi Kumari, Bhawesh Chandra Saha, Kalyan Kumar Saha, Bibhuti Prasanna Sinha
Keywords
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