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Michael Smith, Marcus Colyer, David Greenburg; Correlation of Ocular Trauma Score and visual acuity outcomes in combat-related traumatic cataracts. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4436.
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© ARVO (1962-2015); The Authors (2016-present)
To determine if ocular trauma scores are predictive of visual outcomes in eyes sustaining traumatic cataracts as a result of combat-associated ocular trauma.
A retrospective comparative case series of United States military personnel treated at Walter Reed Army Medical Center who sustained traumatic cataracts from combat ocular trauma from March 2003 to December 2010. Ocular trauma scores (OTS) were calculated and eyes were grouped according to OTS classifications. Eye injuries were described according to the Birmingham Eye Trauma Terminology System (BETTS). The primary outcome is visual acuity at final follow-up. Visual outcomes were predicted using the OTS and the predictions were compared with actual outcomes.
Records of 200 eyes of 178 patients with traumatic cataracts were reviewed. 22 eyes were excluded for lack of calculable ocular trauma score or final visual acuity. The average patient age was 27.2 +/-7.7 years. 33 cataracts (19%) were caused by closed globe injuries. 143 cataracts (80%) were associated with open globe injuries. 15 eyes (8%) were ruptured globes. 102 cataracts (57%) were associated with intraocular foreign bodies. 21 (12%) eyes had penetrating injuries and 22 (12%) sustained perforating injuries. Visual outcomes were compared to OTS predictions. In OTS category 1 (n=32), 69% of eyes were no light perception (vs. 73% predicted), 22% were light perception to hands motion (versus 17% predicted), 3% were 20/400-20/200 (vs. 7% predicted) and 6.3% were 20/40 or better (vs. 1%). In OTS category 2 (n=69), 30% were NLP (28% predicted), 30% were LP-HM (26% predicted), 9% were 20/400-20/200 (18% predicted), 17% were 20/200-20/50 (13% predicted) and 13% were ≥20/40 (15% predicted). In OTS category 3 (n=67), 15% were LP-HM (11% predicted), 8% were 20/400-20/200 (15% predicted), 24% were 20/200-20/50 (28% predicted) and 54% were ≥20/40 (44% predicted). In OTS category 4 (n=7), 14% of eyes were NLP and LP-HM respectively (1% & 2% predicted) and 71% were ≥20/40 (74% predicted). In OTS category 5 (n=3), 100% were ≥20/40 (92% predicted). Spearman rank correlation of OTS score with visual category was coefficient = 0.64, p<0.001.
Despite origins in the civilian setting, the Ocular Trauma Score is a reliable predictor of final visual outcome in traumatic cataracts associated with combat ocular trauma.
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