Eye injuries, a 4 year study.

Abstract

Abstract: : Purpose: To evaluate the clinical course and prognosis of ocular injuries. Methods: A retrospective study of ocular trauma cases at a referral eye center over a 4–year period (1998–2002). All of the patients with a history of hyphema, open–globe injury and orbital fracture were studied. Results: Two hundred and forty patients were studied. Seventy–nine patients were diagnosed with traumatic hyphema secondary to closed–globe injury. Sixty–seven had open–globe injury. Ninety–four had fracture of one or more orbital wall(s). Eighty–three percent of the traumatic hyphema patients, 41% of the open–globe patients and 91% of the patients with orbital wall fracture had a final visual acuity of 20/50 or better. The mean hyphema resolution time was 7.1 days (range 2–20). Only 7.6% had IOP above 30 and 2.5% had rebleeding. Ten patients (12.8%) had angle recession. No case of endophthalmitis after penetrating trauma was seen. Half of the orbital fracture cases noted diplopia in one or more directions of gaze. Surgical reconstruction of orbital wall fractures was needed in 27% of cases. Conclusions: The poor visual outcome of open–globe injuries stresses the need of taking measures to prevent eye injuries. Broad–spectrum antibiotic coverage and a surgical intervention within the first 24 hours seem to be effective in preventing endophthalmitis in open–globe injuries. Diplopia is a common presenting symptom in orbital fracture cases. About one quarter of orbital fractures need surgical reconstruction. The incidence of high IOP or rebleeding is low in traumatic hyphema cases. The risk of angle recession suggests the need of a close follow–up.

Keywords: trauma • wound healing • visual acuity