Juliana Rositta, Stephen (2013) A clinical study of penetrating eye injuries. Masters thesis, Madurai Medical College, Madurai.
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Abstract
INTRODUCTION: Ocular trauma is an important cause of preventable morbidity worldwide. It is a major cause of acquired unilateral blindness and visual impairment. It constitutes about 1.5% of all the causes of blindness, 7% of all bodily injuries and 10-15% of all eye diseases. It is common in young males especially young adults. Since ocular injuries affect mostly the productive population, it causes a major socioeconomic loss. Recently ocular trauma has gained more importance because of its increased incidence and advancement in the therapeutic approach. These have improved the prognosis. Ocular injuries can occur in any setting like recreational, sports activities, home, agricultural activities, at workplace and road traffic accidents. Penetrating ocular trauma caused by sharp objects and foreign bodies are considered as emergency. The availability of diagnostic modalities like CT, MRI and ultrasound have improved the assessment and management of trauma. The advent of microsurgical techniques and vitreoretinal surgeries has greatly improved the visual prognosis of the patients with ocular trauma. Hence ocular trauma should be given greater importance. Nearly 90% of the eye injuries are preventable. Preventive measures should be taken in sports, agriculture and work related activities. People should be educated regarding the prevention of ocular injuries. Children should be supervised and taught about the dangers of sharp objects like pens ,pencils, scissors, compasses, etc. Glasses and sharp metals should be kept out of reach of children. Protective eye wears should be provided for people working with high speed grinders, cutters and in activities where there is risk of flying objects. Ophthalmologists play an important role in the management as well as prevention of ocular trauma. The adage ‘PREVENTION IS BETTER THAN CURE’ is apt for ocular injuries. AIMS AND OBJECTIVES: The following were the aims and objectives of this prospective study: 1. To determine the risk factors associated with penetrating eye injuries. 2. To study the different causative agents and to analyse the visual outcome following penetrating eye injuries. MATERIALS AND METHODS: This is prospective study of 52 patients with penetrating eye injury admitted at government Rajaji Hospital, Madurai from March -2012 to November – 2012. A total of 60 patients were enrolled but 8 of them were excluded from the study because of poor follow up. All patients who presented with penetrating eye injuries were selected for this study. Various patients were enrolled and categorized according to many criteria like age, sex, place at which the injury occurred and causative factors. All patients were examined and been followed up for a minimum of three months. INCLUSION CRITERIA: 1. Patients with history of injury having slit lamp evidence with or without the presence of foreign body. 2. All age group 3. Minimum follow up period of 3 months. EXCLUSION CRITERIA: 1. Poor follow up of less than 3 months. 2. Pre existing corneal pathology like previous scar, prior ocular trauma and keratoconus. SUMMARY OF RESULTS: A prospective study was conducted at Government Rajaji Hospital, Madurai for a period of Nine months including 52 patients to analyse the risk factors, agents causing injury and visual outcome of the penetrating eye injuries. Most of the patients with penetrating eye injuries were in the age group16 to 45 years accounting to 65.3%. Males constituted 76.9% and females were 23.0% among injured. Male to female ratio was 3.33 Right eye was more involved than left eye. Right eye was involved in 51.9% and left eye was involved in 48.1% 34.6% of the penetrating eye injuries were caused by stick followed by thorn which accounted for 19.2%. 38.4% of the patients were injured in domestic setting. 26.9% of the injuries occurred in the fields. Farmers were most commonly involved accounting to 30. 7%. 44.2% of the injuries were leaking and 55.7% of the injuries were self sealed. DISCUSSION: Ocular trauma is a major cause of preventable monocular blindness and visual impairment in the world. Despite its public health importance, there is relatively less population based data on the magnitude and risk factors for ocular trauma, specially from developing countries. Worldwide there are about 1.6 million blind and 19 million unilateral visual loss from eye injuries. 23.5% of the world’s blind population is confined to India.36 NPCB survey in Tamilnadu found that corneal diseases is responsible for 4% of blindness37 In our study the commonest age group affected was 16-45 years accounting for 65.38% followed by age group less than 15 years (19.2%). In Israeli ocular injuries study by Ronkoval et al, largest group was in the age group 18-44 years(37.9%). According to Eye injuries: A prospective study of 5671 patients the average age was 30.6 years and 96% were over 10 years. In a study conducted at Goa medical college by Mukherjee AK 44.91% of the patients were less than 30 years of age. According to the study by David et al, patients less than 40 years accounted for 77%. CONCLUSION: Eye trauma occurs fairly frequently in developing countries and constitutes major health problem.29 It is the cause of blindness or partial loss of vision in more than half a million people worldwide.27 This prospective study was aimed at describing the risk factors, agents involved and final visual outcome of 52 patients who presented with penetrating eye injuries. Majority of the patients were in the age group of 16- 45 years representing the working population. The visual impairment in terms of loss of productivity and economic gain can be devastating. Most penetrating eye injuries are potentially preventable. The improvement in farming techniques should be done. Education should be aimed at young individuals. Penetrating eye injury should also be given importance among the other societal problems. Parental education regarding the danger of sharp toys and air-guns should be emphasized. The use of protective eye wear in both work related as well as recreational activities should be the main focus of preventive education.21 When prevention fails and an eye injury occurs early and appropriate referral is very essential to preserve vision.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | penetrating eye injuries; ocular trauma |
| Subjects: | MEDICAL > Ophthalmology |
| Depositing User: | Devi S |
| Date Deposited: | 22 Sep 2017 06:24 |
| Last Modified: | 22 Sep 2017 06:24 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/3254 |
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