Prevalence Of Ocular Trauma In Kles Hospital – A One Year Cross Sectional Study

Abstract

Background and Objectives Although the eyes represent only 0.1% of the total body surface, most of the information reaches humans through vision. Ocular trauma causes a great socio-economic impact. Those affected by eye injury often have to face loss of career opportunities, major lifestyle changes and occasionally permanent disfigurement. In addition to the physical and psychological trauma of eye injuries to the individual, the direct and indirect financial costs to the society are enormous. Prevention of ocular injuries should form the basis of management for which collection of data is a must. Seeing the seriousness and enormity of ocular trauma, the present study is being undertaken to know the prevalence, cause of injury, clinical and demographic profile of ocular trauma patients. Aims are:- 1. To find the prevalence of ocular trauma in patients attending our hospital 2. To find the clinical profile of ocular trauma patients and the cause of trauma in them. Methodology The present one year cross sectional study was conducted in the Department of Ophthalmology, KLES Dr. Prabhakar Kore hospital and Medical Research Centre, Belagavi on patients presenting with ocular trauma to the casualty and Ophthalmology OPD of the hospital during the period between 1st January 2014 and 31st December 2014. The study was approved by the Ethical and Research Committee of Jawaharlal Nehru Medical College, Belagavi. All cases of injury to the eyeball, optic nerve, orbit, upper and lower lids, eyebrows and the lacrimal system were included and examined in a systematic manner. Investigations like CT scan, X ray and B scan were carried out where ever required. The conditions were treated medically or surgically, as was the need. Results A total of 2308 patients presented to the casualty and the Ophthalmology OPD, out of these, 217 patients had ocular trauma. Hence the prevalence rate of ocular trauma came out to be 9.40%. Maximum patients (27.19%) were in the age group of 21-30 years and minimum patients (0.92%) belonged to the age group of 71-80 years. 182 (83.87%) patients were males and 35 (16.13%) patients were females. Male:Female ratio was 5.2:1. Most common cause of ocular trauma was RTA (66.36%), followed by occupational injury (6.91%) and fall from height (6.91%). Foreign bodies entering the eye accounted for 6% of injuries. Other causes which were responsible for 1-2% of injuries included assault, vegetative matter, stick, knife, firecracker, bull horn, glass, ball, sports related, stone chip and blast injury. Time of the day was divided into Morning (5 AM – 12 PM), Afternoon (12 PM – 4 PM), Evening (4 PM – 8 PM) and Night (8 PM – 5 AM). In our study, 92 (42.40%) patients were injured in the night followed by 53 (24.42%) at afternoon, 40 (18.43%) in the evening and 32 (14.75%) in the morning. Right eye was involved in 106 (48.85%) patients followed by left eye in 78 (35.94%). In 33 (15.21%) patients, both eyes were involved. Clinically good vision was considered as vision of counting fingers at a distance of more than 3 meters when recorded in the absence of a visual acuity chart in the casualty. 145 eyes (58%) had clinically good vision whereas no perception of light was present in 5 eyes (2%). 190 (87.56%) patients presented to the casualty of the hospital whereas 27 (12.44%) presented to the Ophthalmology OPD. Patients presented with orbital fractures (12.90%), eyelid findings (84.79%), conjunctival involvement (71.43%), corneal findings (15.67%), anterior chamber findings (12.44%), pupillary findings (24.88%), iris involvement (5.07%) and lens findings (6.45%). Out of 217 ocular trauma patients, 138 (63.59%) patients underwent medical treatment and the rest 79 (36.41%) patients underwent surgical treatment. Conclusion Most common cause of ocular trauma was found to be Road Traffic Accidents (RTA), seen most commonly amongst males in the age group of 21-30 years. Males are commonly injured in RTA which is probably related to both exposure and risk taking behavior. Several human and environmental risk factors were found to be associated with increased risk of RTA. Apart from RTA, occupational hazard was the next major cause of ocular trauma. Certain laws and legislations and their strict enforcement can curb these two major causes of ocular trauma.