Title: Pattern and Visual Outcome in Paediatric Open Globe Injuries- Two Years Prospective Interventional Study in Tertiary Care Centre in Central India

Authors: Dr Sunil Motiram Bhad MS, Dr Swati Kamble (JR-II)

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i5.52

Abstract

Purpose: To evaluate the pattern and the final visual outcome in paediatric (Up to 12 years) open globe injuries (OGI) in tertiary care centre in central India.

Methods: This was prospective interventional study at department of ophthalmology, government medical college Nagpur, India. We selected to include all the patients with OGI up to 12 years. We documented the 6 pattern of injuries and classified them and accordingly pattern wise BCVA at the presentation and the 6 months follow up was compared. Standard protocol was applied to all the patients from the very first day of admission up to 6 months follow up (1 week, 1 month, 3 months, and 6 months). Patients who are unable to follow as per protocol are excluded from the study.

Results: We studied total 56 eyes of the 56 patient with OGI, presenting to the outpatient department of Ophthalmology, Government Medical College, Nagpur, Central India.

We divided the pattern of OGI of the patients in the following categories-1)Corneal tear involving visual axis, 2) Corneo-scleral tear, 3) Scleral tear, 4) Traumatic cataract at presentation, 4) Presence of iris tissue/vitreous incarceration in wound, 6)Mixed injuries including adnexal injuries.

We divided the patients presenting BCVA in 6 categories (A-F) with the numbers of the patients as-

  • A->6/18, 16 patients (28.57%),
  • B- 6/18 to >6/36, 20 patients (35.71%),
  • C- 6/36 to >6/60, 6 patients (10.71%),
  • D- >1/60 to 6/60, 5 patients (8.93%),
  • E- PL,PR to 1/60, 7 patients (12.50%),
  • F- No PL/Def. PR, 2 patients (3.57%)

We analyse the final BCVA at 6 months as

  • A- >6/18, 25 patients (44.64%)
  • B- 6/18 to >6/36, 11 patients (19.64%),
  • C- 6/36 to >6/60, 4 patients (7.14%),
  • D- >1/60 to 6/60, 5 patients (8.93%),
  • E- PL,PR to 1/60, 7 patients (21.43%),
  • F- No PL/Def. PR), 4 patients (7.14%).

From above observations we can say that more than 50% of the OGI are having the final visual outcome is poor.

Conclusion: Most of the OGI are blinding in nature, although the final visual outcome mainly depends upon the type of injury and the BCVA at presentation.

Keywords: (OGI)- Open globe injuries, (BCVA)- Best corrected visual acuity.

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Corresponding Author

Dr Sunil Motiram Bhad

Department of Ophthalmology, Government Medical College and Hospital,

Nagpur, Maharashtra, India