Indian Journal of Ophthalmology

ORIGINAL ARTICLE
Year
: 1987  |  Volume : 35  |  Issue : 3  |  Page : 112--116

Ocular injuries : An analytical study in a teaching general hospital


BS Jain, SR Soni 
 Deptt of Ophthalmology, MLB Medical College, Jhansi, India

Correspondence Address:
B S Jain
Deptt of Ophthalmology, MLB Medical College, Jhansi
India

Abstract

A total of 319 cases of ocular injuries were examined in a period of 3 years by us. Out of these only 108 cases needed hospitalization. The total incidence among patients attending the ophthalmic O.P.D. was 1.43%. The patients had many different modes of injuries and the ocular tissue involved differed in many ways but notably injuries among stone crushers were in abundance (157 cases) in this region The injuries lead to partial blindness in 52.3% and total blindness in 11.6% of cases



How to cite this article:
Jain B S, Soni S R. Ocular injuries : An analytical study in a teaching general hospital.Indian J Ophthalmol 1987;35:112-116


How to cite this URL:
Jain B S, Soni S R. Ocular injuries : An analytical study in a teaching general hospital. Indian J Ophthalmol [serial online] 1987 [cited 2022 Oct 5 ];35:112-116
Available from: https://www.ijo.in/text.asp?1987/35/3/112/26202


Full Text

Sight is the most cared for function of the human Although, nature has provided a protective bony wall and lids to cover the eye to protect it from injury, still it is exposed to all types of trauma. In most of the cases of ocular injuries, it is the anterior segment of the eye, including conjunctiva cornea, iris, lens, and the angle of the anterior chamber, which bear the brunt of direct as well as indirect force of the injuries However ciliary body, choroid, retina and vitreous may also be involved.

The present communication deals with 319 cases of ocular injuries treated as out patients or hospitalized during a period of 3 years

 Material and Methods



In the period between 1 August 1980 and 30th June, 1983, a total of 22,187 patients attended the ophthalmic out patient department (ALB Medical College, Jhansi), of which a total of 319 patients were labeled as cases of injury to the eye(s) (mostly uniocular) after detailed examina­tions and on the basis of clinical history. The patients who had minor injuries were treated as out patients. These patients numbered 211 and the rest were hospitalized for further examination and treatment and followed for a minimum period of 3 months

The out patient care involved removal of super­ficial foreign bodies, mostly comeal (90%), and suturing of conjunctival injuries (if needed) and lid injuries and appropriate medical treatment.

Hospitalized patients were examined by direct indirect ophthalmoscopy, slit lamp and gonio­scopy (where ever possible), localization of foreign bodies by X-ray examination (plain as well as with limbal ring applied).

Vitreous injuries were assessed with the help of direct/indirect ophthalmoscope and slit lamp examination.

 Management



Superficial F.B./Tear

Superficial F. B's were removed. Lacerations of lid or conjunctiva, if any were sutured and patients were treated in O.P.D.. Corneal tear/fine globe tear were repaired with 8/0 silk

Traumatic Cataract

If the lens is swollen and A C shallow or collapsed, lens was aspirated at the time of repair/removal of F. B itself. If the lens was only cataractous and A .C. was well formed with no evidence of synechiae, it was left as such to be operated at a later date.

Vitreous haemorrhage, retained F B. and Retinal detachment

Cases with vitreous haemorrhage were mostly treated conservatively; only in few cases vitrectomy was considered. Foreign bodies were localized and depending on their position, appropriate approach was undertaken with/without the help of magnet There was not even a single case of retinal detachment immediately following injury. However in one case retinal detachment developed after a gap of 3 months The patient was referred to a specialised centre for treatment

 Observations



A total of 22,187 patients attended the Ophthal­mic out patient during the above period, of which 319 were cases of various types of injuries to the eye(s). Thus, the incidence of injuries to the eye was found to be 1.43. Out of these, 211 cases came with minor injuries, the remaining 108 patients being admitted to the hospital (a total of 221 males and 98 females with a ratio of 2.2: 1).

[Table 2] shows, that most of the patients involved were industrial workers (which in this area is mostly due to abundance of stone crushers) (178 cases 55.8%) followed by farmers (66, 20.8%). [Table 3] gives an account of mode of injuries Most common injuries were blunt or perforating injuries (254 cases). Other injuries were by Diwali Crackers and road accidents Part of the eye involved was noted in every case of injury to the eye. A case involving multiple tissues layers was included in more than one subgroup of tissues involved [Table 4]. Several cases had multiple involvement penetrating injuries were noted in83 cases [Table 5] shows their depth and details about the foreign body whether retained intra ocular/ intra orbital; magnetic or non magnetic. Hand magnet was used to determine the nature of foreign body.

 Discussion



[Table 1] shows age and sex incidence of ocular injuries Out of 319 cases 221 were males whereas 98 were females, with a male : female ratio of 2.2: 1. This clearly denotes higher in­volvement of males The maximum incidence of injuries was seen in the age group 16-30 years and next maximum in the children below 15 years It is notable that children and young adults are more prone to injuries All of these results are quite comparable to those of previous workers; Cos grove et al [1]sub , Kerby [2], Lambah [3], Apt [4] and Duke Elders [5].

The commonest mode of injuries was blunt (total 157 cases) specially by stones (Commonest in: stone crushers), which is very peculiar to this region. Other injuries were perforating with/ without retained foreign bodies (total 83 cases). These results (more or less) are well in tune with the studies of Wemer [6], Lambah [3], Apt [4] and Canavan et a1 [7] etc. except that the abundance of stone crushers in this rocky area lead to more stone injuries The injuries due to crackers and other causes were found to be a few only. Out of 319 cases a total of 301 were mechanical injuries including 26 cases with retained foreign bodies Our findings differ very much with other worker due to the difference in occupation of subjects in the region and a good number of patients which were not included as they might have attended other nearby hospitals

Thus the injuries caused 167 (52.3%) cases to become partially blind (person with 6/36 vision in one or both eyes) and 37 (14.6%) totally blind (person with less than 6/60 vision or almost PL PR). These findings too are similar to those of Lambah [3] and Cosgrove [1]

References

1Cosgrove, KW.; Henry, J.F. Jr. and Stevenson, R Study of various type's of eye injuries Southern Med J., 1956; 49:161
2Kerby, C E : Causes of blindess in children at school age. Sight-saving Rev., 1958; 28: 10
3Lambah, P.: Some common causes of eye injury in the young. Lancet 1962; 2 : 1351.
4Apt, L and Sarin, L K : Causes for enucleation of the eye in infants and children, JAMA 1962; 181 : 948
5Duke-Elder, S.: In system of ophthalmology, London : Text book: Henry Kimpton : 1977; 15: 5­5-60
6Wemer, S.: On the injuries to eye in children Acta Ophthalmol (Kbh.). 1952; 30: 97
7Canavan, Y.M and Archer, D.&: Anterior segment consequences of blunt injury. Br. J. OphthalmoL 1982; 66: 549