International Globe and Adnexal Trauma Epidemiology Study (IGATES): Visual outcomes in open globe injuries in rural West India.

BACKGROUND/OBJECTIVES: To evaluate the factors influencing final visual outcome after surgical repair of open globe injuries (OGIs) in a rural population using the International Globe and Adnexal Trauma Epidemiology Study (IGATES) online registry. SUBJECTS/METHODS: Retrospective cohort study of patients with OGI. OGIs were identified from the IGATES database at a tertiary referral eye care centre in rural West India over a period of 12 years. Patient demographics, clinical and pre-operative factors affecting final visual outcome was evaluated. RESULTS: A total of 791 eyes with OGIs were included in data analysis. 11 eyes that were lost to follow-up and 12 eyes with incomplete data were excluded. Most of the patients were male (559, 70.6%) and mean age of all patients was 23.9 years ± 19.4 years. Occupational hazards (including domestic housework) (307, 38.8%) and leisure play (324, 41.0%) were the leading causes of OGI. The most common mechanism of injury was being struck by a wooden stick (250, 31.6%). Univariate analysis of pre-operative variables showed initial visual acuity (VA), zone of injury, size of wound, structures involved in the injury and presence of infection were significant prognostic factors for worse final visual outcome (p < 0.001). Multivariate analysis showed VA ≤ 3/60 or worse at presentation had statistically significantly higher odds ratio of ending up with worse visual outcomes (p < 0.012). CONCLUSIONS: Males in working age groups suffer from OGIs more frequently, usually from agricultural and pastoral activities. Initial VA, zone 3 injuries, corneoscleral wound, large wound size and presence of post-traumatic infections are significant prognostic factors.

Comparative study of final visual outcome between open- and closed-globe injuries following surgical treatment of traumatic cataract.

OBJECTIVE: The objective of this work is to compare final visual outcomes in cases of surgically treated traumatic cataract between open-globe and closed-globe groups, as classified by the Birmingham Eye Trauma Terminology system. DESIGN: Observational cohort study. SETTING: Tertiary eye-care center at the trijunction of Gujarat, Madhya Pradesh, and Rajasthan states in central western India. METHODS: We enrolled patients meeting specific inclusion criteria, examined their eyes to review any co-morbidities due to trauma, performed surgery for traumatic cataracts, and implanted lenses. The patients were re-examined 6 weeks postoperatively. We classified the cases of traumatic cataract as either open-globe (group 1) or closed-globe (group 2), according to the Birmingham Eye Trauma Terminology (BETT) system, and compared visual acuity. OUTCOME MEASURES: Visual Acuity. RESULTS: Our cohort of 687 eyes with traumatic cataracts included 496 eyes in group 1 and 191 in group 2. Six weeks postoperatively, the visual acuity was >20/60 in 298 (58%) and 75 (39.1%) operated eyes in groups 1 and 2, respectively (p < 0.001, ANOVA). At follow-up, >20/60 vision was significantly higher in group 1 than in group 2 (OR = 1.61; 95% CI, 0.85-3.02). Overall, 373 eyes (54.3%) regained final visual acuity >20/60. CONCLUSIONS: Open-globe injury has a more favorable prognosis for satisfactory (>20/60) visual recovery after management of traumatic cataracts.

Successful repair of injury to the eyelid, lacrimal passage, and extraocular muscle.

INTRODUCTION: Injury is a known cause of monocular blindness. Ocular trauma may affect lacrimal canaliculi and the extraocular muscle. We report this case as it includes injury to lid, lacrimal canaliculi and inferior rectus. CASE DESCRIPTION: A 25-year-old male presented with an injury caused by a sharp object that resulted in a conjunctival tear, lid tear involving the lacrimal canal, and rupture of the inferior rectus muscle. All of the structures were repaired successfully during a single procedure. CONCLUSION: An extraocular injury involving the conjunctiva, lid, lacrimal passages, and extraocular muscles can be repaired successfully during a single procedure.