OCULAR TRAUMA

M. NURDIN ZUHRI, MD
Epidemiology

Ocular trauma is a disease

Well established natural history, modifiable risk factors, and
distinct prevention, classification and treatment schemes
Literature replete with reports of ocular trauma (visually
significant and insignificant)
Unfortunately, very different population
 Ocular trauma incredibly consistent :
1. Bimodal age
2. Affects men 3-5 times as frequently as women
3. Significant cause of visual loss
4. Largely preventable, especially in the work place
5. A reccurent disease
WHO, published in 1998. Data (1971-1995)
1. 55 milion eye injury which restrict activities for > 1 day annually
2. 750.000 eye injuries require hospitalization annually
3. 200.000 open globe injuries occur annually
4. 19 million people unilaterally blind.
- 2,3 million bilateral low vision
- 1,6 million bilaterally blind due to eye injury
A person with eye injury 3 times more likely to have second eye injury
 Severe eye trauma may slowly be decreasing in incidence in large
part due to improved safety standarfs in the workplace.
How ever, it is clear that current prevention strategies are
woefully inadequate
Studies shown that appropiate eye protection is rarely in plce at
the time of injury.
Cohort study in Singapore 71,4% were work related (21,7% wore
eye protection, 43,7% were given eye protector but did not use it,
and 34,6% were not provided eye protection
Prevention of eye injury

A number of professional organizations are involved in the

standards of eye protection manufacturing, testing of eyewear to
conform to safety standards and dissemination of safety
information.
ANSI (American National Standards Institute)
History and examination of the injured eye

History
1.Date, time and location of incident
2. Mechanism of injury (struck by fist, hammering metal on metal, etc)
3. Accidental, intentional, or self-inflicted injury)
4.Accident setting (work, home, sports-related, etc)
5.Use of contact lenses, corrective glasses, or safety glasses at the time
of accident
6.Presence of witnesses to the accident
Examination

General consideration
Visual acuity
Pupils
Brightness testing and color vision
Visual field
Exraocular motility
Intraoculer pressure
External examination (conjungtiva, cornea, anterior chamber, iris,
Lens, Vitreous, retina and choroid, optic nerve)
Radiologic imaging

Plain radiography
MRI
USG
Definition and classification in ocular trauma
BETT (Birmingham Eye Trauma Terminology).
Prognosis (Ocular Trauma Score)
6 month visual accuity prediction