OCULAR INJURIES- An introduction & nomenclature Ayesha S Abdullah
Learning outcomes By the end of this lecture the students would be able to Describe the epidemiology of ocular injuries Classify globe injuries according to the Birmingham Eye Trauma Terminology (BETT) system of classification Differentiate between OGI and CGI
How common is it? Trauma is the commonest cause of ocular emergencies reported in trauma centres A total of 1.6 million cases of blindness are caused by eye injures Some 2.3 million cases with low vision are due to ocular injuries Some 19 million cases of mono ocular blindness are due to eye injuries
Risk factors Gender, any guess? 3:1 male to female ratio Rural areas Compromised socioeconomic status Illiteracy Conflicts
Classification According to vector (The Agent) According to settings (Place of injury) According to pathology (Effects produced) According to anatomical structures involved According to severity (Damage produced)
According to the site involved Orbital trauma Superficial & corneal foreign bodies Lid injuries Globe injuries
Nature of injurious agent Mechanical Injuries Chemical Injuries Acid Alkali Others Radiation Injuries Thermal Injuries Electrical Injuries
Place of Injury Home School Playground Agriculture Industry Laboratory Workshops Assault/ combat
Birmingham Eye Trauma Terminology System (BETTS)
Definitions -BETTS Closed Injury in which cornea & sclera are intact but there is intraocular damage. Open Injury is associated with full-thickness wound of cornea or sclera or both. Rupture is a full-thickness wound caused by blunt trauma Laceration is full-thickness injury caused by a sharp object Penetration is caused by a single laceration with a sharp object Perforation consists of two lacerations, one entry and one exit
Orbital trauma Blow out floor fracture, medial wall, floor, roof Contusion injury Lacerations Orbital haematoma
Eye Lids Contusion Hematoma Lacerations
Beware of the blood loss especially in children
Late Complications
Effects of close globe injury (CGI) Mechanism AP compression Expansion in the equatorial plan Transient & excessive increase in IOP Impact is primarily absorbed by ?? Lens –Iris diaphragm & vitreous The damage can happen in any tissue commonly has long-term effects/ sequelae
Close Globe Injuries Subconjunctival Haemorrhage Corneal abrasion Acute corneal oedema Traumatic iritis Traumatic Mydriasis / Miosis Hyphaema Iridodialysis Cyclodialysis / Angle recession Ciliary shock
Close Globe Injuries Subluxation and dislocation of lens Cataract Posterior vitreous detachemet Vitreous haemorrhage Choroidal rupture Commotio retinae Retinal Breaks Dialysis Equatorial tears Macular holes Optic nerve avulsion
Home work List three recommendations for the following Primary Secondary Tertiary prevention of ocular trauma Three power point slides with three points on each slide send at with your name and role number