A Prospective Clinical Study to Evaluate the Ocular Findings in Patients with Head Injury

Background: Ocular trauma is the reason of blindnessamongst more than half a million subjects around the worldand for partial sight loss amongst many more and it isfrequently the leading reason for unilateral loss of vision,especially amongst the people of developing nations. Thepresent study was aimed to assess the ocular findings inpatients with head injury.Materials and Methods: The mode of injury along with theclinical characteristics of the patient were recorded in astandard proforma. Glasgow comma scale was used toevaluate the state of consciousness of the patients. Intraocularpressure estimation was performed using Goldmannapplanation tonometer wherever required. CT scan of brain,skull and spine or MRI and B-Scan was done wheneverrequired. The required medical and surgical treatment wasgiven to the subjects as needed. All the data thus obtained wasarranged in a tabulated form and analyzed using SPSSsoftware.Results: There were 75 males and 25 females. There was1 subject less than 10 years of age. Majority subjects i.e. 30were between 21-30 years of age. There were 40 cases ofperiorbital ecchymosis, 7 cases of lid laceration, 20 cases ofsubconjunctival hemorrhage, 4 cases of proptosis, 7 casesptosis, 8 cases of corneoscleral rupture, 5 cases of hyphema.Conclusion: In our study, Periorbital ecchymosis was the mostcommonly observed finding in case of ocular trauma.

Multiple transfused thalassemia major: Ocular manifestations in a hospital-based population.

Purpose: To study the ocular manifestations in multiple transfused beta-thalassemia major patients and assess the ocular side-effects of iron chelating agents. Materials and Methods: In this prospective observational study, 45 multiple transfused beta-thalassemia major children between six months and 21 years of age were enrolled and assigned groups according to the treatment regimens suggested. Group A received only blood transfusions, Group B blood transfusions with subcutaneous desferrioxamine, Group C blood transfusions with desferrioxamine and oral deferriprone and Group D blood transfusions with deferriprone. Ocular status at the time of enrolment was documented. Subjects were observed quarterly for one year for changes in ocular status arising due to the disease process and due to iron chelation therapy. Children with hemoglobinopathies other than beta-thalassemia major, congenital ocular anomalies and anemia due to other causes were excluded. Results: Ocular involvement was observed in 58% of patients. Lenticular opacities were the most common ocular finding (44%), followed by decreased visual acuity (33%). An increased occurrence of ocular changes was observed with increase of serum ferritin and serum iron levels as well as with higher number of blood transfusions received. Desferrioxamine seemed to have a protective influence on retinal pigment epithelium (RPE) mottling. Occurrence of lenticular opacities and RPE degeneration correlated positively with use of desferrioxamine and deferriprone respectively. Follow-up of patients for one year did not reveal any change in ocular status. Conclusion: Regular ocular examinations can aid in preventing, delaying or ameliorating the ocular complications of thalassemia.