Ocular complications in head and facial injuries: a retrospective study

ABSTRACT

To assess the prevalence of ocular injury and its severity among the trauma patients admitted with head and facial injuries [which may be missed as the priority is given to save the life of the patient]; and to develop guidelines for the optimum ophthalmology referral in such cases. The medical records of 134 patients who were admitted to the trauma intensive care unit of Hamad General Hospital with head and facial injury, during a one year period from 1/1/2005 to 31/12/2005, were reviewed. Presence of ocular trauma, its severity and the ophthalmology referral were noted. Visual outcome, periocular signs and relevant radiological findings were also recorded. Among the 134 charts reviewed, 94% were males. Head injury was the commonest [69.4%], followed by combined head and facial injury [27.6%]. Fifty-two [38.8%] cases were found to have either ocular or periocular signs. Twenty [14.9%] were found to have both. Among the 52, four patients [7.7%] lost vision completely in one eye and in one case [1.9%] visual acuity was reduced to hand movements in one eye. Fifteen [28.8%] patients had serious ocular complications and 32 [61.5%] patients had transient ocular or periocular signs. Among the 52 patients only 22 [42.3%] received ophthalmology referral. In all patients with head and facial injury, visual acuity, colour vision and ocular motility should be assessed as soon as the general condition permits. Patients with ocular or periocular signs and those with radiological evidence of orbital or periorbital fractures should be referred to an ophthalmologist without delay