Patterns of Ocular Trauma at the Main Referral Hospital in Rwanda: Kigali University Teaching Hospital

ABSTRACT

Background: Eye injuries are the most common cause of referral to the Ophthalmology department; KUTH. No research data is available on ocular trauma in Rwanda. To understand the impact of eye injuries in KUTH and to plan for preventive strategies; it is important to understand the magnitude of this problem. Aim: The aim of this study was to identify the patterns of ocular trauma at Kigali University Teaching Hospital. Methods: In this retrospective study; 352 reviewed patients were referred to KUTH; from January 1st; 2007 to January 1st; 2013. Patient's ocular trauma details were recorded and analyzed. Patients' demographic data; medical history; diagnosis; treatment and possible complication were retrieved from files in archive and recorded on a questionnaire for further analysis. Results: Out of the 352 patient's files; 72.7 were males and 27.3 were females. The male to female ratio was 2.7. Majority of patients were of age group between 11 and 40 years. Among files reviewed; 75.2 sustained blunt ocular injuries whereas 22.1 sustained penetrating injuries. Main risk factors for those injured patients were work place injuries (37); road traffic accident (21) and assault (15). Most frequent offending agents were pieces of wood (21.5); foreign bodies (16.4) and vehicle crush (16.1). However; metal objects; motorbike and stone missile represented important causes of ocular trauma at KUTH respectively 13.9; 13.06 and 11.07. A big number of patients were found to have corneo-limbal perforation (29.2); corneal abrasions (18.4); corneal abrasions (18.4); sub-conjunctival hemorrhage (17.8) and peri-orbital injuries (17.6). The common visual acuity observed on the affected eye on admission was (6/60-3/60) (38) and below 3/60 (30). The main post-traumatic complication at KUTH was corneal scaring (42.04). Conclusion: Males and young patients were more affected by ocular injuries because of their involvement in high risk activities in their daily life. Blunt and penetrating ocular injuries were two main types of ocular trauma recorded. Work place ocular injuries; road traffic accident and assaults were the main risk factors of ocular trauma at KUTH. Piece of wood; ocular foreign bodies and vehicle crush were the main offending agents causing ocular injuries. Main diagnoses in ocular trauma were corneo-limbal perforation; corneal abrasion and sub-conjunctival hemorrhage. On admission; most of injured patients had visual acuity (6/60-3/60) and below 3/60. Management of ocular trauma mainly described at KUTH was antibiotherapy and steroid therapy; however surgery was performed for penetrating trauma and conservative treatment for few cases. The most common complication due to ocular trauma at KUTH was corneal scaring