Predicting visual outcome after open globe injury using classification and regression tree model: the Moradabad ocular trauma study.

OBJECTIVE: This study was conducted to identify factors associated with visual outcome in patients with open globe injuries (OGIs). DESIGN: Retrospective case series of OGIs presenting to a tertiary eye care institute in North India from October 2009 to December 2016. METHODS: A total of 157 patients with open globe injury have been included in the study. Multivariate analysis to ascertain the effects of different identified variables on the likelihood of poor visual outcome was done using binomial logistic regression. "Visual survival" (counting fingers or better) versus "minimal/no vision" (hand motion, light perception, and no light perception) was predicted using the classification and regression tree (CART) model. Main outcome measures were visual outcomes, risk factors, and rates of postoperative complications. RESULTS: Univariate analysis determined 9 predictors associated with poor visual outcome. Out of these, presence of relative afferent pupillary defect (RAPD), poor presenting visual acuity, presence of adnexal injuries, and location of injuries were the most significant predictors of vision loss. Absence of RAPD led to 79% chance of vision survival. Sixty-eight percent of patients with RAPD and initial visual acuity (VA) of less than 6/60 resulted in poor vision. CONCLUSION: The CART model is useful in predicting final VA based on some prognostic factors present initially.

Comparative Evaluation of the Prognostic Value Between the Ocular Trauma Score and the Pediatric Penetrating Ocular Trauma Score.

Controversy exists about the utility of the Ocular Trauma Score (OTS) in children. A new score was developed specifically for children-the Pediatric Penetrating Ocular Trauma Score (POTS)-which proved to be of prognostic value in young patients with penetrating eye injuries. The purpose of the study was to compare the prognostic value of OTS and POTS in children with open-globe injuries in a cohort of Brazilian children. This was a retrospective, interventional case series and included 37 children with open-globe injuries seen at the Santa Casa de Sao Paulo Emergency Service. Mean age was 8.0 ±â€Š3.9 years; 28 were male and 9 female. All patients were reviewed on the basis of time and circumstance of injury, time of surgery, type of penetrating injury, initial and final visual acuity (VA), and concomitant eye disease. Both OTS and POTS categories were calculated based on specific variables. The final achieved VA was compared with the predicted VA for both scores with Kendall's test for significant association; the agreement between the predicted VA for both OTS and POTS was accessed with the Cohen kappa coefficient. The association between OTS and achieved VA was good (Kendall Tau-b = 0.511, P = 0.001), as well as between POTS and achieved VA (Kendall Tau-b = 0.422, P = 0.002). The agreement between the predicted VA for OTS and POTS was fair (kappa = 0.400). In conclusion, in this small cohort of Brazilian children with open-globe injuries, there was no superiority of one score over the other and both OTS and POTS underestimated the potential best-corrected VA after treatment.

Traumatic open globe injury in young pediatric patients: characterization of a novel prognostic score.

BACKGROUND: Open globe injury is a common cause of monocular blindness in children. Current formulas to predict outcomes of open globe injury often rely heavily on visual acuity and presence of an afferent pupillary defect, examination elements that are difficult to assess in young children. We aimed to analyze the features of open globe injuries in children aged 0-6 years to facilitate development of a novel algorithm for predicting visual outcomes in this age group. METHODS: The medical records of patients 0-6 years of age presenting at a single institution with open globe injury from 2000 to 2013 were retrospectively reviewed. Epidemiology, physical examination, and intervention data were used to develop a prognostic algorithm. RESULTS: A total of 28 patients were included. Mean age at presentation was 4.2 years (range, 1.9-6.7). Glass was the most common mechanism of injury. Associated findings included uveal prolapse (93%), choroidal detachment (39%), hyphema (32%), and retinal detachment (11%). In addition to primary repair, 43% patients required a lensectomy, and 7% underwent surgery to repair retinal detachment. Complicating cataract (P < 0.005) and a wound >6 mm (P < 0.05) were associated with a final visual acuity worse than 20/40. A novel algorithm for predicting visual outcome was devised with a sensitivity of 81% and a specificity of 92%. CONCLUSIONS: Patients 0-6 years of age with open globe injuries present unique risk factors for poor outcome. The trauma score generated by our algorithm is not reliant on presenting visual acuity and may be useful in predicting prognosis in very young children.

Retinectomy vs vitrectomy combined with scleral buckling in repair of posterior segment open-globe injuries with retinal incarceration.

PurposeTo evaluate the anatomic and functional outcome of pars plana vitrectomy (PPV) combined with scleral buckling (SB) vs retinectomy in treating posterior segment open-globe injuries with retinal incarceration.MethodsPatients (38 eyes) with posterior segment open-globe injuries and retinal incarceration were identified, and they underwent either PPV combined with SB (PPV+SB, n=19) or retinectomy (n=19). The two groups were matched in the following categories: the severity of injury (including wound length), the location of the incarceration site and the presence of retinal detachment. Anatomic reattachment of the retina and best-corrected visual acuity (BCVA) were measured at the time of 12 months after operation.ResultsAt 12 months after operation, the PPV+SB group demonstrated a better anatomic retinal attachment rate (84.2% vs 68.4%, P=0.252) and BCVA (73.7% vs 47.4%, P=0.247) compared with the retinectomy group, however, the differences failed to reach statistical significance. Compared with the PPV+SB group, the rectinectomy group had significantly higher rates of hemorrhage (47.4% vs 15.8%, P=0.036), inflammation (42.1% vs 10.5%, P=0.027), and a lower intraocular pressure (IOP, 9.8±3.1 vs 13.6±4.1 mmHg, P=0.002) after silicone oil (SO) removal.ConclusionsFor patients with posterior segment open-globe injuries and retinal incarceration, PPV and SB treatments resulted in a better anatomic and functional outcome and less post-operation complications compared with the retinectomy.

Novel method for comparing coverage by future methods of ballistic facial protection.

The wearing of eye protection by United Kingdom soldiers in Afghanistan has reduced the morbidity caused by explosive fragments. However, the remaining face remains uncovered because there is a lack of evidence to substantiate the procurement of methods to protect it. Using a new computerised tool we entered details of the entry sites of surface wounds caused by explosive fragments in all UK soldiers who were injured in the face between 1 January 2010 and 31 December 2011. We compared clinical and predicted immediate and long term outcomes (as defined by the Abbreviated Injury Score (AIS) and the Functional Capacity Index (pFCI), respectively). We also used the tool to predict how additional protection in the form of a visor and mandible guard would affect outcomes. A soldier wearing eye protection was 9 times (1.03/0.12) less likely to sustain an eye injury than one without. However, 38% of soldiers in this series were not wearing eye protection at the time of injury. There was no significant difference between the AIS and pFCI scores predicted by the tool and those found clinically. There is limited evidence to support the use of a mandible guard; its greatest asset is better protection of the nose, but a visor would be expected to reduce long-term morbidity more than eye protection alone, and we recommend future trials to assess its acceptability to users. We think that use of this novel tool can help in the selection of future methods of ballistic facial protection.

Nail gun-induced open-globe injuries: a 10-year retrospective review.

PURPOSE: To describe the characteristics of nail gun-related open-globe injuries. METHODS: Retrospective series of all patients presenting with open globes secondary to nail gun injury from 2000 to 2010. Data were collected on demographics, setting of accident, presenting clinical examination findings, visual acuity, management, surgical procedures needed, and long-term outcomes. RESULTS: Forty-two patients (43 eyes; mean age, 31.6 years; 100% male; 79% Hispanic) suffered open-globe injury from nail gun accidents. Thirty-seven eyes (86%) sustained injury at work. One of 15 (6.7%) patients, on whom data were available, wore protective eyewear during the incident. Entrance wounds were classified into Zone I (n = 24 [56%]), Zone II (n = 12 [28%]), and Zone III (n = 7 [16%]). Six eyes (14%) had retained intraocular foreign bodies. Mean presenting logarithm of the minimum angle of resolution visual acuity was 1.64 ± 0.83, whereas mean final logarithm of the minimum angle of resolution visual acuity was 1.01 ± 0.96 (P = 0.004). Two eyes (4.7%) had no light perception vision at final examination. Seventeen (40%) patients developed a traumatic cataract, and 2 (4.7%) had dislocated lens fragments. Most common findings on presentation included vitreous hemorrhage (n = 30 [70%]) and hyphema (n = 28 [64%]). Two eyes (4.7%) had a retinal detachment at presentation, and 10 (23%) developed a retinal detachment during follow-up visits. Anatomical success was observed in 11 eyes (92%) with a retinal detachment. Three eyes (7.0%) became phthisical or prephthisical, and 1 was enucleated for severe pain. No eyes developed endophthalmitis or sympathetic ophthalmia. CONCLUSION: This is the largest compilation of nail gun-related open-globe injury reported to date. Posterior segment complications, noted in the majority of cases, likely contributed to the overall guarded visual outcomes. Preventative measures for eye protection should be strictly followed while using nail guns.

Pre-operative variables affecting final vision outcome with a critical review of ocular trauma classification for posterior open globe (zone III) injury.

PURPOSE: To identify pre-operative variables affecting the outcome of posterior open globe (zone III) injuries. Secondary objective was to re-look at the definition or landmarks for zone III injury and its clinical significance for predicting visual prognosis following open globe injury. MATERIALS AND METHODS: Retrospective review of medical records of all hospitalized patients with surgical repair of open globe injury over last 10 years at a tertiary referral eye care center in Singapore. Out of 172 eyes with open globe injury, 28 eyes (16.3%) with zone III injury was identified and reviewed further. Pre-operative visual acuity (VA) and other variables, extent of scleral wound in reference to rectus insertion, relative afferent pupillary defect (RAPD) and final vision outcome were recorded. RESULTS: Median age was 37 years with male predilection (92.9%). Mean follow-up was 12.9 months. Pre-operative VA was no light perception (NLP) in 16 (57.1%) eyes. Final VA remained NLP in 14 eyes (50.0%). The factors contributing to poor post-operative vision based on univariate regression analysis were the presence of RAPD, poor pre-operative VA, blunt trauma, extent of trauma, associated traumatic cataract, hyphema, vitreous loss and associated vitreo-retinal trauma. Further on, zone III injuries with scleral wound limited anterior to rectus insertion (6 eyes) had better vision outcome than those with injuries extending beyond rectus insertion (22 eyes). CONCLUSION: Initial VA, blunt ocular trauma, visual axis involvement, loss of light perception, presence of RAPD, traumatic cataract, hyphema, vitreous loss were the important determinants for final visual outcome in patients with zone III injury. Wound extending posterior to rectus insertion has poorer outcome as those limited anterior to rectus insertion. We suggest that there may be a need to relook at zone III injuries with reference to rectus insertion for prognostic significance, and further studies are warranted.

Controversies in traumatic cataract classification and management: a review.

Traumatic cataract is one of the important causes of blindness after ocular trauma, either open or close globe. Visual outcome is unpredictable because it is not only lens that decides visual outcome. There is no standard classification, investigation, or treatment guidelines for the same. There are controversies regarding predictive models. We would like to highlight these controversies and try to reach certain guidelines that may help clinicians to manage traumatic cataracts.

Prediction of visual outcomes after open globe injury in children: a 17-year Canadian experience.

PURPOSE: To analyze the predictive value of ocular trauma scoring systems for open globe injury in children, to determine risk factors for poor visual outcome, and to assess circumstances under which trauma occurs. METHODS: The medical records of patients <18 years of age who presented with open globe injuries from January 1992 to December 2009 were examined retrospectively. Information recorded included demographic profile; date, time, and place of injury; cause and extent of injury; complications; and final best-corrected visual acuity. Injuries were classified by Ocular Trauma Classification Group guidelines. RESULTS: A total of 131 patients were included. Final best-corrected visual acuity was ≥20/40 in 74 patients (56.5%) after mean follow-up of 24.8 months. Injuries occurred more commonly in boys (98/131), and 45% of injuries occurred in children aged ≤5 years (P = 0.001). Injuries were more common indoors (P = 0.003), in the afternoon (P < 0.001), and on Saturdays and Mondays (P = 0.004). Multiple regression analysis identified risk factors for final best-corrected visual acuity <20/40: age <5 years, injuries with retrolimbal involvement, wound length >5 mm, globe rupture, vitreous hemorrhage, and retinal detachment (P < 0.05). CONCLUSIONS: Visual outcomes after pediatric open globe injury in this study compare favorably to results reported previously. Knowledge of weekly fluctuations in occurrence may help guide development of prevention strategies. Age <5 years is an independent risk factor for a poorer outcome. The ocular trauma score is useful in assessing prognosis after pediatric open globe injury.

Work-related open-globe injuries: demographics and clinical characteristics.

PURPOSE: To describe the demographics and clinical characteristics of work-related open-globe injuries (OGIs) at a level I trauma center over a 10-year period. METHODS: Retrospective series. RESULTS: A total of 183 eyes with work-related OGIs were identified. The majority of injuries occurred in men (96.7%). The anatomic site of the wound was zone 1 in 107 eyes (72.3%). The most common cause was nail gun use (47.0%). The types of OGI included 32 ruptures (17.5%), 112 penetrating injuries (61.2%), 38 intraocular foreign bodies (IOFB) (20.8%), and 1 mixed rupture/IOFB injury (0.5%). Presenting visual acuity (VA) was worse than 20/200 in 112 eyes (65.9%) and no light perception (NLP) in 10 eyes (5.8%). Final VA worse than 20/200 occurred in 64 eyes (37.2%); 11 eyes underwent enucleation. In comparison to non-work-related OGIs (420 eyes), we found significant differences in types and zones of injury, initial and final mean VA, enucleation rate, incidence of cataracts, hyphema, retinal detachment, hemorrhagic choroidals, and afferent pupillary defect (APD). Using multivariate analysis, significant prognostic factors for a final VA of NLP were zone 3 injury, rupture injury, and initial VA of NLP. Risk factors for enucleation included zone 3 injury, APD, and endophthalmitis. CONCLUSIONS: Work-related injuries were noted to have a much higher incidence of IOFBs and cataracts compared to non-work-related OGIs. Zone 3 injuries, rupture injuries, and a presenting VA of NLP were found to be significant predictors for a final VA of NLP. Zone 3 injury, APD, and endophthalmitis were found to be significant predictors for enucleation.

Ocular Trauma Score as a predictor of final visual outcomes in traumatic cataract cases in pediatric patients.

PURPOSE: To validate the predictive value of the Ocular Trauma Score (OTS) in children with traumatic cataract. DESIGN: Retrospective cohort study. SETTING: Tertiary eye care center at nexus of Gujarat, Madhya Pradesh, and Rajasthan states, central Western India. METHODS: After meeting inclusion criteria, eyes with traumatic cataract were enrolled and examined to review comorbidities caused by trauma. Surgery was performed for traumatic cataract, intraocular lenses were implanted, and patients were treated for amblyopia, as applicable. Patients were reexamined 6 weeks postoperatively. Based on ocular trauma described according to the Birmingham Eye Trauma Terminology System, the patients were divided into 2 traumatic cataract groups: open-globe injury and closed-globe injury. The relationship between final corrected distance visual acuity (CDVA) and demographic and clinical variables was analyzed. Visual outcomes were predicted using the OTS, and the predictions were compared with actual outcomes using statistical tests. RESULTS: The study enrolled 354 children. Six weeks postoperatively, the CDVA was better than 20/200 in 181 eyes (63.0%) and 20/40 or better in 110 eyes (38.4%) in the open-globe group and better than 20/200 in 36 eyes (53%) and 20/40 or better in 15 eyes (22.4%) in the closed-globe group. The differences between the groups were not significant (P=.143). Of all eyes, 214 (61.3%) achieved a final CDVA of better than 20/200 and 123 eyes (35.3%), of 20/40 or better. CONCLUSION: The OTS was a reliable predictor of the final visual outcome in cases of pediatric traumatic cataract.

Incidence and severity of ocular and adnexal injuries during the Second Lebanon War among Israeli soldiers and civilians.

PURPOSE: To analyze the incidence and severity of ocular and adnexal injuries in the Second Lebanon War among Israeli soldiers and civilians. DESIGN: Retrospective cohort study. PARTICIPANTS: All patients recorded in the Israeli National Trauma Registry during the Second Lebanon War (July-August, 2006). METHODS: Retrieval of all data relevant to ocular and adnexal injuries sustained during the study period, and differentiation between those associated with combat/terrorist and other events. MAIN OUTCOME MEASURES: Analysis of data according to the severity of trauma , anatomical location of the injury, and whether the patients were military personnel or civilians. RESULTS: A total of 69 war-related ocular trauma patients (58 military personnel and 11 civilians) were registered during the 34 days of war. The injuries involved the anterior segment injury (n = 25), posterior segment (n = 29) and the periocular region (n = 15, all severe). Twenty-seven of the patients had open-globe injuries, of which 18 involved intraocular foreign bodies, and 27 patients had closed-globe injuries. The rate of ocular injuries was 7% among all registered wounded military personnel and 1.2% among all injured civilians. CONCLUSION: The incidence and severity of ocular and adnexal injuries among military personnel during the Second Lebanon War were consistent with previous reports from American sources of ocular injuries sustained in Iraq and Afghanistan. The rates of ocular injury associated with wartime events sustained by civilians has not been investigated before, and it was relatively low, probably as a result of stringent government-mandated building regulations for passive defense that are discussed.

Geriatric traumatic open globe injuries.

PURPOSE: To characterize the pattern of ocular trauma in the geriatric population. DESIGN: Retrospective, comparative case series. PARTICIPANTS: Eight hundred forty-six consecutive patients comprising 848 open globe injuries, of which 166 injuries occurred in geriatric patients (defined as 65 years old or older at the time of injury), with the remaining patients serving as control subjects. METHODS: Charts of open globe injuries (848 in total) treated surgically at the Massachusetts Eye and Ear Infirmary between January 2000 and April 2009 were retrospectively reviewed. MAIN OUTCOME MEASURES: Ocular Trauma Score, age, gender, mechanism of injury, zone of injury, site of injury, time of day, visual acuity at presentation, and best post-repair visual acuity were analyzed. RESULTS: Of 848 open globe injuries, 166 occurred in the geriatric population. The mean patient age in the geriatric group was 79.8 years. Females comprised most (58%) of this subpopulation. The most common mechanisms of injury were fall (65%), blunt trauma (16%), and motor vehicle accident (6%). The geriatric traumas tended to happen in late morning or late at night. There were no cases of endophthalmitis and fewer instances of enucleation in this group. The median raw Ocular Trauma Score was 47 in the geriatric population, compared with 70 in the younger subset (P < 0.0001). The injuries more often were in zones II and III in the geriatric population compared with the nongeriatric population (P < 0.0001). The geriatric patients were much more likely to have undergone previous intraocular surgery (P < 0.0001), which consisted of primarily cataract procedures. Visual acuity at presentation was significantly worse in the geriatric population than the nongeriatric population (P<0.0001). Similarly, the best postoperative visual acuity was worse in the elderly group than the younger group (P < 0.0001). CONCLUSIONS: The elderly represent a unique, yet neglected ocular trauma population. The pattern of ophthalmic injury and outcome differs greatly between the geriatric and nongeriatric populations. A better understanding of these injuries is necessary to improve prevention and treatment strategies for potentially devastating open globe injuries in this susceptible population.

The incidence of intraocular foreign bodies and other intraocular findings in patients with corneal metal foreign bodies.

PURPOSE: To review the findings of dilated fundus examinations (DFEs) in patients with the diagnosis of corneal metal foreign body (CMFB) and to assess the likelihood of concomitant intraocular foreign body (IOFB) in this clinical setting. DESIGN: Retrospective, case review series. PARTICIPANTS: All 288 cases with a new diagnosis of CMFB that had a documented DFE in the emergency department at Massachusetts Eye and Ear Infirmary from January 1, 2008, to December 31, 2008. In addition, all 9 separate cases of metal IOFB seen in the same time period were also reviewed. METHODS: The medical records of all patients were individually reviewed. MAIN OUTCOME MEASURES: The DFE findings of each visit were analyzed in addition to mechanism of injury, visual acuity and anterior segment abnormalities. RESULTS: Of the 288 CMFB cases, all but 1 presented without corneal or conjunctival laceration. The etiologies of the injuries included low- and high-velocity impact. Best-corrected visual acuity ranged between 20/15 and 20/150. The anterior chamber (AC) reaction ranged from quiet to 4+ cells. None of the DFEs revealed an IOFB. Only 1 case had a posterior segment abnormality related to the injury-commotion retinae in the setting of an explosion. There were 14 cases with unrelated DFE findings. Among the separate 9 cases of metal IOFB reviewed, all had a history of high-velocity injury and evidence of corneal or conjunctival laceration. In 1 of the 9 cases, the IOFB was protruding from the cornea; in 2 cases, IOFBs were seen on DFE. Six cases were diagnosed by computed tomography. All documented AC examinations for this group of patients had significant findings such as 4+ cells, hyphema, or lens fragments. CONCLUSIONS: The finding of IOFB on a DFE for patients with a CMFB without clinical evidence of penetrating injury is very rare. FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any of the materials discussed in this article.

Visual outcome after open globe injury: a comparison of two prognostic models--the Ocular Trauma Score and the Classification and Regression Tree.

AIMS: To compare the ocular trauma score (OTS) and the classification and regression tree (CART) as prognostic models of visual outcome after open globe injury. METHODS: A retrospective review of 100 consecutive open globe injuries at the Sunderland Eye Infirmary was conducted from January 1999 to December 2007. Univariate chi-square analysis was used to identify the variables associated with visual outcome. We compared the CART and OTS predictions with the actual visual outcomes and calculated the sensitivity and specificity of each model. RESULTS: The variables most predictive of visual loss were an RAPD, poor initial vision, lid laceration, posterior wound, and globe rupture. The sensitivity to predict visual survival (LP or better) was 97.4% for OTS and 93.5% for CART. The specificity to predict no vision (NPL or enucleation) was 100% for OTS and 73.9% for CART. The sensitivity to predict minimal-to-severe visual loss (3/60 or better) was 90.9% for OTS and 85.7% for CART. The specificity to predict profound visual loss (worse than 3/60) was 100% for OTS and 81.8% for CART. CONCLUSIONS: We identified several factors that can help in deciding on the prognostic value of primary globe repair. Both the OTS and CART had high predictive accuracy, but the OTS had higher prognostic accuracy and could be used in counselling patients and in management decision-making.

Epidemiology of pediatric eye injury in Split-Dalmatia County.

AIMS: The aim of this study was to assess the etiological factors and circumstances associated with the occurrence of eye injuries in children in Split-Dalmatia County, and to assess the visual outcomes of such injuries. METHODS: All 106 cases of pediatric eye trauma presenting to the Clinical Hospital Split, during a 4-year period, were identified by a medical record search. RESULTS: The annual calculated incidence of serious eye injuries in pediatric patients of Split-Dalmatia County that required hospitalization was 22.5 per 100,000 in the underage population. The most common causes of ocular injury were blunt objects and missiles, which mostly caused contusions and lamellar lacerations, and sharp objects, which mostly caused penetrating eye injury. In 99 (90.83%) eyes, the injuries were mechanical. Open globe injuries were significantly severer than closed globe injuries. Final visual acuity was better than upon admission in 78.10% of cases. The annual incidence of pediatric monocular blindness in Split-Dalmatia County was 0.63 per 100,000 in the underage population. CONCLUSIONS: Eye trauma in children occurs most frequently outdoors and generally results from the use of blunt objects. Prevention of ocular injury requires greater education of both children and their parents and adult supervision of children, especially while at play.

[Intraocular and intraorbital foreign bodies characteristics in patients with penetrating ocular injury]. / Charakterystyka cial obcych wnikajacych do wnetrza galki i oczodolu powodujacych u pacjenta przenikajacy uraz narzadu wzroku.

PURPOSE: To determine clinical features of intraocular and intraorbital foreign body (IOFB) injuries. MATERIAL AND METHODS: 62 patients with IOFB injury were retrospectively reviewed. Data on age, sex, activity at the time of injury, initial visual acuity and presenting clinical features were recorded. Special attention was paid on foreign bodies characteristics. Factors analyzed included: material, quantity and size of IOFB, site of entrance wound and final IOFB location. RESULTS: The mean patient age was 38.1 years. All but one patient were male. Hammering and chiselling were the most common activities at the time of injury. 93.5% of patients had single IOFB. Metallic foreign body comprised 85.5% of all cases. The average IOFB size was 3.9 x 15.1 mm. 83.9% of IOFBs were located inside the globe, among them: 46.1% in the anterior segment; 44.2% in the vitreous and the rest in the posterior part of globe. The most frequent entrance wound site was cornea (59.7%). Initial visual acuity was worse or equal 5/50 in 50% of the cases. Patients with greater size of IOFB had worse initial visual acuity. The most common clinical features, presenting at the time of injury, were corneal wound (64.5%), lens lesion (33.9%), endophthalmitis (29%) and vitreous hemorrhage (25.8%). CONCLUSIONS: The majority of patients with IOFB injury were young male. Tool-related activities, particularly hammering, were more likely to cause of IOFB injuries. Single metallic foreign body occurred much more frequently. Cornea was the most frequent site of entrance wound. The vitreous and the anterior segment were the most common final location of IOFB. Increasing IOFB size was associated with worse initial visual acuity. IOFB injury has been found to be associated with a lot number of the ocular tissues lesions.

Ocular Trauma Score in childhood open-globe injuries.

BACKGROUND: To assess prognostic value of the Ocular Trauma Score (OTS) in childhood open-globe injuries. METHODS: This retrospective, interventional case series included 61 children with open-globe injuries. Certain numerical values rendered to the OTS variables (visual acuity, rupture, endophthalmitis, perforating injury, retinal detachment, afferent pupillary defect) at presentation were summated and converted into OTS categories; the likelihood of the final visual acuities in the OTS categories were calculated, and compared with those in the OTS Study. RESULTS: Age ranged from 3 years to 14 years (mean, 8.0 years). Forty-two boys and 19 girls were included. Follow-up ranged from 6 months to 56 months (mean, 18 months). The likelihood of the final visual acuities (no light perception, light perception/hand motion, 1/200-19/200, 20/200-20/50, and > or = 20/40) in the OTS categories (1 through 5) in this group were similar to those in the OTS Study group. CONCLUSIONS: OTS calculated at initial examination may provide prognostic information in children with open-globe injuries.

Validation of the ocular trauma score for intraocular foreign bodies in deadly weapon-related open-globe injuries.

BACKGROUND AND OBJECTIVE: To evaluate the prognostic value of the Ocular Trauma Score (OTS) in cases of deadly weapon-related open-globe injuries with intraocular foreign bodies. PATIENTS AND METHODS: A retrospective, interventional case series included 20 eyes of 20 patients who had deadly weapon-related open-globe injuries with intraocular foreign bodies. The OTS was calculated for each patient by adding the determined numbers of OTS variables at presentation (initial visual acuity, rupture, endophthalmitis, perforating injury, retinal detachment, and afferent pupillary defect). Patients were categorized based on their score (category 1 through 5). Final visual acuities in the OTS categories were calculated and compared to those in OTS study group. RESULTS: No statistically significant difference was found between the categorical distributions of the study patients and those in the OTS study group. No patient in the study was in category 5. CONCLUSION: The OTS, which was designed to predict visual outcomes of general ocular trauma, may also provide reliable information about the prognosis of deadly weapon-related open-globe injuries with intraocular foreign bodies.