Gothwal V K, Adolph S, Jalali S, Naduvilath T J
Retina-Vitreous Services, L V Prasad Eye Institute, Hyderabad, India.
Aust N Z J Ophthalmol. 1999 Oct;27(5):318-25. doi: 10.1046/j.1440-1606.1999.00225.x.
To evaluate the extent of visual recovery after multi-disciplinary approach of treatment in serious ocular injuries; to determine the prognostic factors associated with poor final visual outcome and suggest adequate precautionary measures.
A retrospective analysis of 325 consecutive patients with direct ocular trauma who were examined and treated at a tertiary eye care centre in South India over a 3-year period was undertaken.
Males (86.8%) outnumbered the females (13.2%) and children (< 16 years) constituted 46.8% of the total affected population. Anterior segment was involved in 51.1%, the posterior segment in 8.9% and both anterior and posterior segments were involved in 31.4% of patients. Prompt and meticulous surgical treatment restored useful vision (better than or equal to 6/18) in 60.5% of patients. Post-treatment, a reduction in blindness and visual impairment rates in the affected eye with respect to WHO classification was 66.7 and 54.1% respectively (P < 0.0001). Two eyes needed prompt enucleation. The factors associated with visual impairment (visual acuity less than 6/18) were poor initial visual acuity, full chamber hyphema, endophthalmitis, retinal detachment, and vitreous haemorrhage.
Direct ocular trauma remains an important potentially preventable cause of ocular morbidity, but the advent of modern surgical techniques can often restore useful vision in such situations. Mandatory use of protective eye wear at work, public health education including awareness on the part of parents to the potential dangers of some childrens' toys can to an extent help reduce ocular morbidity due to direct ocular trauma.
评估严重眼外伤多学科治疗后的视力恢复程度;确定与最终视力不佳相关的预后因素,并提出适当的预防措施。
对印度南部一家三级眼科护理中心在3年期间检查和治疗的325例连续性直接眼外伤患者进行回顾性分析。
男性(86.8%)多于女性(13.2%),儿童(<16岁)占总患病人数的46.8%。51.1%的患者累及眼前段,8.9%累及眼后段,31.4%的患者眼前段和眼后段均受累。及时、细致的手术治疗使60.5%的患者恢复了有用视力(优于或等于6/18)。治疗后,根据世界卫生组织分类,患眼的失明和视力损害率分别降低了66.7%和54.1%(P<0.0001)。有两只眼需要及时摘除眼球。与视力损害(视力低于6/18)相关的因素包括初始视力差、全前房积血、眼内炎、视网膜脱离和玻璃体积血。
直接眼外伤仍然是一个重要的、潜在可预防的致盲原因,但现代手术技术的出现通常可以在这种情况下恢复有用视力。工作时强制使用护目镜,开展公共健康教育,包括提高家长对某些儿童玩具潜在危险的认识,在一定程度上有助于减少因直接眼外伤导致的眼部发病率。