2010, Number 3
<< Back Next >>
Cir Cir 2010; 78 (3)
Ocular trauma score para la evaluación inicial del trauma ocular
Lima-Gómez V, Blanco-Hernández DMR, Rojas-Dosal JA
Language: Spanish
References: 22
Page: 209-213
PDF size: 249.66 Kb.
ABSTRACT
Background: The system for classifying mechanical injuries of the eye can identify the status of an injured eye at the trauma room, but it has no prognostic value. The ocular trauma score (OTS) estimates the 6-month visual prognosis, but some of its variables require evaluation by an ophthalmologist. We identified the proportion of injured eyes without diseases that required assessment of an ophthalmologist during the initial evaluation in order to determine whether the OTS could be used by non-ophthalmologists at the trauma room.
Methods: We evaluated patients with ocular trauma who attended a general hospital in Mexico City between 1995 and 2008 and graded them with the system for classifying mechanical injuries of the eye. The rate of eyes with retinal detachment and endophthalmitis that needed evaluation by an ophthalmologist was identified, and all the eyes were assigned an OTS category. The proportion and 95% confidence intervals (95% CI) of eyes that could be graded using the OTS in a trauma room was determined.
Results: We evaluated 742 eyes. Retinal detachment was found in six eyes (0.8%, 95% CI 0.16-1.44) and endophthalmitis in two eyes (0.3%, 95% CI 0-0.69). The proportion of eyes that could be graded using the OTS in a trauma room was 98.9% (95% CI 98.15-99.65).
Conclusions: OTS can be used to estimate the visual prognosis of almost every injured eye during the initial evaluation in a trauma room without the evaluation of an ophthalmologist.
REFERENCES
Wong TY, Klein BE, Klein R. The prevalence and the 5-year incidence of ocular trauma. The Beaver Dam Eye Study. Ophthalmology 2000;107:2196-2202.
Nash EA, Margo CE. Patterns of emergency department visits for disorders of the eye and ocular adnexa. Arch Ophthalmol 1998;116:1222-1226.
Bhopal RS, Parkin DW, Gillie RF, Han KH. Pattern of ophthalmological accidents and emergencies presenting to hospitals. J Epidemiol Community Health 1993;47:382-387.
Pieramici DJ, Sternberg P, Aaberg T, Bridges WZ, Capone A, Cardillo JA, et al. A system for classifying mechanical injuries of the eye (globe). Am J Ophthalmol 1997;123:820-831.
Lima GV, Alonso GA. Habilidades clínicas que facilitan la evaluación inicial del trauma ocular. Rev Hosp Juarez Mex 2004;71:150- 155.
Kuhn F, Morris R, Witherspoon CD. Birmingham Eye Trauma Terminology (BETT): terminology and classification of mechanical eye injuries. Ophthalmol Clin North Am 2002;15:139-143.
Kuhn F, Maisiak R, Mann L, Mester V, Morris R, Witherspoon, CD. The Ocular Trauma Score (OTS). Ophthalmol Clin North Am 2002;15:163-165.
Unver YB, Kapran Z, Acar N, Altan T. Ocular trauma score in openglobe injuries. J Trauma 2009;66:1030-1032.
Sobaci G, Akin T, Erdem U, Usyal Y, Karagül S. Ocular Trauma Score in deadly weapon-related open-globe injuries. Am J Ophthalmol 2006;141:760-761.
Unver YB, Kapran Z, Acar N, Altan T. Visual predictive value of the ocular trauma score in children. Br J Ophthalmol 2008;92:1122- 1124.
Uysal Y, Mutlu FM, Sobaci G. Ocular Trauma Score in childhood open-globe injuries. J Trauma 2008;65:1284-1286.
Savar A, Andreoli MT, Kloek Ce, Andreoli CM, Enucleation for open globe injury. Am J Ophthalmol 2009;147:595-600.
Colyer MH, Chun DW, Bower KS, Dick JSB, Weichel ED. Perforating globe injuries during Operation Iraqui Freedom. Ophthalmology 2008;115:2087-2093.
Weichel ED, Colyer MH, Ludlow SE, Bower KS, Eoseman AS. Combat ocular trauma visual outcomes during operations Iraqui and Enduring Freedom. Ophthalmology 2008;115:2235-2245.
Peña-Aceves A, Pérez-Reguera A, Hernández-Fernández F, Suárez- Tatá L, Quiroz-Mercado H. Epidemiología de heridas corneoesclerales en un hospital de especialidad. Rev Mex Oftalmol 2006;80:333- 339.
Urrutia M, Ramírez EJA, Levine BA. Evaluación de la escala de severidad en trauma ocular abierto. Rev Mex Oftalmol 2007;81:264- 266.
Lima GV. Traumatismo ocular. Comparación entre las lesiones evaluadas por el ATLS y las de una serie nacional. ¿Utilidad de una clasificación estandarizada? Cir Ciruj 2002;70:36-39.
Weyll M, Silveira RC, Lopes-da Fonseca N. Trauma ocular abierto: características de casos atendidos no complexo Hospitalar Padre Bento de Guarulhos. Arq Bras Oftalmol 2005;68:505-510.
Mellema PA, Dewan MA, Lee MS, Smith SD, Harrison AR. Incidence of ocular injury in visually asymptomatic orbital fractures. Ophthal Plas Reconstr Surg 2009;25:306-308.
Hodge C, Lawless M. Ocular emergencies. Aust Fam Physician 2008;37:506-509.
Pokhrel PK, Loftus SA. Ocular emergencies. Am Fam Physician 2007;76:829-836.
Sillah A, Ceesay B. Primary level management of eye injuries. Community Eye Health 2005;18:105.