Assessment of Predicted Visual Outcome by Ocular Trauma Score In Mechanical Trauma Patients

Abstract

Background: Ocular trauma is a leading cause of preventable blindness and visual impairment. The Ocular Trauma Score (OTS) was proposed to predict the visual outcome of patients after an ocular trauma. It acts as a useful system that allows clinician to efficiently plan, manage and monitor the full range of ocular injuries. Objectives: To assess the predicted visual outcome by Ocular Trauma Score in mechanical trauma patients. Methods: This prospective interventional study was carried out at National Institute of Ophthalmology and Hospital (NIO&H) from July 2022 to September 2023. A total of 88 patients at or above 10 years, presented with mechanical trauma were enrolled in this study. Initial visual acuity was recorded and proper in-hospital management was given. Ocular Trauma Score was calculated and recorded and followed for six months to see final visual acuity. Results: The mean age of study subjects was 34.61±13.20 years, among them 80.7% were male and 19.3% were female. 59.1% of the cases had closed globe injuries and 40.9% cases presented with open globe injuries. The most prevalent type of injury was accidental (63.6%). Majority of individuals (71.6%) sought medical attention within 24 hours of the injury. But most of them (57.9%) did not get any initial treatment before coming to the tertiary hospital. Initial visual acuity ≥6/12 was 9.1%, 6/60-6/15 was 27.3%, 1/60-5/60 was 35.2%, PL-HM was 20.5%, NPL 7.9%. OTS was 1 in 10.2% patients, 2 in 28.4%, 3 in 29.5%, 4 in 23.9% and OTS 5 in 8.0%. At the end of 06 months, 22.5% patients had ≥6/12 VA, 31.3% had 6/60-6/15 vision, 22.5% had 1/60 5/60, 13.8% had PL-HM, 10.0% had NPL vision. The ‘P’ value associated with the change of visual acuity from baseline to at 06 months follow up was 0.016, indicating a statistically significant difference between the two time points for this category. Patients with an OTS value of 1 had a higher risk of worst final visual outcome NPL (75.0%), whereas patients with an OTS value of 5 had a higher probability of getting the best visual outcome ≥ 6/12 (85.7%). Conclusion: This study shows that the higher the raw score and OTS category of the patient, the better the final visual acuity in patients with ocular trauma. This suggests that the initial ocular trauma score upon presentation could serve as a valuable prognostic indicator. As a result, this scoring system could play a significant role in providing useful insights for counselling both patients and their relatives dealing with ocular trauma.

J.Natl.Inst.Ophthalmol.2024;7(1): 18-23