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Indian Journal of Clinical and Experimental Ophthalmology


Profile of head injuries in Road Traffic Accident cases with Ocular trauma in a rural tertiary care hospital


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Author Details: Sandhya Ramachandra, Sai sushma Yeturu, Chandrakant Pujar, Spoorthy Sagara, Sameera Nikhil.Veerakan

Volume : 1

Issue : 4

Online ISSN : 2395-1451

Print ISSN : 2395-1443

Article First Page : 245

Article End Page : 251


Abstract

Background: Road traffic accidents form a major part of accident and emergency care not only in cities but also in rural places. Improved affordability, changed socio economic conditions, personality and mind set of the younger generation, etc.. have influenced the behavioral pattern directly & indirectly. Access to accident and emergency care in rural India is still limited; especially with regards to management of head injuries. This research was conducted as an arm of a study of ocular injuries, as it was felt that there was a close inter relation between ocular injuries & head injuries, the outcome of this research may help in drawing attention to head injuries and better management of the same.
Objectives:       

·         To study profile and pattern of head injuries in relation to eye injury presenting to Accident and Emergency services of a tertiary care hospital, wherein ophthalmology reference was sought. Head injuries include both injuries to the brain and those to other parts of the head, such as the scalp and skull.

·         It is also useful to study common ophthalmic manifestation in various types of head injury and to attempt a correlation between the neurological signs, ocular signs, GCS (Glassgow Coma Scale).

·         It was a non-interventional study to analyze correlation, if any, between Ocular trauma & head injuries.

·         This study aims to record incidence & various modes of injury which can cause serious eye involvement with mild head injury as well as serious head injury with minimal eye involvement.

Materials & Methods: 60 consecutive patients presenting to Ophthalmology outpatient department or accident and emergency department of PESIMSR, with ocular trauma from the period August 2013-April 2015 were included in the study. This was an added arm of the study of ocular injuries, approved by the hospital ethical review board. And it did not include any additional intervention or investigation.
Results:  In our study 31 patients were associated with head injury along with associated ocular injury. Out of 31, 27 were males and only 4 were females. Out of 31, 21 were two wheelerdrivers,2 were two wheeler passengers, 4 were four wheeler passengers, 4 were pedestrians.25 patients had mild head injury,2 patients had moderate head injury,4 patients had severe head injury. Out of 31, 6 patients had traumatic optic neuropathy. Invariably all patients of skull fracture were associated with periorbital edema/ecchymosis. Out of 31, 20 patients had Ocular Trauma Score (OTS) -100.OTS between 80-100 -1 patient. 55-80 -2 patients, 45-55 -4patients.
Conclusion: Those with head injury other than skull fractures had intraocular findings rather than extra ocular involvement. Thus it signifies the importance of intraocular findings in relation to head injury.

Keyword:
Head Injury, Road Traffic Accidents.