TITLE:
Mechanical Eye Trauma Epidemiology, Prognostic Factors, and Management Controversies—An Update
AUTHORS:
Sharah Rahman, Ava Hossain, Sarwar Alam, Anisur Rahman, Chandana Sultana, Saiful Islam, Yusuf Jamal Khan, Md. Amiruzzaman
KEYWORDS:
Mechanical Eye Trauma, Bermingham Eye Trauma Terminology, Prognostic Factors for Mechanical Trauma, Epidemiology of Mechanical Eye Injury, Open Globe Injuries (OGI), Ocular Trauma Scoring (OTS), Classification and Regression Tree (CART) Model, Update of Mechanical Eye Trauma, Classification of Ocular Trauma, Controversies of Ocular Trauma, Challenges in Ocular Trauma Management
JOURNAL NAME:
Open Journal of Ophthalmology,
Vol.11 No.4,
November
30,
2021
ABSTRACT: Purpose of Review: The management of eye injuries is both difficult and argumentative. This study attempts to highlight the management of ocular trauma using currently available information in the literature and author experience. This review presents a workable framework from the first presentation, epidemiology, classification, investigations, management principles, complications, prognostic factors, final visual outcome and management debates. Review Findings: Mechanical ocular trauma is a leading cause of monocular blindness and possible handicap worldwide. Among several classification systems, the most widely accepted is Birmingham Eye Trauma Terminology (BETT). Mechanical ocular trauma is a topic of unsolved controversy. Patching for corneal abrasion, paracentesis for hyphema, the timing of cataract surgery and intraocular lens implantation are all issues in anterior segment injuries. Regarding posterior segment controversies, the timing of vitrectomy, use of prophylactic cryotherapy, the necessity of intravitreal antibiotics in the absence of infection, the use of vitrectomy vs vitreous tap in traumatic endophthalmitis is the issues. The pediatric age group needs to be approached by a different protocol due to the risk of amblyopia, intraocular inflammation, and significant vitreoretinal adhesions. The various prognostic factors have a role in the final visual outcome. B scan is used to exclude R.D, Intraocular foreign body (IOFB), and vitreous haemorrhage in hazy media. Individual surgical strategies are used for every patient according to the classification and extent of the injuries. Conclusion: This article examines relevant evidence on the management challenges and controversies of mechanical trauma of the eye and offers treatment recommendations based on published research and the authors’ own experience.