TNOA Journal of Ophthalmic Science and Research

EXPERT COMMENT
Year
: 2018  |  Volume : 56  |  Issue : 4  |  Page : 275-

Expert opinion on ocular trauma score


Gangadhara Sundar 
 Orbit and Ophthalmic Plastic and Reconstructive Surgery, National University Hospital, Singapore

Correspondence Address:
Dr. Gangadhara Sundar
Department of Orbit and Ophthalmic Plastic and Reconstructive Surgery, National University Hospital, 1 E, Kent Ridge Road
Singapore




How to cite this article:
Sundar G. Expert opinion on ocular trauma score.TNOA J Ophthalmic Sci Res 2018;56:275-275


How to cite this URL:
Sundar G. Expert opinion on ocular trauma score. TNOA J Ophthalmic Sci Res [serial online] 2018 [cited 2023 Feb 5 ];56:275-275
Available from: https://www.tnoajosr.com/text.asp?2018/56/4/275/252490


Full Text



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Globe injuries, no matter how trivial, have an immense effect on the affected individual, not only medically but also psychosocially and even economically. The greatest concern of the patient is the likelihood of recovery, possibility of irreparable damage, and consequences for their continued normal personal and professional lives.

The ocular trauma score (OTS)[1] was proposed based on a large series of patients both from the Birmingham Eye Injury Registry and the Hungarian Eye Injury Registry by Kuhn et al.[2] This was a single major advance in the prognostication following both closed and open globe injuries which guided management and also helped counsel the injured patient. Despite this being described decades ago, it is unfortunately not being practiced at all ophthalmic trauma centers. Several studies have shown clear benefit of its use in various situations – open and closed globe injuries, traumatic cataract[3] high impact injuries.[4] Some have even proposed modifications and validated its benefit in pediatric eye injuries.[5]

We encourage all ophthalmologists to routinely incorporate the use of appropriate eye trauma terminology, based on the Birmingham Eye Trauma Terminology, use the OTS, and calculate the visual prognosis, which aids the ophthalmologist and the patient. A routine audit postrepair regarding both globe preservation and visual preservation/restoration is also highly advised. Despite a guarded visual prognosis, all injuries including severe injuries should undergo immediate and meticulous surgical wound closure and early postoperative imaging (ultrasound, computed tomographic scan, etc.) not only to assess the integrity of posterior segment, presence of foreign bodies,[6] etc., but also to rule out associated orbital and orbitofacial injury, which may have both medical and medicolegal consequences.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Kuhn F, Maisiak R, Mann L, Mester V, Morris R, Witherspoon CD. The ocular trauma score (OTS). Ophthalmol Clin North Am 2002;15:163-5, vi.
2Kuhn F, Morris R, Witherspoon CD. Birmingham Eye Trauma Terminology (BETT): Terminology and classification of mechanical eye injuries. Ophthalmol Clin North Am 2002;15:139-43, v.
3Shah MA, Shah SM, Applewar A, Patel C, Shah S, Patel U. OcularTrauma score: A useful predictor of visual outcome at six weeks in patients with traumatic cataract. Ophthalmology 2012;119:1336-41.
4Agrawal R, Wei HS, Teoh S. Predictive factors for final outcome of severely traumatized eyes with no light perception. BMC Ophthalmol 2012;12:16.
5Acar U, Tok OY, Acar DE, Burcu A, Ornek F. A new ocular trauma score in pediatric penetrating eye injuries. Eye (Lond) 2011;25:370-4.
6Unal MH, Aydin A, Sonmez M, Ayata A, Ersanli D. Validation of the ocular trauma score for intraocular foreign bodies in deadly weapon-related open-globe injuries. Ophthalmic Surg Lasers Imaging 2008;39:121-4.