OCULAR INJURIESAn introduction & nomenclature
22.11.2013
Ayesha S Abdullah
Learning outcomes
By the end of this lecture the students would be able
to
 Describe the epidemiology of ocular injuries
 Classify globe injuries according to the Birmingham
Eye Trauma Terminology (BETT) system of
classification
 Differentiate between OGI and CGI
How common is it?
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Trauma is the commonest cause of ocular
emergencies reported in trauma centres
A total of 1.6 million cases of blindness are caused
by eye injures
Some 2.3 million cases with low vision are due to
ocular injuries
Some 19 million cases of mono ocular blindness are
due to eye injuries
Risk factors
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Gender , any guess?
3:1 male to female ratio
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Rural areas
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Compromised socioeconomic status
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Illiteracy
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Conflicts
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Classification
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According to vector (The Agent)
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According to settings (Place of injury)
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According to pathology (Effects produced)
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According to anatomical structures involved
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According to severity (Damage produced)
According to the site involved
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Orbital trauma
Superficial & corneal foreign bodies
Lid injuries
Globe injuries
Nature of injurious agent
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Mechanical Injuries
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Chemical Injuries
Acid
Alkali
Others
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Radiation Injuries
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Thermal Injuries
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Electrical Injuries
Place of Injury
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Home
School
Playground
Agriculture
Industry
Laboratory
Workshops
Assault/ combat
Birmingham Eye Trauma Terminology System
(BETTS)
http://www.asotonline.org/bett.html
Definitions -BETTS
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Closed Injury in which cornea & sclera are intact but
there is intraocular damage.
Open Injury is associated with full-thickness wound of
cornea or sclera or both.
Rupture is a full-thickness wound caused by blunt
trauma
Laceration is full-thickness injury caused by a sharp object
Penetration is caused by a single laceration with a sharp
object
Perforation consists of two lacerations, one entry and one exit
http://www.asotonline.org/bett.html
http://bestpractice.bmj.com/best-practice/monograph/961/basics/classification.html
Orbital trauma
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Blow out floor fracture, medial wall, floor, roof
Contusion injury
Lacerations
Orbital haematoma
Eye Lids
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Contusion
Hematoma
Lacerations
Beware of the
blood loss
especially in
children
Late Complications
Effects of close globe injury (CGI)
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Mechanism
 AP
compression
 Expansion in the equatorial plan
 Transient & excessive increase in IOP
 Impact is primarily absorbed by ??
 Lens
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–Iris diaphragm & vitreous
The damage can happen in any tissue
commonly has long-term effects/ sequelae
Close Globe Injuries
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Subconjunctival Haemorrhage
Corneal abrasion
Acute corneal oedema
Traumatic iritis
Traumatic Mydriasis / Miosis
Hyphaema
Iridodialysis
Cyclodialysis / Angle recession
Ciliary shock
Close Globe Injuries
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Subluxation and dislocation of lens
Cataract
Posterior vitreous detachemet
Vitreous haemorrhage
Choroidal rupture
Commotio retinae
Retinal Breaks
Dialysis
 Equatorial tears
 Macular holes
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Optic nerve avulsion
Home work
List three recommendations for the following
 Primary
 Secondary
 Tertiary prevention of ocular trauma
Three power point slides with three points on each
slide send at
msqheartline@hotmail.com with your name and role
number