Abstrak
Introduction: Penetrating eye injuries represent a significant cause of visual loss in the younger age groups. Many factors had been associated with poor visual outcome in these patients. The aim of this review is to evaluate the outcome of penetrating ocular injuries and the prognostic factors among patients presenting to a tertiary eye care.
Method: All cases of penetrating ocular injury presenting to our institution, over a 10 year period, were identified by a medical records search. Recruitment of cases was by a review of the eye clinic emergency register, ward admissions register and theatre operations register of the institution.
Result: One hundred and thirty-five cases (108 males) were analyzed with male to 27 female ratio of 4:1. The first (31.1%) and third (31.9%) decades of life were most affected. Seventy-two (53.3%) patients presented within 24 hours of injury, while only 44 (35.2%) had surgical repair within 24 hours of presentation. The major reason for delay in surgical repair was financial. At last follow-up, 20 (14.8%) eyes attained best corrected visual acuity better than 6/18, while 80 (59.3%) had acuity less than 3/60. Poor presenting visual acuity correlates well with a poor visual outcome in our patients. Four patients with delayed presentation and features of endophthalmitis underwent primary evisceration.
Conclusion: The visual prognosis in patients with penetrating eye injuries in our environment remains poor. Late presentation and delayed surgical repair are still rampant among our patients. Sustained efforts at enlightening the populace on early presentation to a health facility after sustaining ocular trauma, and subsidizing treatment for indigent patients, may help to reduce this burden in our environment.
Keywords: Eye injuries, Ibadan, penetrating, prognostic factors, retrospective, visual outcome.
Résumé
Les blessures affectant les yeux représentent une cause significative de la cause de la perte de vision chez les groupes des jeunes. Plusieurs facteurs ont été associés avec les résultats de la mauvaise vision chez ces patients. Le but de cette étude est d’évaluer les resultats des blessures oculaires et les facteurs pronostiques parmi les patients aux soins visuels tertiaires. Toutes les cas enregistrés dans les dernières dix ans étaient identifies par une recherché dans le registre. Le recrutement des cas était fait par un diagnostic cliniques des yeux, admission et chirurgie dans l’institution en santé. Cent trente cinq cas (108 males) étaient analyses dans les proportions de male-femelle de 4:1. La première (31.1%) et la troisième (31.9%) dizaines de la vie étaient les plus affectés. Saxointe douze (53.3%) patients se présentaient dans les 24 heures de la blessure, lorsque seulement 44 (35.2%) avaient une réparation chirurgicale dans les 2’ heures de leur présentation. La raison du retard en chirurgie était financière. A la suivi 20 (14.8%) des yeux avaient une meilleure correction de l’acuité visuelle plus de 6/18, tandis que 80 (59.3%) avaient une acuité moins de 3/60. La faible acuité visuelle corrélait bien avec de résultat visuel faible chez nos patients. Quatre patients se présentant tardivement et ayant des symptômes de l’ endophthalmite suivaient une éviscération primaire. Le pronostic visuel chez les patients avec des blessures oculaires dans notre environnement reste faible. La présentation tardive et la chirurgie retardée sont communes parmi nos patients. Les efforts soutenues dans la sensibilisation des populations sur la présentation précoce dans les facilités de santé après un traumatisme oculaire, et un traitement avec subsidie chez les patients indigènes peut aider à réduire cette souffrance dans cet environnement.
Correpondence: Dr. Oluyemi Fasina, Department of Ophthalmology, University College Hospital, Ibadan, Nigeria. Email: yemifash2000@yahoo.com
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