Dr. HIMANTO HAZARIKA

DR. C. K. BARUA

DR. P.K.GOSWAMI

Dr. ROHIT.R.MODI

REGIONAL INSTITUTE OF OPHTHALMOLOGY, GUWAHATI

FINANCIAL DISCLOSURE

This study was done by Regional Institute of Ophthalmology, Guwahati.

The authors are consultants and have no direct financial interest in the above mentioned study.

Introduction :

Globally, it is estimated that 1.6 million cases of blindness are caused by eye injuries. WHO programme for the prevention of blindness, suggested that some 55 million eye injuries restricting activities of more than one day, occur each year.

Ultrasonography (USG) has emerged in recent years as an useful technique for detecting and outlining the soft tissue abnormalities of the eye and orbit in ocular trauma.

The first diagnostic application of ultrasound in ophthalmology was by Mundt and Hughes (1956). The experience about cross-sectional B-scan display of the eye was reported by Baum and Greenwood (1958).

AIMTo determine the use of BScan in

diagnosis of vitreoretinal(VR) pathologies in blunt ocular trauma

(BOT) with media opacity especially in rural setting.

Materials and Methods: A prospective study of 57 eyes of 57 patients was

done between March, 2008 to August, 2008.

Age of the patients : 5-73 yrs

Number of male patients : 46

Number of female patients : 11

INCLUSION CRITERIA

a) History of blunt ocular trauma of various origin.

b) Presenting within one week.

c) Presence of media opacities : Corneal haziness/edema Hyphaema Secondary cataract Vitreous opacities.

EXCLUSION CRITERIA

a) Globe rupture

b) Critically traumatized patients

RTA accidents

Coma/Unconscious patients

ICU admitted patients

RESULTS

A total No. of 57 eyes of 57 patients were studied.

Male : Female ratio = 46 : 11

Mean age of the patients : 25.2 yrs.

47.4% of cases were below 20 years of age.

Male patients are more vulnerable to BOT.

RD, PVD and Vitreous hemorrhage

Choroidal Detachment

Vitreous Hemorrhage with PVDPVD with subhyaloid hemorrhage.

Retinal Detachment Dislocated lens into the vitreous

DISCUSSION:

Of the 57 eyes studied, 50% of patients had history of BOT while playing with bat & ball, stick/wood, stone throwing and fist injury.

In a study by Babar et al. males constituted 79.66% and females 20.33%, by Khan et al. (84.7% versus 15.3%). In this study the ratio was found to be 80.7% versus 19.3%.

Saxena et al. reported pediatric ocular trauma from New Delhi, India, were 133 (65.1%) boys and 71 (34.9%) girls. Babar et al. reported ocular trauma below 15 years as 351 (80.87%) boys and 83 (19.12%) girls.

Ref: Tariq Farooq Babar, Muhammad Tariq Khan, Mir Zaman Marwat, Shafqat Ali Shah, Yasir Murad and Mohammad Daud Khan Patterns of Ocular Trauma, JCPSP 2007, Vol. 17 (3): 148-153]

Saxena R, Sinha R, Purohit A, Dada T, Vajpayee RB, Azad RV. Pattern of pediatric ocular trauma in India. Indian J Pediatr 2002; 69: 863-7

contd........ In our study 47.4% were below 20 years of which 23 (88.5%)

boys and 3 (11.5%) girls. Vitreous hemorrhage was found to be the commonest

pathological posterior segment findings with 35 (61.4%) followed by PVD 15 (26.3%), Retinal Detachment 07 (12.3%), Subluxated lens 05 (8.8%) and hemorrhagic Choroidal Detachment 04 (7.0%).

Cases with subluxated cataractous lens, Retinal detachment, posterior globe rupture and other vitreoretinal pathologies were promptly managed accordingly.

[Ref: 1.Chugh JP, S, Verma M. Role of ultrasonography in ocular trauma. Indian J Radiol Imaging [serial online] 2001 [cited 2008 Jun 12];11:75-9. . 2. Pavlin CJ, Harasiewicz K, Sherar MD, Foster FS. Clinical use of ultrasound biomicroscopy. Ophthalmology 1991; 98: 287-295.]

Conclusion: BScan is an useful non-invasive diagnostic tool to

evaluate Vitreoretinal Pathologies at an earlier stage in Blunt Ocular Trauma in rural setting. It helps in prompt referral of patient with VR Pathologies to higher centres.

As most of the patients belong to younger age group; USG assisted appropriate diagnosis and management, also helps in prompt referral and thus prevention of severe loss of vision.

USG should be considered as a routine procedure for all cases of BOT with media opacity in rural setting.

THANK YOU…