A dissertation on analytical study on intraocular foreign body visual outcome according to ocular trauma scoring.

INTRODUCTION: Ocular trauma is one of the major cause of world wide vision impairment. Annual incidence of ocular trauma exceed 2million cases with more than 40000 people sustaining permanent vision impairment to a significant level. The place of injury could be anywhere from working place to recreational /agricultural /rural settings. Mainly the people affected are younger individuals ;the male to female ratio being around 9:1. Financial penalty to person and family is another aspect of IOFB. Because of recent micro surgical technique and instrumentation prognosis of IOFB has improved for the past decades. Use of safety glasses in work places and education are the 2 factors which can reduce the incidence and ophthalmologists can play a key role in educating the population. AIM: 1) To study the annual incidence of intraocular foreign body at a teritiary level institute 2) To compare the expected visual outcome as per OTS with the final vision outcome according to our management 3) To compare the complications of anterior segment vs posterior segment IOFB 4) To assess the efficacy of different modalities of treatment MATERIALS AND METHODS: 163cases of penetrating injuries presented to RIOGOH for past 2 years from 2006 june to 2008 june are included in this study. The intra ocular foreign body nature varied from magnetic/ non magnetic / vegetable etc. A detailed history regarding nature of injury +/- presence of protective glasses nature of foreign body previous ocular disease etc are assessed. Vision at presentation and final vision assessed by Snellens chart and tension recorded by non contact tonometry. Detailed examination done for site of entry of foreign body AC reaction lens damage vitreous hemorrhage IOFB site of lodgement and fundus examination done by IDO and 90 D . location of foreign body assessed with x-ray limbal ring and B – Scan. CONCLUSION: 1) OTS is an excellent tool to assess the final vision out come in patients with retained intra ocular foreign body. 2) The initial vision at presentation , +/- rupture , +/- endophthalmitis +/- RD , +/- RAPD, +/- perforating injury are counted and given score. 3) The expected vision depends on the OTS. 4) X-ray limbal ring and B-Scan provided exact localization of foreign body. 5) PPV, GM, were used to remove the posterior segment foreign body and in anterior segment, forceps were used for removal. 6) PPV proved to be an excellent method of IOFB removal with good vision out come. 7) According to this study it is proved that the final vision out come is comparable with world trauma group standards. 8) Since IOFB causes a major drop in vision we ophthalmologist should educate people to wear protective glasses