Controversies in ocular trauma classification and management: review

Area of Science:

• Ophthalmology
• Trauma Surgery

Background:

• Ocular trauma, particularly open-globe injuries (OGIs), presents numerous unresolved management controversies.
• Existing international classifications for ocular trauma require updates to improve outcome prediction.

Purpose of the Study:

• To review current controversies and debatable management strategies for ocular trauma, especially OGIs.
• To provide evidence-based recommendations for treatment based on published data and expert experience.

Main Methods:

• Review of pertinent data regarding management issues and controversies in ocular trauma.
• Synthesis of available published data and authors' personal experience.

Main Results:

• Controversies exist in anterior segment trauma (corneal abrasion, laceration repair, hyphema management) and posterior segment trauma (vitrectomy timing, prophylactic cryotherapy/scleral buckle, intravitreal antibiotics).
• Debates continue regarding traumatic optic neuropathy (steroid therapy, optic canal decompression) and orbital/adnexal trauma management.
• Special considerations are needed for pediatric ocular trauma and the management of eyes with no light perception due to sympathetic ophthalmia risk.

Conclusions:

• There is a need for updated classifications and evidence-based guidelines for managing complex ocular trauma.
• Addressing these controversies through further research and standardized protocols is crucial for improving visual outcomes in OGI patients.