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Published on: August 25, 2021
Prognostic Value of Ocular Trauma Score in Evaluating Visual Outcome of Pediatric (4-16 Years) Open Globe Injuries
Ava Hossain1, Enayet Hussain, Nahid Ferdausi
1From the *Department of Ophthalmology, Green Life Medical College; and Departments of †Ophthalmology, ‡Pediatric Ophthalmology, and §Vitreo-retina, National Institute of Ophthalmology and Hospital, Dhaka, Bangladesh.
Insights
The Ocular Trauma Score (OTS) effectively predicts outcomes in pediatric open globe injuries. Proper evaluation, timely surgery, and follow-up enhance its prognostic value for visual acuity.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Trauma Care
Background:
- Pediatric open globe injuries present unique challenges in predicting visual outcomes.
- The Ocular Trauma Score (OTS) is a tool used to classify injury severity and predict vision.
- Assessing the prognostic value of OTS in pediatric populations is crucial for guiding treatment and managing expectations.
Purpose of the Study:
- To evaluate the prognostic significance of the Ocular Trauma Score (OTS) in children with open globe injuries.
- To correlate OTS categories with final visual acuity outcomes in pediatric patients.
- To determine the reliability of OTS in predicting visual prognosis for pediatric ocular trauma.
Main Methods:
- A prospective observational study included 210 pediatric patients (4–16 years) with open globe injuries.
- Ocular Trauma Score variables (visual acuity, rupture, endophthalmitis, perforating injury, retinal detachment, afferent pupillary defect) were recorded.
- Patients were categorized into 5 OTS groups, and final visual acuity was compared with prognostic outcomes.
Main Results:
- Patients were distributed across 5 OTS categories, with varying proportions in each.
- Excellent final visual acuity (≥20/40) was exclusively achieved by patients in OTS category 5.
- No patients in OTS category 1 achieved ≥20/40 vision, and severe vision loss (no light perception) was concentrated in categories 1 and 2.
Conclusions:
- The Ocular Trauma Score demonstrates significant prognostic value for pediatric open globe injuries.
- Effective utilization of OTS is contingent upon comprehensive evaluation, prompt surgical intervention, and diligent follow-up care.
- OTS serves as a reliable indicator for predicting visual outcomes in young patients sustaining ocular trauma.
Purpose:
This study aimed to assess the prognostic value of ocular trauma score (OTS) in pediatric open globe injury.
Design:
A prospective observational study was conducted.
Methods:
A total of 210 patients aged 4 to 16 years (mean ± SD age, 9.30 ± 3.29 years) with open globe injury were recruited by nonrandomized purposive sampling based on the inclusion and exclusion criteria. Ocular trauma score variables, including visual acuity (VA), rupture, endophthalmitis, perforating injury, retinal detachment, and afferent pupillary defect, were determined and converted into OTS categories. The final VA in each category was compared with the prognostic outcome.
Results:
Patients were categorized into 5 groups according to the OTS model, with 30 (14.28%) patients in category 1, 52 (24.77%) patients in category 2, 40 (19.05%) patients in category 3, 40 (19.05%) patients in category 4, and 48 (22.86%) patients in category 5.Forty-three (20.48%) patients had a final VA of 20/40 or greater, all of whom were in category 5. No patients in category 1 could achieve a VA of 20/40 or greater. Of the 35 (16.67%) patients who had no perception of light in follow-up visits, 28 were from category 1 and 7 were from category 2.
Conclusions:
Ocular trauma score has good prognostic significance if other interventions such as proper evaluation, early surgery, and proper follow-up can be ensured.
