Abstract :
Purpose: To assess clinically the ocular manifestations and correlate them with neurological findings in patients with closed head injury.
Study Design: Prospective study.
Materials and Methods: The study included 150 patients from three different teaching institutes with closed head injury who after assessing the severity of head injury with the Glasgow coma scale (GCS) and Revised Trauma Score (RTS) were subjected for detailed ocular examination at the earliest possible. Later the findings were charted. Patients were managed by multidisciplinary approach when needed. Conclusion: Out of 150 head injury patients 136 were male (91%) 14 were female (9%). Age ranged from 7 years to 60 years with a mean of 30.12 years. The common age group being the young adults and common mechanism being the road traffic accident 90 patients out of 150 (60%) leading to head injury and ocular manifestations. 102 patients (68%) out of 150 patients had ocular manifestations. The commonest ocular injury being the soft tissue injury with abrasions and lacerations around the globe involving ocular adnexae. The commonest form of neuro ophthalmological manifestation noted was traumatic optic neuropathy also affecting the pupillary reaction. When patients outcome was compared to ocular manifestations a statistically significant association was noted (p value 0.0026). There was also correlation of GCS and ocular signs with the outcome. Patients had a poor visual outcome who had abnormal papillary reaction (RAPD) or involvement of optic nerve (traumatic optic neuropathy) or 6th nerve palsy. All patients who died in the study had some form of ocular involvement. Ocular manifestations along with GCS, RTS may act as significant predictor of final outcome.
Keyword :
Traumatic optic neuropathy (TON), Closed head injury, Neuro ophthalmic manifestations, GCS, RTS.