Ocular Manifestations In Head Injury

OCULAR MANIFESTATIONS IN

HEAD INJURY

By –Dr. Ashwini SonkambleUNDER THE GUIDANCE –

DR. V. M. SAHASRABUDHE SIR

INTRODUCTION Incidence Of Head injury Increasing With

Urbanization And Vehicular congestion. ALCOHOLISM is common risk factor. NEGLIGENCE to the wear of HELMET. POOR maintenance of road. Every Min Accident And Every 8min Death Head Injury Is Often Associated With Ocular

Injury. Clinical correlation important in early

localization of site, prompt, assessment, management and for good prognosis .Hence he study was under taken

AIMS AND OBJECTIVES TO STUDY THE INCIDENCE,TYPES OF

OCULAR INJURY ,PROGNOSIS, IN HEAD INJURY PATIENTS.

TO STUDY CAUSES OF VISUAL LOSS IN CASE OF HEAD INJURY PATIENTS.

STUDY DESIGN Hospital based,Prospective,Observational,non-

interventional study Dept. of Ophthalmology, Dr. S.C.GMC,Nanded Institutional ethical committee approved Duration- 18 months from Nov.2014 to May 2016

PATIENTS OF ALL AGES BOTH SEXES ATTENDING CASUALTY ,SURGERY

OPD ,IPD,REFERRED CASES OF HEAD INURY TO THE DEPARTMENT OF OPHTHALMOLOGY DR S C GMC NANDED

INCLUSION CRITERIA EXCLUSION CRITERIA

MATERIALS AND METHODS

OBSERVATIONS

without ocular 32%

ocular68%

Head Injury Patients

AGE VARIATION

age groups01020304050607080

3

24

80

4427

184

0-10 11--20 21-30 31-4041-50 51-60 61 & over

ETIOLOGY

54%33%

12%1%

Etiology

RTAAssualtFallsMisc

97%

3%

Gender Variationmale (193)

GENDER VARIATION Male -193 Female - 6

0

25

50

75

100100

27 88

24 4

Ocular Manifestations

Lid ecchymosis & subcon-junctival hemorrhage(50%)

Pupillary finding(13.5)

Papilloedema(4%)

Ocular nerve palsy(4%)

Fracture orbit(12%)

Traumatic optic neuropa-thy(2%)Ocular manifestations

Num

ber

of p

atie

nts

DISCUSSION Ocular manifestations -136of the 200 (68%

of study population LID Ecchymosis most common finding. Pupillary findings-site , severity,prognosios. Aids in localizing site of supratentorial

herniation, EDH,SDH AND PONTINE lesions 15 patients BOTH PUPIL DILATED 4 UNILATERAL PUPIL DILATED 2 ANISOCORIA 1 UNILATERAL CONSTRICTED 4 RAPD

CONTINUE Papillodema -8 patients 6patients with

bilateral 2 with unilateral Cranial nerve palsy -2patients of 3rd Nerve 1 Patient -6th nerve 4patients-7th nerve –FRACTURE temporal bone 1Patient 4th nerve TRAUMATIC OPTIC NEUROPATHY –CAUSE was

INDIRECT OPTIC NERVE INJURY-4patients Ptosis -2 patients not of NEUROGENIC but

direct injury lid . AUTOENUCLEATION WAS EVIDENT IN ONE

CASE

SUMMARY MOST COMMON CAUSE OF HEAD INJURY

ROAD TRAFFIC ACCIDENT.(54%) MOST COMMON MANIFESTATION INJURY TO

SOFT TISSUE ADNEXA(ECCHYMOSIS).(50%) SECOND MOST COMMON PUPILLARY

ABNORMALITIES. (11.5%) MOST COMMONLY AFFECTED AGE

GROUP(21-30 years) 80% TRAUMATIC OPTIC NERUROPATHY

COMMON CAUSE OF VISUAL LOSS AFTER HEAD INJURY.(2%)

REFERENCESLIST OF REFERENCES

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