15) patients and describe their complexities and outcomes.MATERIALS AND METHODS: Over a 10-year period (1991-2001), all polytrauma patients admitted in our institution were evaluated. Patients with ocular and orbital injuries were identified and their records were retrospectively analyzed.RESULTS: Out of a total of 2,985 polytrauma patients, 222 (7.5%) met the inclusion criteria. Forty-one case notes were not retraceable. The files of 181 patients were therefore available for review. The mean age of this group of patients was 33 years (3-84) with a sex ratio (male: female ratio) 5:1. The types of eye injuries encountered were orbital wall fractures (61%), periorbital swelling or hematoma (46%), sub-conjunctival hemorrhage (23%), periorbital lacerations (22%), optic nerve trauma (11%) and penetrating eye injuries (6%). Visual impairment resulted in about 67% of survivors, including loss of eye in 24%. Diplopia requiring intervention was seen in 24% of the cases.CONCLUSIONS: Polytrauma patients are at high risk for vision-threatening injuries, and an early multidisciplinary approach is essential for early detection and treatment." />
Display options
Share it on

Eur J Trauma Emerg Surg. 2011 Apr;37(2):135-40. doi: 10.1007/s00068-010-0029-6. Epub 2010 Jun 12.

Prevalence of ocular and orbital injuries in polytrauma patients.

European journal of trauma and emergency surgery : official publication of the European Trauma Society

T Georgouli, I Pountos, B Y P Chang, P V Giannoudis

Affiliations

  1. Ophthalmology Department, St James's University Hospital, Leeds, UK.
  2. Academic Department of Trauma and Orthopaedics School of Medicine, University of Leeds, Leeds, UK.
  3. Academic Department of Trauma and Orthopaedics School of Medicine, University of Leeds, Great George Street, Leeds, LS1 3EX, UK. [email protected].

PMID: 26814952 DOI: 10.1007/s00068-010-0029-6

Abstract

INTRODUCTION: Polytrauma patients usually suffer from both life-threatening injuries, where early intervention is mandatory in order to prevent mortality from uncontrollable haemorrhage-especially during the "golden hour", and secondary injuries of lower priority which receive delayed referral or treatment. Non-life-threatening injuries can sometimes be overlooked and so remain untreated until a much later stage. The aim of this study was to investigate the incidence of eye (ocular and orbital) injuries in polytrauma (injury severity score >15) patients and describe their complexities and outcomes.

MATERIALS AND METHODS: Over a 10-year period (1991-2001), all polytrauma patients admitted in our institution were evaluated. Patients with ocular and orbital injuries were identified and their records were retrospectively analyzed.

RESULTS: Out of a total of 2,985 polytrauma patients, 222 (7.5%) met the inclusion criteria. Forty-one case notes were not retraceable. The files of 181 patients were therefore available for review. The mean age of this group of patients was 33 years (3-84) with a sex ratio (male: female ratio) 5:1. The types of eye injuries encountered were orbital wall fractures (61%), periorbital swelling or hematoma (46%), sub-conjunctival hemorrhage (23%), periorbital lacerations (22%), optic nerve trauma (11%) and penetrating eye injuries (6%). Visual impairment resulted in about 67% of survivors, including loss of eye in 24%. Diplopia requiring intervention was seen in 24% of the cases.

CONCLUSIONS: Polytrauma patients are at high risk for vision-threatening injuries, and an early multidisciplinary approach is essential for early detection and treatment.

Keywords: Eye injuries; Orbital fractures; Polytrauma; Visual impairment

References

  1. J Trauma. 1993 Feb;34(2):223-6 - PubMed
  2. Br J Ophthalmol. 1987 Dec;71(12):938-42 - PubMed
  3. Surv Ophthalmol. 1994 May-Jun;38(6):487-518 - PubMed
  4. Surv Ophthalmol. 2001 Nov-Dec;46(3):234-42 - PubMed
  5. Klin Monbl Augenheilkd. 1999 Nov;215(5):287-93 - PubMed
  6. Injury. 2004 Apr;35(4):407-10 - PubMed
  7. Ophthalmology. 1999 Sep;106(9):1847-52 - PubMed
  8. Eye (Lond). 2001 Feb;15(Pt 1):75-81 - PubMed
  9. J R Soc Med. 1984 Mar;77(3):198-200 - PubMed
  10. Graefes Arch Clin Exp Ophthalmol. 2000 Feb;238(2):153-7 - PubMed
  11. J Trauma. 2005 Jul;59(1):169-74 - PubMed
  12. Emerg Med J. 2006 Dec;23(12):915-7 - PubMed
  13. Injury. 1972 Aug;4(1):79-80 - PubMed
  14. Klin Monbl Augenheilkd. 2000 Jul;217(1):23-9 - PubMed
  15. Ophthalmic Epidemiol. 2005 Jun;12(3):185-90 - PubMed
  16. J Trauma. 1999 Mar;46(3):494-9 - PubMed
  17. Am Surg. 1999 Aug;65(8):790-3 - PubMed
  18. Ophthalmology. 1995 Nov;102(11):1696-701 - PubMed

Publication Types