Ocular Manifestations In Head Injury
-
Upload
dr-jagannath-boramani -
Category
Healthcare
-
view
59 -
download
0
Transcript of 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
1) AR Kulkarni, SP Aggarwal, RR Kulkarni, MD Deshpande, PB Walimbe and AS Labhsetwar. Ocular Manifestations of Head Injury: A Clinical Study. Eye 2005;19:1257-1263.
2) TO Odebode, DS Ademola-Popoola, TA Ojo and AA Ayanniyi. Ocular and Visual Complications of Head Injury. Eye 2005;19:561-566.
3) Baker RS, Epstein AD. Ocular motor abnormalities from head Trauma. Surv Ophthalmol 1991;35:245-267.
4) Kowal L. Ophthalmic manifestations of head Injury. Austra New Zealand J Ophthalmol 1992;20:35-40.
5) Pollard ZF. Accomodative esotropia after ocular and head Injury. Am J Ophthalmol 1990;109:195-198.
6) Keane JR. Neurologic eye signs following motorcycle accidents. Arch Neurol 1989;46:761-762.
7) Raju N. Ocular manifestations in head injuries. Indian J Ophthalmol 1983;31:789-792.