Clinical characteristics and prognostic factors of scleral rupture due to blunt ocular trauma

Abstract

PurposeTo describe and identify ocular and wound characteristics, and prognostic factors associated with final visual acuity (VA) in patients with scleral rupture due to blunt ocular trauma.MethodsThe medical records of 61 patients with globe rupture due to blunt ocular trauma who underwent primary repair were reviewed retrospectively. The data recorded included demographic characteristics, initial and final VA, ocular signs, wound characteristics, and surgeries. Initial VA, ocular signs, wound characteristics, and surgeries were analyzed to determine the association with the final VA.ResultsForty three women and 18 men with a mean age of 43.6±23.5 years were included in the study. The locations of scleral wounds were mostly in the superonasal quadrant (41.0%) and zone 2 (75.4%). In eyes with hyphema (P=0.009), vitreous hemorrhage (P=0.001), and retinal detachment (P=0.004), final VA was statistically worse than eyes without these signs. A moderate positive correlation was found between the initial and final VA (P<0.001). Final VA was statistically worse in eyes with horizontal midline wounds than in eyes with vertical midline wounds (P=0.002). A moderate negative correlation was found between scleral wound length and final VA (P<0.001). Patients who underwent cataract surgery had statistically better final VA (P=0.002).ConclusionsScleral rupture was detected mostly in females, superonasal quadrant and zone 2. Poor final VA was significantly associated with poor initial VA, longer wound length, horizontal midline wound, presence of hyphema, vitreous hemorrhage and retinal detachment at presentation, and cataract surgery not performed during follow-up period. Scleral ruptures have different demographic, ocular and wound characteristics than other open globe injuries.

Globe rupture: a single-center retrospective study of demographic patterns and outcomes

“…In eyes with scleral rupture limited to zone II and zone III, Yucel et al observed that as high as 42.6% of eyes resulted in final vision of NPL. Poor final VA was significantly associated with poor presenting VA, horizontal midline wound, longer wound length, presence of hyphema, vitreous hemorrhage or retinal detachment, and no cataract surgery 29 . In this study, approximately one-fourth (26%) of eyes had NPL.…”

Traumatic Cataract in Children in Eastern China: Shanghai Pediatric Cataract Study

“…Due to the distinct features of ocular injuries, children with penetrating injuries tend to experience a more obvious deterioration in visual acuity 16 , making it easier for parents to notice the penetrating injury and take the child to the hospital at that time. However, the onset of traumatic cataract due to blunt injury tends to be gradual, which might delay proper treatment and result in an unsatisfactory prognosis in many children 20 . In children who mention being hit in the eye, regardless of whether there is immediate vision loss or wounds around the eyeball, parents should closely observe the child’s eye for timely detection of injuries requiring surgical intervention.…”

Risk Factors for Trauma-Related Eviscerations: Analysis of 821 Cases

“…Severe trauma is one of the main causes of evisceration [11, 12]. Analysis of the aforementioned factors may help to develop targeted prevention procedures to reduce the frequency of resorting to this devastating ocular treatment option.…”