Clinical findings provide criteria to evaluate priorities of ophthalmologic intervention in conscious multiple trauma patients

Vahdati, Samad Shams; Gholipour, Changiz; Jalilzadeh-Binazar, Mehran; Moharamzadeh, Payman; Sorkhabi, Rana; Jalilian, Respina

doi:10.1016/j.injury.2014.10.056

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…32 Utilising their assessment, emergency physicians are required to determine the need for urgent ophthalmology review. 22,30 Georgouli et al retrospectively reviewed all multi-trauma patients admitted to St James University Hospital in Leeds, United Kingdom, over 10 years. 8 Motor vehicle accidents and falls were common MOI frequently associated with head, facial and ocular injuries.…”

Section: Ocular Traumamentioning

confidence: 99%

“…Therefore, to improve patient care and prevent missed injuries, a guideline would be beneficial to highlight suspicious symptoms and signs allowing for urgent assessment. 8,19,20,22,23,26,29,37 Where delayed ophthalmic examination occurs, changes within the clinical picture can cause or further exacerbate ocular injuries. 7 The Advanced Trauma and Life Support report discusses the numerous factors within trauma management that affects ocular injuries.…”

Section: Ocular Traumamentioning

confidence: 99%

“…34 Likewise, integrating ophthalmology would allow for specialist knowledge and expertise in the assessment and grading of ocular injury. 22 The need for referral may be complicated by the inability for thorough examination due to patient instability or life-threatening conditions 19,30 ; however, it is important that specialist involvement does occur when there is ocular or adnexal involvement to recognise ocular injury and in turn decreases the risk of missed injuries. 20,22,31…”

Section: Ocular Trauma In Australiamentioning

confidence: 99%

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Integration of ophthalmology in ocular trauma to improve patient care: A narrative review

Bartimote

Fraser

Watson

2021

Trauma

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Introduction Ocular trauma can cause significant morbidity and is a leading cause of unilateral blindness. In multi-trauma, life- and sight-threatening injuries can co-occur causing increased complexity in the assessment and management of ocular injuries as the competing priorities in the severely injured must be balanced. We conducted a narrative review to determine how ophthalmology may be further integrated into a trauma service and/or the organisation of an ocular trauma service. Methods The literature was reviewed via EMBASE, MEDLINE, CINAHL and Google Scholar utilising comprehensive search strategies and keyword searches. Our review was conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Results The search yielded 437 articles, 30 studies met selection criteria and were included in the review. The included literature comprised guidelines, observational studies and reviews of registry data from Australia, England, the United States, Singapore, Iran and Israel. Conclusion The Australian Trauma Model has clear guidelines for referral of trauma patients to ensure appropriate care of the severely injured. However, there are no clear guidelines for the integration of ophthalmology into trauma. Therefore, early referral to ophthalmology and streamlining of referral pathways of specialist care would improve the care of patients with ocular trauma.

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Section: Ocular Traumamentioning

confidence: 99%

Section: Ocular Traumamentioning

confidence: 99%

Section: Ocular Trauma In Australiamentioning

confidence: 99%

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Integration of ophthalmology in ocular trauma to improve patient care: A narrative review

Bartimote

Fraser

Watson

2021

Trauma

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“…A traumatic head injury is the main etiology of neuro-ophthalmic injuries. Eye Injuries are classified into blunt injuries, perforating injuries, injuries by foreign bodies and chemical injuries [3,4,5].…”

Section: Introductionmentioning

confidence: 99%

Computed tomography estimation of the prevalence of neuro-ophthalmic injuries in head trauma patients seen in a tertiary health facility in Ghana

Gorleku

Edzie

Dzefi-Tettey

et al. 2020

Heliyon

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Prevalence of traumatic brain injury (TBI) is extremely high and potentially associated with severe incapacitating consequences. Literature reports that 90% of road traffic deaths and injuries including TBI occur in low and middle-income countries including Ghana. Computed Tomography (CT) scan is the imaging modality of choice for the initial assessment of the extent of head injury. Some Neuro-ophthalmic injuries (NOI) may sometimes be ambiguous and indistinct although a serious injury with potential damaging consequences. Data on the prevalence of NOI post trauma is non-existent in Ghana to inform policy. The onus therefore lies on the Radiologist who will review the head CT scan to be very meticulous not to miss any NOI if present. We therefore decided to diligently review a large cross-sectional retrospective post trauma head CT scans for occurrence of NOI. Objective: To determine the incidence of NOI secondary to head trauma and the possible loss of vision thereof in a retrospective study using patients' head CT scan data from a tertiary hospital's CT centre in Cape Coast, Ghana. Method: All head CT scans secondary to trauma for the period January 2016 to December 2018, were retrieved and carefully analysed. A total number of 1043 of head CT scan images were analyzed by Consultant Radiologists. Results: Results showed out of 1043 CT scans reviewed, 742 (71,1%) were males and 301 (28.9%) were females. A total of 609 (58.4%) out of the 1043 patients sustained NOIs of various anatomical types. More Males 398 (65.4%) sustained NOI than females 211 (34.6%). The incidence of NOI was more among the youth as majority 167 (27.4%) of the patients were within the 18-29 years followed by 30-39 years bracket of 148 (24.3%). Fourteen anatomical types of NOI were elicited and further analysis revealed, intra-ocular foreign body to be the highest 107 (17.6%) cases, orbital floor fractures injury was 92 (15.1%) cases, with globe rupture injury and intraocular hemorrhage recording 79 (13.0%) cases each. Optic nerve injury was the least revealing 7 (1.1%) cases. There was a relationship between the gender of patient and the propensity to sustain NOI as males were more disposed to NOI than females. Road traffic accident (RTA) was the main pervasive cause of TBI and this accounted for 71.9% of all cases, followed by fall from height 24%, and the least cause of TBI was ascribed to gunshot injury of 0.33%. Conclusion: Prevalence of NOI is high. Urgent measures must therefore be implemented to reduce the RTA menace in general and to mitigate the associated NOI and possible loss of vision thereof.

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Globe and adnexal trauma at Australian trauma centres

Bartimote,

Hoskin,

Fraser

et al. 2024

Injury

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Clinical findings provide criteria to evaluate priorities of ophthalmologic intervention in conscious multiple trauma patients

Cited by 4 publications

References 9 publications

Integration of ophthalmology in ocular trauma to improve patient care: A narrative review

Integration of ophthalmology in ocular trauma to improve patient care: A narrative review

Computed tomography estimation of the prevalence of neuro-ophthalmic injuries in head trauma patients seen in a tertiary health facility in Ghana

Globe and adnexal trauma at Australian trauma centres

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