Epidemiological study of ocular trauma in an urban slum population in Delhi, India

Abstract

Purpose:To study the epidemiology and clinical profile of victims of ocular trauma in an urban slum population.Materials and Methods:This cross-sectional study, conducted on 500 families each in three randomly selected urban slums in Delhi, collected demographic data for all members of these families, and clinical data for all those who suffered ocular trauma at any time, that required medical attention. Data was managed on SPSS 11.0.Results:Of 6704 participants interviewed, 163 episodes of ocular trauma were reported by 158 participants (prevalence = 2.4%, confidence interval = 2.0 to 2.7) Mean age at trauma was 24.2 years. The association between the age of participants and the history of ocular trauma was significant (P < 0.001), when adjusted for sex, education and occupation. Males were significantly more affected. Blunt trauma was the commonest mode of injury (41.7%). Blindness resulted in 11.4% of injured eyes ( P = 0.028). Of 6704 participants, 1567 (23.4%) were illiterate, and no association was seen between education status and trauma, when adjusted for sex and age at injury. A significant association was noted between ocular trauma and workplace (Chi-square = 43.80, P < 0.001), and between blindness and place (Chi-square = 9.98, P = 0.041) and source (Chi-square = 10.88, P = 0.028) of ocular trauma. No association was found between visual outcome and the time interval between trauma and first consultation (Chi-square = 0.50, P = 0.78), between receiving treatment and the best corrected visual acuity (Chi-square = 0.81, P = 0.81), and between the person consulted and blinding ocular trauma (Chi-square = 1.88, P = 0.170).Conclusion:A significant burden of ocular trauma in the community requires that its prevention and early management be a public health priority.

Viral posterior uveitis

“…33,143,158,159,174,177,180,203 On examination, there may be mild vitritis, areas of retinitis with or without macular star, retinal hemorrhages, retinal edema, multifocal choroiditis, neuroretinitis, and optic neuritis. 33,143,158,159,174,177,180,203 It may morphologically mimic herpetic viral retinitis, but the clinical history (symptoms of fever, joint pain, and rash) can be used to distinguish between the 2. 158 It may also resemble WNV retinitis; however, peripheral fundus lesions and linear chorioretinal streaks seen in WNV retinitis are not present in chikungunya retinitis.…”

“…33,158,159,177 On OCT scan, areas of retinitis are seen as hyperreflective with after shadowing, whereas serous retinal detachment is seen as a hyporeflective area. 158,177 …”

“…158 Systemic corticosteroids have been used to treat inflammation and optic neuritis caused by chikungunya virus infection. 33,143,158,159,174,177,180,203 It is important to institute early therapy once there is onset of optic disk involvement, as a delay in treatment could result in poor visual outcomes. 174 There is no specific antiviral available for chikungunya virus.…”

“…Some patients have been empirically treated with acyclovir, although its efficacy is doubtful. 158,177,180 …”

“…Complications include retinal detachment, central retinal artery occlusion, and optic nerve involvement (papillitis, neuroretinitis optic atrophy, or edema), which may result in severe vision loss in the minority. 33,143,158,159,174,177,180,203 …”