@article{ref1,
title="Ocular manifestations of head injury: a clinical study",
journal="Eye",
year="2005",
author="Kulkarni, A. R. and Aggarwal, S. P. and Kulkarni, R. R. and Deshpande, M. D. and Walimbe, P. B. and Labhsetwar, A. S.",
volume="19",
number="12",
pages="1257-1263",
abstract="AIM: This prospective study aimed to clinically correlate the various ocular findings with the neurological status in cases of closed head injury. METHODS: A total of 200 consecutive cases of closed head injury admitted to a major teaching hospital underwent a thorough ophthalmic assessment. The Glasgow coma scale (GCS) and the Revised trauma score (RTS) were applied to grade the severity of injury and assess the prognosis. Kendall's tau-b and Fisher's exact test were used in the analysis. RESULTS: The main causes of head injury were road traffic accidents 52.5% followed by assaults in 34%. Ocular involvement was found in 167(83.5%) cases. These included corneal and scleral tears in 2%, subconjunctival haemorrhage or ecchymosis in 46%, orbital fractures 12%, pupillary involvement 6.5%, papilloedema 5.5%, intraocular trauma 5.5%, proptosis 3%, lateral rectus palsy 2%, lacrimal gland prolapse 1%, and optic nerve trauma 0.5%. All 21 patients (10.5%) who died had eye involvement. In all, 150 cases (75%) with a RTS of 12 had a good prognosis. Of these 124 (82.6%) had ocular involvement of no neurological significance. CONCLUSIONS: Although sophisticated imaging techniques are available to localize lesions, early ophthalmic assessment in correlation with the GCS aids in prognosticating outcomes. Pupillary involvement, papilloedema, and ocular motor paresis pointed to a more severe head injury. To our knowledge, this is the only prospective study recording ocular findings in the first few hours and attempting a correlation with the final outcome.<p /><p>Language: en</p>",
language="en",
issn="0950-222X",
doi="10.1038/sj.eye.6701753",
url="http://dx.doi.org/10.1038/sj.eye.6701753"
}