TY  - JOUR
PY  - 2005//
TI  - Ocular manifestations of head injury: a clinical study
JO  - Eye
A1  - Kulkarni, A. R.
A1  - Aggarwal, S. P.
A1  - Kulkarni, R. R.
A1  - Deshpande, M. D.
A1  - Walimbe, P. B.
A1  - Labhsetwar, A. S.
SP  - 1257
EP  - 1263
VL  - 19
IS  - 12
N2  - 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> 
LA  - en
SN  - 0950-222X
UR  - http://dx.doi.org/10.1038/sj.eye.6701753
ID  - ref1
ER  -