Patterns of Ocular Injuries Following Road Traffic Accidents: A Hospital-Based Study

Background: The objective is to evaluate the epidemiology, type of ocular injury, clinical presentation and visual outcome of the cases who presented for ocular trauma after road traffic accident. Material and Methods: A prospective observational study was undertaken in the department of Ophthalmology at Vijayanagar Institute of Medical Sciences, Ballari, with a study period of 18 months (from January 2021 till June 2022). All 85 patients by all age groups and gender with accident-related eye injuries were included. Detailed demographic and injury-related data were collected such as age, sex, type of protection used, alcohol consumption and when the patient attended. Full ophthalmological examination included Ophthalmoscopy, IOP measurement, anterior segment examination, and visual acuity assessment. When necessary, other tests including ultrasound (B-scan) and computed tomography of the orbit were carried out. Patients were followed up for clinical and visual outcomes. Results: All 85 patients were assessed of which 67% were within the age range of 21-40 years. The male-to-female ratio was 13:1 with males making up 92.9% of the cases. The majority lived in urban areas (57.6%) and only positive measures (8.2%) used were helmets or seat belts. 56% reported drinking alcohol at the time of their injury. injuries to the adnexa of the eyes (58%), followed by anterior segment injuries (29%) and combined anterior and posterior segment (13%) lesions were the most frequently recorded injuries. All patients had injuries of the eyelids, and 42.3% had conjunctival involvement. Closed globe injury was seen in 97.6% while open glob injury was seen in 2.4% of cases. Involvement of the right eye was 52% compared to 41% of the left eye, 7% had both eyes involved. The majority of patients were reported within 24 hours of the injury, and were able to have favourable visual outcomes after proper management. Conclusion: The incidence of road traffic accidents has great impact on ocular morbidity with a high percentage of young adult males. Nearly all injuries are linked with risk factors that can be modified, including the lack of use of protective measures and drinking of alcohol or drugs. The most common patterns of trauma are ocular adnexal or closed globe injuries. Often, the results of a better visual outcome are a combined result of early presentation, prompt diagnosis and timely intervention. Improvement of the road safety infrastructure, compelling the use of helmets and seat belts, and raising awareness of road users are important to decrease the burden of ocular injury due to road traffic accidents.

Keywords: Ocular trauma, Road traffic accidents, Ocular injuries, Closed globe injury, Visual outcome, Eye trauma, Ocular morbidity, Ophthalmology.