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Incidence of Ocular injuries in patients with Maxillofacial Trauma at Government Medical College and Hospital, Nizamabad, Telangana, India: A Prospective Study

Kamran Bokhari Syed, Atul Gupta.




Abstract
Cited by 0 Articles

Introduction:
Background Maxillofacial trauma and ocular injuries almost always co-exist and are considered as crossroads for inter-disciplinary branches of Maxillofacial Surgery, Ophthalmic Surgery and Neurosurgery. Ocular injuries can manifest from simple lid laceration and peri-orbital oedema to extensive injury leading to blindness. The complex osseous and soft tissue anatomy of the orbit and the potential for ocular injuries requires a multidisciplinary approach. Effective and efficient treatment protocol at the level of triage itself helps in establishing proper treatment protocol. Patients with facial trauma with co-existing ocular injuries are best examined in the first few hours of arrival at the hospital before oedema sets in.

Aim & Objectives: This paper aims to highlight the Incidence of Ocular injuries in patients with Maxillofacial Trauma.
Material & Methods: This is a cross-sectional study with a descriptive analysis of the data. Demographic data included gender, age group, the region from where the patient was represented. . Demographic data included gender, age group, the region from where the patient represented. The clinical presentation of the ocular injury associated with maxillofacial trauma, aetiology, was assessed in the study. Every patient was assessed by a senior ophthalmologist and maxillofacial surgeon. Ophthalmic evaluation for the diagnosis of ocular injuries include a) assessment of visual acuity b) Visual acuity test using Snellen chart c) Assessment of direct and indirect light reflexes d) Neuro-sensory disturbances along with the distribution of the infraorbital nerve. Apart from these, clinical findings of the ocular and peri-orbital areas were examined and documented. These included a) peri-orbital oedema b) Sub-conjunctival haemorrhage c) chemosis d) Lacerations e) Enopthalmus f) Proptosis g) Ptosis h) Retrobulbar haemorrhage
The findings were being represented as frequency tables and percentages and results presented as tables and graphs
Inclusion Criteria: All patients presenting with maxillofacial trauma with or without associated injuries were included in the study.
Exclusion Criteria:
1. Patients reporting for maxillofacial surgeries for cosmetic improvement
2. Patients with Dento-facial deformities indicated for Orthognathic surgery
3. Old cases of fractures with malunion and non-union
4. PatientÂ’s treated elsewhere and referred to our centre for secondary surgeries or for inter-maxillary fixation removal.
Discussion & Conclusion:
1. Majority of the ocular injuries in our study were in the third and fourth decades of life and males had a higher incidence of ocular injuries than females in all age groups.
2. Peri-orbital oedema and sub-conjunctival ecchymosis were the significant clinical findings in this present study. None of the patients developed blindness
3. Zygomatico-maxillary complex group were the predominant one with ocular manifestations as compared to le-fort fractures.
4. Road traffic accidents were the major etiological factor in causing ocular injuries followed by inter-personal assault.

Key words: Pattern of fracture, maxillofacial injuries, Alcohol






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