Ocular Manifestations in Head Injury at SSIMS&RC

To determine the prevalence and pattern of ophthalmic manifestations in patients with head injury and the outcome in patients with neuro-ophthalmic manifestations. Methods This prospective study provides a complete assessment of all patients with head injury having associated ophthalmic manifestations. It includes the signs and symptoms following head injury, initial examination with torch light and bedside visual acuity then a detailed assessment with Snellenss acuity chart and slit lamp biomicroscope. Intraocular pressure and gonioscopy performed wherever necessary. Fundus examination done with direct, indirect ophthalmoscopy. CTscan was done. Patients were managed accordingly and wherever needed surgical intervention was considered. Results In this study of 63 cases of head injury, 48 cases had ocular involvement. Young adult males were more vulnerable to head injury (21-30 years (44.4 %)). Road traffic accident was the most common cause of head injury in 56cases (88.8 %). The ocular manifestations observed in 63 cases included soft tissue injuries- periorbital ecchymosis in 25 cases (39.7 %) and subconjunctival haemorrhage in 17cases (27 %). Neuro-ophthalmic abnormalities in 22cases (34.9 %), pupillary involvement in 12 cases (19 %) being most common, fracture of orbit in 10 cases (15.9 %), globe rupture in 1 case (1.5 %). CT scan showed extradural hemorrhage and diffuse cerebral edema in 9 cases (14.3 %) respectively. GCS was assessed of all patients and head injury was classified accordingly. Conclusion Injury to the globe and adnexae and constitute the most common oculovisual complications following head injury in our centre. The GCS, Neurodeficit and ocular signs contribute significantly to the prediction of outcome.