Review of ocular trauma in Tamale Teaching Hospital, Tamale, Ghana

Abstract

Objective: To establish the epidemiologic characteristics, referral pattern, interventions, visual outcomes and complications resulting in visual impairment/blindness among ocular trauma patients in Tamale Teaching Hospital (TTH) Eye Clinic, Tamale, Ghana.

Materials and Methods: This was a retrospective hospital-based case series in which all new patients of all ages with various eye conditions from 1st January to 31st December 2010 were reviewed from the outpatient/inpatient record books and the sex and age recorded. The files/ folders of patients with ocular trauma were selected and retrieved. The epidemiological characteristics, referral pattern, interventions, visual outcomes and complications resulting in visual impairment/blindness among ocular trauma patients were analysed.

Results: A total of 2,027 records of new patients with various eye conditions were retrieved. Three hundred and sixty one (377 eyes) new ocular trauma patients’ files/ folders were analyzed. The Male: Female ratio was 1:1.1 (p=0.09) for all new patients with various eye conditions whilst it was 1.8:1 (p<0.01) for new ocular trauma patients. Ocular trauma patients were younger than general patients with 20 – 29 years age group having most new patients (27.4%) compared with the over 49 years age group for other new cases (23.4%). Approximately 68.4% of the ocular trauma patients were seen at TTH without a referral. Conjunctival lesions were the commonest finding affecting 124(32.9%) of the ocular trauma patients. The majority of patients 88.1% sustained closed globe trauma, 8.3% had adnexal trauma whilst 3.6% had open globe trauma. The commonest intervention rendered was medical treatment alone to 64.4% of the patients. By the WHO classification, majority 67.4% of traumatized eyes had normal vision, 13.9% were visually impaired and 18.7% were blind. Thus, 110 (32.6%) were visually impaired/ blind in the traumatized eye. The commonest complications resulting in visual impairment/ blindness were corneal opacities/ scars in 33(30.0%) cases.

Conclusion: Majority of ocular trauma patients presented with minor injuries which healed without complications. However, ocular trauma was a major cause of monocular blindness and visual impairment. Ocular trauma also tended to affect a younger age group and especially males compared to other eye diseases.