Chapter 3 In cases of serious eye trauma, it is invaluable for both patient and ophthalmologist to obtain, as early as possible, reliable information regarding the expected outcome of the injury. Unfortunately, no comprehensive method is available to calculate objectively the eye’s functional prognosis.
THE OTS: PREDICTING THE FINAL VISION IN THE INJURED EYE
| Variable | Prognostic Value (references) | No Prognostic Value (references) | ||
|---|---|---|---|---|
| Age | 1–3 | 4 | ||
| Cause of injury | 5–7 | 8 | ||
| Endophthalmitis | 9 | 10 | ||
| Extent of wound | 5, 7, 9, 11–15 | 16 | ||
| Facial fracture | 8 | 17 | ||
| Hyphema | 4, 18 | 1 | ||
| initial visual acuity | 1–4, 9, 10, 12, 14, 15, 19–22 | 11, 23, 24 | ||
| injury type | 2, 12, 13, 19–21, 25–27 | 4, 11, 23 | ||
| IOFB | 16, 23, 26 | 12, 14 | ||
| IOFB location | 22, 23 | 1 | ||
| Laterality of eye injured | 8 | 17 | ||
| Lens injury | 3, 4, 11, 12, 18, 21 | 1, 16 | ||
| Lens: absence | 9 | |||
| Lens: presence | 28 | |||
| NLP initial vision | 6, 29 | 30, 31 | ||
| Perforating injury | 12 | 23 | ||
| Retinal detachment | 1, 14, 16, 19, 24, 32 | 33 | ||
| Sex | 34 | 2, 4 | ||
| Tissue prolapse | 4, 9, 19, 22 | 1 | ||
| VEP, ERG | 14, 35 | 30, 31 | ||
| Vitreous hemorrhage | 4, 6, 12, 16, 19, 21, 27 | 1 | ||
| Wound location | 3, 6, 9, 11, 12, 19–21, 27, 32 | 1, 10, 14 |
• Several variables have been found to have predictive value in certain published reports, only to be described in other studies as not having any impact on the outcome (Table 3–1).
• In addition, even among studies finding a factor to have prognostic significance, the cutoff values are controversial (Tables 3–2 and 3–3).
• Finally, individual factors such as the type of surgery should also be taken into consideration (Table 3–4).
| Length (mm) | References | |
|---|---|---|
| 2 | 21 | |
| 3 | 11 | |
| 4 | 10 | |
| 5 | 36 | |
| 6 | 7, 16 | |
| 9 | 9, 17 | |
| 10 | 2, 5, 12, 13, 21, 24 | |
| 11 | 15 | |
| 12 | 4, 14 | |
| 15 |
