Pattern and Clinical Profile of Ocular Trauma Presenting to a Tertiary-Care Hospital: A Retrospective Observational Study

Abstract

Background: Ocular trauma remains an important and potentially preventable cause of visual morbidity. Its clinical spectrum ranges from relatively limited closed-globe injury to open-globe trauma with profound visual loss, making early injury classification and prognostic assessment clinically relevant.

Objective: To describe the demographic and clinical pattern of ocular trauma and evaluate the relationship of injury type and Ocular Trauma Score (OTS) category with recorded visual outcome.

Methods; This retrospective observational study analysed 44 patient-level records of mechanical ocular trauma. Age, sex, laterality, injury type and subtype, zone, mechanism, presenting visual acuity, OTS category, anterior and posterior segment involvement, surgery, final visual acuity, and outcome were evaluated. Three bilateral cases were retained as single patient-level observations because only one composite trauma record was available per patient. Categorical variables were summarised as frequencies and percentages. Sparse contingency tables were assessed using Fisher-Freeman-Halton exact tests with Monte Carlo estimation; OTS and ordered outcome were examined using Spearman rank correlation.

Results: Mean age was 38.09 ± 13.37 years and 35 (79.5%) patients were male. Closed-globe injury (CGI) occurred in 30 (68.2%) and open-globe injury (OGI) in 14 (31.8%). Industrial trauma was the leading mechanism (12, 27.3%), followed by road traffic accidents (8, 18.2%). OGI patients were younger than CGI patients (median 28.0 versus 44.5 years; Mann-Whitney U=342, p<0.001). Good, moderate, and poor outcomes were recorded in 14 (31.8%), 20 (45.5%), and 10 (22.7%), respectively. Poor outcome occurred in 10/14 (71.4%) OGI patients and in none of the 30 CGI patients (p<0.001). OTS category correlated strongly with ordered outcome (Spearman rho=0.880, p<0.001).

Conclusion: Ocular trauma in this series predominantly affected males, with closed-globe injuries being more common overall. Industrial injury and road traffic accidents were prominent mechanisms. Open-globe injury was concentrated in younger patients and was associated with substantially poorer visual outcome. OTS showed a strong graded relationship with outcome and may support early prognostic counselling when interpreted alongside the clinical examination.