FP252 : The Birmingham Eye Trauma Terminology: Suggestions for Re-Inforcement

Dr. Ankita Mulchandani, M17408, Dr. Parth Rana,
Dr. Kashyap Patel, Dr. Mehul Ashvin Kumar Shah

INTRODUCTION:

• Ocular trauma is common, preventable yet the most under-recognized major health problem today. Blindness due to injury is a social and economical burden for every individual. Optimizing visual outcome in ocular injury requires prompt diagnosis and treatment. ^1,2,
• With the introduction of the Birmingham Eye Trauma Terminology System (BETTS), the documentation of ocular trauma has been standardized.⁴
• In practice, BETT only concerns mechanical eyeball injury. As a result, eye lid, orbital and ocular adnexa injury cannot be classified by BETT, although part of orbital and ocular adnexa injuries associated with globe injury can be categorized into globe injury by BETT, this classification is still incomplete and misses some information. BETT was proposed 12 year before so it needs some additional information regarding eye lid, orbital and ocular adnexal injuries. ^5,6

AIM:

To implement modification in Birmingham Eye Trauma Terminology System classification for ocular trauma.

MATERIALS AND METHODS:

Study Design:

• Prospective And Retrospective Cohort Study.
• All patients with ocular trauma in either eye, diagnosed  and  managed  between  January 2002 to December 2015 at Drashti Netralaya,  Dahod  were included in the  study, and  patients  consenting to participate were included.

Inclusion Criteria:

• All patients coming to Drashti Netralaya with ocular trauma.

Exclusion Criteria:       

• Severe trauma to other body parts.
• Patient with ocular trauma, already treated for the same in any other hospital.

Sample size:

• 4721

RESULTS:

• Of 4721 eyes that suffered mechanical injuries, 1335 (28.2%) eyes could not be classified with BETTS. These include 345 globe injuries (7.5%) associated with orbital, eye lid, extra ocular muscles and lacrimal injury termed as periocular injuries; 715 eyes (15.1%) with ocular surface foreign body (OSFB) or ocular wall foreign body (IMFB) or periocular foreign bodies; 77(1.6%) eyes  with contusion, 9(0.19) eyes  with lamellar laceration associated OSFB or OWFB, 29 eyes (0.6%) with globe rupture associated OSFB, OWFB or intraocular foreign body (IOFB), and 60 eyes (1.4%) with laceration associated OSFB or OWFB.

DISCUSSION:

• Ocular trauma is believed to be one of the significant cause of visual impairment. It can cause a wide variety of damage to the ocular tissues.
• Trauma generally occurs in the younger age group and in males who are commonly involved in outdoor activities. It is comparatively rare in old age and in females. Most of the people sustain injuries during work, which in a rural setup includes agricultural activity most commonly.
• Trauma can cause a variety of damage to the ocular tissues. This damage can involve both the anterior and posterior segment. The damage can be relatively mild or can be very severe, leading to loss of vision. In mild cases, medical management is sufficient whereas in severe cases, early surgical intervention such as paracentesis, globe repair and vitrectomy is required to restore some useful vision.

CONCLUSION:

• Standardized international classification of mechanical eyeball injury proposed by BETT considering incomplete, we propose a new classification of mechanical eye injuries. This classification nearly includes all mechanical eye injuries to makes epidemiological study and clinical records easier.