Ocular trauma score at the initial evaluation of ocular trauma.
BACKGROUND
The system for classifying mechanical injuries of the eye can identify the status of an injured eye at the trauma room, but it has no prognostic value. The ocular trauma score (OTS) estimates the 6-month visual prognosis, but some of its variables require evaluation by an ophthalmologist. We identified the proportion of injured eyes without diseases that required assessment of an ophthalmologist during the initial evaluation in order to determine whether the OTS could be used by non-ophthalmologists at the trauma room.


METHODS
We evaluated patients with ocular trauma who attended a general hospital in Mexico City between 1995 and 2008 and graded them with the system for classifying mechanical injuries of the eye. The rate of eyes with retinal detachment and endophthalmitis that needed evaluation by an ophthalmologist was identified, and all the eyes were assigned an OTS category. The proportion and 95% confidence intervals (95% CI) of eyes that could be graded using the OTS in a trauma room was determined.


RESULTS
We evaluated 742 eyes. Retinal detachment was found in six eyes (0.8%, 95% CI 0.16-1.44) and endophthalmitis in two eyes (0.3%, 95% CI 0-0.69). The proportion of eyes that could be graded using the OTS in a trauma room was 98.9% (95% CI 98.15-99.65).


CONCLUSIONS
OTS can be used to estimate the visual prognosis of almost every injured eye during the initial evaluation in a trauma room without the evaluation of an ophthalmologist.
Lima-Gómez
Virgilio
V
Hospital Juárez de México, D.F., Mexico.
Blanco-Hernández
Dulce Milagros Razo
DM
Rojas-Dosal
José Adrián
JA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005131:Eye Injuries / Q000175:diagnosis*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D055815:Young Adult