title: The role of computerised tomography in predicting visual outcome in ocular trauma patients.
abstract: OBJECTIVE
  Ocular blast injuries in the military setting are particularly associated with significant maxillofacial trauma and/or brain injury. The opportunity to perform a comprehensive ophthalmic evaluation is frequently limited in the acute multiple trauma scenario. We aim to describe the relationship between the clinical effects of acute ocular and orbital blast trauma with the findings on computerised tomography (CT).
  
  
  METHODS
  This was a retrospective consecutive case series of all soldiers with facial and/or suspected ocular injuries. A total of 80 eyes that had suffered blast injuries of varying severity were studied. Assessment of orbital and ocular CT images were performed by military consultant radiologists. A comparison was made with actual clinical findings. Statistical analysis was performed using Fisher's exact test.
  
  
  RESULTS
  No pathological findings were described in 37 of the 80 eyes imaged by orbital and ocular CT scans. Clinically, these eyes and orbits were all found to be intact, or had minor trauma. All foreign bodies and penetrating eye injuries were successfully diagnosed by CT. Absence of an orbital fracture did not rule out a globe injury. However, a corneal or scleral defect was less likely when an orbital fracture was absent.
  
  
  CONCLUSIONS
  The eye is a delicate structure prone to injury that requires urgent repair if breached. It is difficult to assess thoroughly in the unconscious or distressed patient. In this context, CT imaging is invaluable to be able to make a relatively confident prediction of clinical findings and decide upon the necessity for acute ophthalmic surgical intervention.
authors: Department of Ophthalmology, Birmingham and Midland Eye Centre, City Hospital NHS Trust, Birmingham, UK.
authors: R
authors: R
authors: Chaudhary
authors: Department of Ophthalmology, Birmingham and Midland Eye Centre, City Hospital NHS Trust, Birmingham, UK.
authors: M
authors: M
authors: Upendran
authors: Section of Neurotrauma and Neurodegeneration, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK.
authors: N
authors: N
authors: Campion
authors: Department of Ophthalmology, Birmingham and Midland Eye Centre, City Hospital NHS Trust, Birmingham, UK.
authors: A
authors: A
authors: Yeung
authors: Section of Neurotrauma and Neurodegeneration, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK.
authors: R
authors: R
authors: Blanch
authors: Section of Neurotrauma and Neurodegeneration, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK.
authors: P
authors: P
authors: Morgan-Warren
authors: Fort Blockhouse, Defence Centre for Imaging, Gosport, UK.
authors: I
authors: I
authors: Gibb
authors: Royal Centre for Defence Medicine, New Queen Elizabeth Hospital, Birmingham, UK.
authors: T
authors: T
authors: Nelson
authors: 1] Department of Ophthalmology, Birmingham and Midland Eye Centre, City Hospital NHS Trust, Birmingham, UK [2] Royal Centre for Defence Medicine, New Queen Elizabeth Hospital, Birmingham, UK.
authors: R
authors: 0000000198227825
authors: R
authors: Scott
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D001753:Blast Injuries / Q000000981:diagnostic imaging*; D005129:Eye Foreign Bodies / Q000000981:diagnostic imaging*; D015807:Eye Injuries, Penetrating / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008889:Military Personnel; D009917:Orbital Fractures / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D015599:Trauma Severity Indices; D006113:United Kingdom; D014792:Visual Acuity / Q000502:physiology