title: Prevalence of ocular and orbital injuries in polytrauma patients.
abstract: BACKGROUND
  Polytrauma patients usually suffer from both life-threatening injuries, where early intervention is mandatory in order to prevent mortality from uncontrollable haemorrhage-especially during the "golden hour", and secondary injuries of lower priority which receive delayed referral or treatment. Non-life-threatening injuries can sometimes be overlooked and so remain untreated until a much later stage. The aim of this study was to investigate the incidence of eye (ocular and orbital) injuries in polytrauma (injury severity score >15) patients and describe their complexities and outcomes.
  
  
  METHODS
  Over a 10-year period (1991-2001), all polytrauma patients admitted in our institution were evaluated. Patients with ocular and orbital injuries were identified and their records were retrospectively analyzed.
  
  
  RESULTS
  Out of a total of 2,985 polytrauma patients, 222 (7.5%) met the inclusion criteria. Forty-one case notes were not retraceable. The files of 181 patients were therefore available for review. The mean age of this group of patients was 33 years (3-84) with a sex ratio (male: female ratio) 5:1. The types of eye injuries encountered were orbital wall fractures (61%), periorbital swelling or hematoma (46%), sub-conjunctival hemorrhage (23%), periorbital lacerations (22%), optic nerve trauma (11%) and penetrating eye injuries (6%). Visual impairment resulted in about 67% of survivors, including loss of eye in 24%. Diplopia requiring intervention was seen in 24% of the cases.
  
  
  CONCLUSIONS
  Polytrauma patients are at high risk for vision-threatening injuries, and an early multidisciplinary approach is essential for early detection and treatment.
authors.affiliation: Ophthalmology Department, St James's University Hospital, Leeds, UK.
authors.forename: T
authors.initials: T
authors.lastname: Georgouli
authors.affiliation: Academic Department of Trauma and Orthopaedics School of Medicine, University of Leeds, Leeds, UK.
authors.forename: I
authors.initials: I
authors.lastname: Pountos
authors.affiliation: Ophthalmology Department, St James's University Hospital, Leeds, UK.
authors.forename: B Y P
authors.initials: BY
authors.lastname: Chang
authors.affiliation: Academic Department of Trauma and Orthopaedics School of Medicine, University of Leeds, Great George Street, Leeds, LS1 3EX, UK. pgiannoudi@aol.com.
authors.forename: P V
authors.initials: PV
authors.lastname: Giannoudis
keywords: Eye injuries; Orbital fractures; Polytrauma; Visual impairment
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