Epidemiological Profiling of Mechanical Ocular Trauma and Analysis Using Proposed New Classification for Ocular Adnexal Injuries

OBJECTIVES: Mechanical ocular trauma can result in wide spectrum of injuries with varying levels of severity. A complete ophthalmic examination is important to achieve a thorough evaluation and provide optimal management. The ocular adnexa play a significant role in the protection of the globe via various mechanisms. Open and closed globe injuries directly affect the visual outcome. Although adnexal injuries may not affect the vision directly, they can lead to severe ocular morbidity in terms of a cosmetic blemish, watering, a long healing period, severe complications, or permanent disfigurement. Currently, there is no appropriate classification of adnexal injuries. This study examined the causes, and effects of adnexal injuries to prepare a new classification system for adnexal injuries. METHODS: A retrospective study of ocular injuries was conducted at a tertiary care center in Gwalior, India. The data of 600 mechanical ocular trauma patients were analyzed and the demographic details, mode of injury, type and sub-type of ocular injury were recorded. The injuries were divided into open and closed globe injuries using the Birmingham Eye Trauma Terminology classification system. Adnexal injuries were categorized by type and sub-type using a proposed classification system. RESULTS: Among the 600 cases, there were 34 closed globe injuries, 26 open globe injuries, and 540 adnexal injuries. Only 10% of the cases could be classified using the conventional classification system. CONCLUSION: The existing classification system is not optimally comprehensive; the majority of the cases could not be categorized. A more detailed framework of classification of adnexal injuries will facilitate better assessment and management.