Prognostic value of Ocular Trauma Score and pediatric Penetrating Ocular Trauma Score in predicting the visual prognosis following ocular injury

Aim: To assess the role of Ocular Trauma Score (OTS) and Pediatric Penetrating Ocular Trauma Score (POTS) in predicting visual prognosis following ocular injury. Methods: 120 patients, aged 3 to 70 years, with ocular injury, presenting between August 2020 and 2021, who fulfilled the inclusion criteria, were classified using the Birmingham Eye Trauma Terminology System (BETTS). Data regarding age, sex, injury type, location, initial visual acuity, and treatment were recorded. Patients were evaluated using OTS and POTS, wherever applicable, to predict visual prognosis. Follow-up was done for 6 months post-treatment to compare the predicted and actual visual outcome. Results: 120 patients (96 males and 24 females) were included in the study. The mean age was 17.2 ± 14.7 years (range 3 to 70 years). 91.6% patients included were under the age of 40 years. Blunt trauma (n=62) was slightly more common. 80 patients (66.67%) reported to the hospital after 48 hours of injury. 34 patients (28.33%) had traumatic cataract alone and IOL implantation was done as a primary procedure. In 20 patients (16.67%), lens aspiration was done primarily, with secondary IOL implantation. Six months after the treatment, the BCVA in the open globe injury patients was 20/ 200 or better in 36 patients (75%) and 20/ 40 or better in 18 patients (37.5%). Amongst the closed globe injuries, 48 patients (66.67%), had a BCVA 20/ 200 or better, while 32 (44.44%) had a BCVA of 20/ 40 or better. Conclusion: OTS is a reliable predictor of final visual outcome, both in blunt and penetrating injuries. The POTS shows gross underestimation of final visual outcome. Abbreviations: BETTS = Birmingham Eye Trauma Terminology System, POTS = Pediatric Penetrating Ocular Trauma Score, OTS = Ocular Trauma Score, OGI = Open Globe Injury, HM = Hand Movement, NLP = No Light Perception, LP = Light Perception, CGI = Closed Globe Injury, VA = Visual Acuity, BCVA = Best Corrected Visual Acuity, IAP = Indian Academy of Pediatrics, IOL = Intraocular Lens, IGATES = International Globe and Adnexal Trauma Epidemiology Study, IOP = Intraocular Pressure, CART = Classification and Regression Tree, USA = United States of America