Ocular trauma among head injury patients at Muhimbili National Hospital Dar es salaam, Tanzania

Abstract

This study was conducted at Muhimbili National hospital neurosurgery department from May 2008 to September 2008. The study population included 212 patients who were diagnosed of head injury during the study period. Main objective was to determine ocular trauma in head injury patient. Patients of all ages and sex were included in this study. Study design. This was a crossection study involving head injury patients. Case note reports were studied regarding causes of head injury and severity of head injury graded on Glascows coma scale as reported by the neurosurgeon. Patients were then thoroughly examined for the presence of eye trauma associated with the head injury. Data were then analysed for age, sex, causes of injury, severity of head injury on admission and associated ocular trauma. Result; Most of the head injury patients were in the middle ages in which 85.6% of the patient were less than 46 years of age. Motor traffic accidents caused highest incidence of head injury (74.1 %) . Majority of the patients had mild head injury accounting to 66%. Incidence of the ocular trauma in the patients was found to be 65.6%. There was an increased incidence of ocular trauma with increasing severity of head injury. Significant statistical association was found between ocular trauma and severity of head injury (X2 = 8.38, P value = 0.004). Lid laceration and lid tear were seen in 31.2% of all head injury patients. Subconjunctiva hemorrhage was found in 25.6% of the patients. Defective ocular motility was seen in 4.2%. Occulomotor nerve palsy was seen in 3.3%, abducent nerve in 0.9% and troclear nerve palsy was in 0.5% of the study population. Traumatic optic neuropathy was seen in 1.4% of the study population.

VI Conclusion; Ocular trauma are commonly associated with head injury. There is increased risk of ocular trauma with increased severity of head injury. Trauma of lid and conjunctiva are frequently seen in head injury than other ocular structures. Recommendations; Patients with severe head injury needs to be reviewed by an Ophthalmologist and study on visual outcome following head injury need to be done.