DR. LATHIKA VASU KAMALADEVI

DR. CHARLES KAKKUZHIYIL SKARIAH

Abstract

Methods :Cross sectional analytical study done at a tertiary care teaching hospital (January 2018-October 2019).112 consecutive patients with closed head injury and ophthalmic manifestations on admission, who completed follow up 4 weeks later were included. Severity of head injury was graded using Glasgow coma scale. Detailed ophthalmic evaluation was conducted during admission and repeated one month later. BCVA at 1month was categorised into severe ,moderate and mild/nil .Results: Ophthalmic predictors of poor visual outcome were EOM paralysis , ptosis ,RAPD ,pupil size >5mm and persistent ecchymosis. GCS 3-8 was a strong predictor of severe visual deficit at one month ( odds 12.6).Conclusion: Red flag ophthalmic signs can help prognostication of visual outcome in closed head trauma. In acute setting of head injury, where ophthalmic assessment is challenging, GCS score is a useful but underutilised predictor of visual outcome in head injury.