Posterior Segment Involvement and Treatment Outcomes of Closed Globe Injury at Tertiary Eye Care Center: An Observational Study

TL;DR

This study examines posterior eye damage and recovery in closed globe injuries at a Nepalese hospital, finding that most patients regained normal vision within six months.

Contribution

The study provides new observational data on posterior segment complications and outcomes of closed globe injuries in a Nepalese tertiary care setting.

Findings

79.31% of patients achieved normal visual acuity within six months.

Commotio retinae was observed in 46.55% of posterior segment cases.

24.14% of patients exhibited posterior segment complications at follow-up.

Abstract

Closed globe injury is a common cause of visual impairment worldwide, affecting both anterior and posterior segments of the eye. This study aimed to determine the posterior segment findings and treatment outcomes in patients with closed globe injury at a tertiary eye care center in Nepal.

A prospective observational study was conducted on 58 patients with clinically diagnosed closed globe injury at a tertiary eye care center in Kathmandu from February 2020 to July 2021. Ethical approval was obtained from the Institutional Review Committee of the National Academy of Medical Sciences (Ref: 76/2077/078). Detailed demographic, clinical, and ocular examination findings were recorded.

Among the 58 patients, 48 (82.76%) were males and 10 (17.24%) females, aged 18-71 years. Fist injuries were, reported in 19 (32.76%) cases, with the left eye affected in 32 (55.17%) patients. At presentation, 30 (51.72%) had normal vision, while 7 (12.07%) were blind. At 6 months, 46 (79.31%) achieved normal visual acuity, with only 1 (1.72%) remaining blind. Commotio retinae was observed in 27 (46.55%) cases of posterior segment findings. At the 6-month follow-up, 44 (75.86%) had fully recovered, while 14 (24.14%) exhibited posterior segment complications, including 4 (6.90%) with choroidal rupture and 2 (3.45%) with optic disc atrophy.

Closed globe injury significantly contributes to visual disability, with fist injuries and commotio retinae being common. Young adults are predominantly affected. Early diagnosis and management are critical to optimize visual outcomes.