VISUAL OUTCOME, CLINICAL FINDINGS AND MANAGEMENT OF BLUNT OCULAR TRAUMA DUE TO SHOTGUN PELLETS.

Abstract

Purpose: To analyze the clinical ndings, management and visual prognosis of blunt ocular injuries due to shotgun pellets. Methods: A prospective observational study on 200 eyes with blunt ocular trauma due to shotgun pellets was conducted. Patients with other causes of ocular trauma or with open globe injury were excluded from study. Surgical interventions were employed when indicated for associations like, traumatic cataract, dense persistent vitreous hemorrhage(VH),retinal detachment(RD) etc. Patients were followed up for 6 months from time of injury. Results: The mean age of patients was 22.6+9.52 years. Majority (99.5%) of our patients were males and only 1(0.50%) was female. Subconjunctival hemorrhage (SCH) was the most common clinical manifestation(77.0%) followed hyphaema in 34.0% of patients and vitreous hemorrhage(VH) (27.5%). Cataractous changes were seen in 7.5% of patients, retinal hemorrhage in 11.0% while retinal detachment(RD) in 4.0%. 60.5% of patients were managed conservatively and 39.5% patients needed surgical intervention. Visual Acuity(VA) at presentation was recorded to be <6/60-PL(light perception) in 51.0% of the patients which progressed to range of 6/6 -6/9 in 82.5% of patients. 2 patients reported with no perception of light (NPL) at the time of trauma which persisted till the end of follow-up. Conclusion: We conclude that the blunt ocular trauma due to pellets occurs most commonly in males, and has a good prognosis in terms of anatomical and functional outcome. Anterior segment was more commonly involved than the posterior segment with reparable damage in majority of the cases. Educating the mass for use of any form of eye protection can prevent ocular trauma in most cases