Prognostication of Globe Injuries
The severity of the damage to the eye and its function at presentation have prognostic significance. Given the complexity of ocular trauma and its inherent unpredictable nature, there is no perfect system for prognostication of ocular injuries. However, some specific factors have been determined to have prognostic importance. Functional assessments include evaluating visual acuity and whether an afferent pupillary defect is present, and noting the injury descriptors, specifically the type of trauma and the zone of injury. The Ocular Trauma Score assigns a point value based on these assessments (Table 18-3). In this system, visual acuity is the most important predictor of injury severity; other characteristics are assigned a negative point value that is subtracted from the visual acuity score to produce the total raw score. The higher the raw score, the better the final visual acuity prognosis (see Table 18-3). This system is a useful general guide to roughly estimate visual acuity outcomes following globe trauma.
Table 18-3 Calculating the Ocular Trauma Score
Kuhn F, Maisiak R, Mann L, Mester V, Morris R, Witherspoon CD. The Ocular Trauma Score (OTS). Ophthalmol Clin North Am. 2002;15(2):163–165, vi.
Pieramici DJ, Au Eong KG, Sternberg P Jr, Marsh MJ. The prognostic significance of a system for classifying mechanical injuries of the eye (globe) in open-globe injuries. J Trauma. 2003;54(4):750–754.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.