Ocular
trauma terminology (proposed by Kuhn and co-workers)
TERM
|
DEFINITION
|
Eyewall
|
Sclera
and cornea
|
Closed
globe
|
Eyewall
doesn’t have full thickness wound, may harbor partial thickness laceration.
|
Open
globe
|
Eyewall
has full thickness wound.
|
Rupture
|
Full
thickness wound caused by blunt object. May or may not be at the impact site.
|
Laceration
|
Full
thickness wound caused by sharp object occurring at the site of impact.
|
Penetrating
injury
|
Single,
full thickness wound usually caused by sharp object.
|
Intraocular
foreign body injury
|
Retained
foreign body through a single entrance wound.
|
Perforating
injury
|
Two
full thickness wounds of the eyewall caused by a same projectile.
|
Contusion
|
Closed
globe injury caused by a blunt object. May or may not be at the site of
impact.
|
Lamellar
laceration
|
Closed
globe (partial thickness) injury of the eyewall or bulbar conjunctiva caused
by a sharp object at the site of impact.
|
Superficial
foreign body
|
Closed
globe injury with impacted foreign
body in the eyewall or conjunctiva not resulting in a full thickness defect
in the eyewall.
|
The Ocular Trauma Classification Group has proposed
a standardized system for classification of ocular injuries. It is based on
four characteristics: Mechanism of injury, initial visual acuity, pupillary involvement
and most posterior location of wound.
OCULAR
TRAUMA CLASSIFICATION SCHEME
OPEN
GLOBE INJURY
|
CLOSED
GLOBE INJURY
|
TYPE
A. Rupture
B. Penetrating
C. Intraocular
foreign body
D. Perforating
E. Mixed
|
TYPE
A. Contusion
B. Lamellar
laceration
C. Superficial
foreign body
D. Mixed
|
GRADE
Visual acuity
1. >=20/40
2. 20/50
- 20/100
3. 19/100
– 5/200
4. 4/200
– light perception
5. No
light perception
|
GRADE
Visual acuity
1. >=20/40
2. 20/50
– 20/100
3. 19/100
– 5/200
4. 4/200
– light perception
5. No
light perception
|
PUPIL
Positive - RAPD + in affected eye.
Negative- RAPD – in affected eye.
|
PUPIL
Positive - RAPD + in affected eye.
Negative – RAPD – in affected eye.
|
ZONE
I. Isolated to cornea including corneoscleral limbus.
II. Corneoscleral limbus to 5mm posterior into the sclera.
III. Posterior to the anterior 5mm of sclera.
|
ZONE
I. External (limited to bulbar conjunctiva, cornea and sclera).
II. Anterior segment involvement upto pars plicata including
posterior lens capsule.
III. Posterior segment involvement.
|