The Role of Nonophthalmologists in the Primary Evaluation of Head Injury Patients with Ocular Injuries

Purpose—Visual complaints are common in trauma cases. However, not every institution provides immediate ophthalmic consultations 24 h per day. Some patients may receive an ophthalmic consultation but without positive findings. We tried to evaluate risk factors for ocular emergencies in trauma patien...

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Autores principales:	Chen-Hua Lin, Xiao Chun Ling, Wei-Chi Wu, Kuan-Jen Chen, Chi-Hsun Hsieh, Chien-Hung Liao, Chih-Yuan Fu
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	head trauma ocular injury ophthalmologist consultation Medicine R
Acceso en línea:	https://doaj.org/article/94d2fbc904754f2cbb359eb587f8092d
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spelling	oai:doaj.org-article:94d2fbc904754f2cbb359eb587f8092d2021-11-25T18:08:07ZThe Role of Nonophthalmologists in the Primary Evaluation of Head Injury Patients with Ocular Injuries10.3390/jpm111112202075-4426https://doaj.org/article/94d2fbc904754f2cbb359eb587f8092d2021-11-01T00:00:00Zhttps://www.mdpi.com/2075-4426/11/11/1220https://doaj.org/toc/2075-4426Purpose—Visual complaints are common in trauma cases. However, not every institution provides immediate ophthalmic consultations 24 h per day. Some patients may receive an ophthalmic consultation but without positive findings. We tried to evaluate risk factors for ocular emergencies in trauma patients. Then, the ophthalmologists could be selectively consulted. Methods—From January 2019 to December 2019, head injuries patients concurrent with suspected ocular injuries were retrospectively reviewed. All of the patients received comprehensive ophthalmic examinations by ophthalmologists. Patients with and without ocular injuries were compared. Specific ophthalmic evaluations that could be primarily performed by primary trauma surgeons were also analyzed in detail. Results—One hundred forty cases were studied. Eighty-nine (63.6%) patients had ocular lesions on computed tomography (CT) scans or needed ophthalmic medical/surgical intervention. Near 70% (69.7%, 62/89) of patients with ocular injuries were diagnosed by CT scans. There was a significantly higher proportion of penetrating injuries in patients with ocular injuries than in patients without ocular injuries (22.5% vs. 3.9%, <i>p</i> = 0.004). Among the patients with blunt injuries (<i>N</i> = 118), 69 (58.5%) patients had ocular injuries. These patients had significantly higher proportions of periorbital swelling (89.9% vs. 67.3%, <i>p</i> = 0.002) and diplopia (26.1% vs. 8.2%, <i>p</i> = 0.014) than patients without ocular injuries. Conclusions—In patients with head injuries, concomitant ocular injuries with indications for referral should always be considered. CT serves as a rapid and essential diagnostic tool for the evaluation of concomitant ocular injuries. Ophthalmologists could be selectively consulted for patients with penetrating injuries or specific ocular presentations, thus reducing the burden of ophthalmologists.Chen-Hua LinXiao Chun LingWei-Chi WuKuan-Jen ChenChi-Hsun HsiehChien-Hung LiaoChih-Yuan FuMDPI AGarticlehead traumaocular injuryophthalmologistconsultationMedicineRENJournal of Personalized Medicine, Vol 11, Iss 1220, p 1220 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	head trauma ocular injury ophthalmologist consultation Medicine R
spellingShingle	head trauma ocular injury ophthalmologist consultation Medicine R Chen-Hua Lin Xiao Chun Ling Wei-Chi Wu Kuan-Jen Chen Chi-Hsun Hsieh Chien-Hung Liao Chih-Yuan Fu The Role of Nonophthalmologists in the Primary Evaluation of Head Injury Patients with Ocular Injuries
description	Purpose—Visual complaints are common in trauma cases. However, not every institution provides immediate ophthalmic consultations 24 h per day. Some patients may receive an ophthalmic consultation but without positive findings. We tried to evaluate risk factors for ocular emergencies in trauma patients. Then, the ophthalmologists could be selectively consulted. Methods—From January 2019 to December 2019, head injuries patients concurrent with suspected ocular injuries were retrospectively reviewed. All of the patients received comprehensive ophthalmic examinations by ophthalmologists. Patients with and without ocular injuries were compared. Specific ophthalmic evaluations that could be primarily performed by primary trauma surgeons were also analyzed in detail. Results—One hundred forty cases were studied. Eighty-nine (63.6%) patients had ocular lesions on computed tomography (CT) scans or needed ophthalmic medical/surgical intervention. Near 70% (69.7%, 62/89) of patients with ocular injuries were diagnosed by CT scans. There was a significantly higher proportion of penetrating injuries in patients with ocular injuries than in patients without ocular injuries (22.5% vs. 3.9%, <i>p</i> = 0.004). Among the patients with blunt injuries (<i>N</i> = 118), 69 (58.5%) patients had ocular injuries. These patients had significantly higher proportions of periorbital swelling (89.9% vs. 67.3%, <i>p</i> = 0.002) and diplopia (26.1% vs. 8.2%, <i>p</i> = 0.014) than patients without ocular injuries. Conclusions—In patients with head injuries, concomitant ocular injuries with indications for referral should always be considered. CT serves as a rapid and essential diagnostic tool for the evaluation of concomitant ocular injuries. Ophthalmologists could be selectively consulted for patients with penetrating injuries or specific ocular presentations, thus reducing the burden of ophthalmologists.
format	article
author	Chen-Hua Lin Xiao Chun Ling Wei-Chi Wu Kuan-Jen Chen Chi-Hsun Hsieh Chien-Hung Liao Chih-Yuan Fu
author_facet	Chen-Hua Lin Xiao Chun Ling Wei-Chi Wu Kuan-Jen Chen Chi-Hsun Hsieh Chien-Hung Liao Chih-Yuan Fu
author_sort	Chen-Hua Lin
title	The Role of Nonophthalmologists in the Primary Evaluation of Head Injury Patients with Ocular Injuries
title_short	The Role of Nonophthalmologists in the Primary Evaluation of Head Injury Patients with Ocular Injuries
title_full	The Role of Nonophthalmologists in the Primary Evaluation of Head Injury Patients with Ocular Injuries
title_fullStr	The Role of Nonophthalmologists in the Primary Evaluation of Head Injury Patients with Ocular Injuries
title_full_unstemmed	The Role of Nonophthalmologists in the Primary Evaluation of Head Injury Patients with Ocular Injuries
title_sort	role of nonophthalmologists in the primary evaluation of head injury patients with ocular injuries
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/94d2fbc904754f2cbb359eb587f8092d
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The Role of Nonophthalmologists in the Primary Evaluation of Head Injury Patients with Ocular Injuries

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