Ocular and visual complications of head injury

Purpose To evaluate the pattern of ocular and visual complications of head injury. Method A prospective study of 225 head-injured patients managed at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. For the purpose of extracting vaisual complications, a Neurosurgeon and an Ophthalmologist examined each patient and appropriate investigations were carried out. Patients with ocular morbidity were analysed for age, sex, cause of injury, admission Glasgow coma score, and associated injuries in addition to findings at ophthalmic and neurosurgical evaluations. Results Two major types of ocular and visual complications were observed in 57 (25.3%) of 225 head-injured patients studied. Soft-tissue injury to the globe and adnexae included periorbital ecchymosis, subconjuctival haemorrhage, lid laceration, or rarely globe rupture in 29 patients. Neuro-ophthalmic ocular cranial nerve palsies occurred in 28 patients, while orbital fracture was encountered in two patients. Ocular injuries were multiple in 60% of cases. The patients, comprising 37 male and 20 female subjects, were aged 9 months to 57 years (mean = 28 years). Traffic accident was the leading cause of head injuries (84.2%), while fall from height (7%), assault (7%), and gunshot (1.8%) were miscellaneous causes. Conclusion Injury to the globe and adnexae and ocular cranial nerve palsies constitute the most common oculovisual complications following head injury in our centre.