Has decreased visual acuity associated with blunt trauma at the emergency department recovered?

PURPOSE: After blunt ocular trauma, many patients complain of visual disturbances at the emergency department of a hospital. The aim of this study was to investigate the clinical manifestations and related factors of refractive change after blunt ocular trauma.

METHODS

This prospective study included 192 patients who had a history of monocular blunt trauma without any corneal or conjunctival open wound. None of them had a history of ocular disease or surgery. The examinations covered uncorrected visual acuity, best corrected visual acuity, intraocular pressure, refractive power, gonioscopy for anterior chamber angle, and A-scan ultrasonography for the measurement of axial length, anterior chamber depth, and the lens thickness. All the examinations were performed right after the trauma and then 1 week, 1 month, and 3 months later. The corneal topography was examined using an ORB scan right after the trauma and 1 month later.

RESULTS

A myopic change of -2.01 ± 2.27 diopters (D) in the injured eyes, compared with the sound eyes, was identified in 161 patients (83.9%), which showed an aspect of recovery as time passed of -0.14 ± 0.51 D at 1 month after the trauma. The anterior chamber depth of the injured eyes, unlike that of the sound eyes, was significantly lower (P = 0.028), and the anteroposterior diameter of the lens of the injured eyes was significantly higher (P = 0.043).

CONCLUSIONS

Blunt ocular trauma induced a significant myopic refractive change due to lens thickening and anterior chamber shallowing, which recovers spontaneously as time passes. Therefore, conservative management and examination of refractive change without artificial refractory correction would be a good choice for managing eyes with blunt trauma at an emergency department.