Binocularity and severe uniocular trauma.

BACKGROUND/AIMS: Monocular outcomes following severe ocular trauma are well described, but little is known about the effect of such injuries on binocular visual outcomes. We therefore report the binocular outcomes in a series of patients with such injuries.

METHODS

A retrospective analysis was undertaken of 6 patients with binocular problems following ocular injuries that were severe enough to warrant referral to the regional centre for vitreoretinal surgery.

RESULTS

Mean age: 24 years. Mean follow-up: 2.9 years. All patients had 1 to 5 vitreoretinal procedures and the final visual acuities ranged from 6/9 to 1/60. Three patients regained some binocularity, 2 had intractable diplopia and 1 was 'suppressing' with prisms. The final visual acuity did not predict the binocular outcome. The time delay between the original injury and presentation at the motility service was between 3 months and 2.25 years.

CONCLUSION

A good monocular visual outcome does not necessarily result in a satisfactory binocular visual outcome and a poor monocular visual outcome does not prevent severe binocular symptoms. Patients need to be counselled regarding this risk, which is an under-recognised problem. We also recommend that all such patients be referred promptly for a thorough orthoptic assessment.