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Title: CAUSES AND CLINICAL PRESENTATION OF PATIENTS WITH TRAUMATIC CORNEAL PERFORATIONS (2017)

Background: Ocular trauma is the commonest cause of unilateral blindness. It can be open globe or closed globe injury. Our study looked at corneal and corneoscleral perforations which are types of open globe injuries. Corneal perforations are common in our setting and often have poor outcome. The time a patient presents after ocular injury for specialized care is an important predictor on the outcome after surgery among other factors. Objective: To determine the causes and clinical presentation of patients with traumatic corneal perforations at REC and factors associated with delayed presentation. Methods: This was a hospital based cross sectional study at Ruharo Eye Center. Ninety-eight patients with traumatic corneal perforations were consecutively recruited. Causes and clinical presentation of the participants were recorded. A statistical analysis of predictors of delayed presentation was done. Results: Majority 59 (60.2%) of the participants were children. The median age was 11 years (IQR 5-26). The male to female ratio of participants was 2.9:1. Most 45 (45.9%) of corneal perforations were caused by stick and 60 (61.2%) occurred at home. Eighty-nine (90.8%) participants had visited other health units and 68(68.4%) had used treatment before reporting to REC after injury. Participants who had corneal perforations only were 68(69.4%) and those who had corneoscleral perforations were 30(30.6%). The median time of presentation was 41 hours (IQR 18-93). The participants who presented early and late were 54(55.1%), 44(44.9%) respectively. Being an adult (age > 18 years), prior treatment use and absence of hyphema on examination were found to be statistically associated with delay in presentation of participants with corneal perforations at REC. Conclusion: Corneal perforations occurred mostly in children; sticks were the commonest cause of injury; and most of the injuries occurred at home. Delayed presentation was associated with being adult, prior treatment use and absence of hyphema.

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