Prevalence and Patterns of Ocular Injuries Associated with Traumatic Brain Injury at a Tertiary Hospital in Zambia

Abstract

Background: Ocular injuries are an under-recognized cause of vision loss, leading to blindness, disability, and significant socioeconomic burden, especially in resource-limited settings. They commonly occur alongside traumatic brain injury, but their incidence and patterns vary widely, and the relationship between ocular injuries and injury severity (such as Glasgow Coma Scale) remains unclear and insufficiently studied. Aims:  To assess the prevalence and patterns of ocular injuries among traumatic brain injury patients and relate them to the Glasgow Coma Scale. Study Design: Cross-sectional study. Place and Duration of Study: University Teaching Hospitals – Adult Hospital, from July 2024 to December 2024. Methodology: A total of 129 traumatic brain injury patients were recruited into the study by means of consecutive sampling. A data collection tool was used to capture sociodemographic details, the patient’s history, the Glasgow Coma Scale (GCS), and ocular examination findings. Analysis of the data was done using the Statistical Package for Social Sciences (SPSS) software version 28. Multiple logistical regression was used to determine predictor variables. Results: The prevalence of ocular injuries among study participants with traumatic brain injury was found to be 58.14% (95% CI: [49.13% - 66.76%]). The eyelid was the most affected ocular structure in 67 participants (89.33%), followed by the conjunctiva 49 (65.33%). The occurrence of structural ocular findings and neuro-ophthalmic manifestations were associated with vision impairment (P < .001 and P = .006 respectively), and conjunctival injury and neuro-ophthalmic manifestations were associated with moderate to severe cases of traumatic brain injury (P = .024 and P = .015 respectively). Participants with scalp and/or facial haematoma (AOR = 4.50; 95% CI: [1.11–18.17], P = 0.035) and facial asymmetry (AOR = 12.11; 95% CI: [1.49–98.81], P = .02) were significantly more likely to sustain ocular injuries. Conclusion: The findings of this study highlight the burden of ocular injuries among traumatic brain injury patients and underscores the need for timely comprehensive ocular examinations in traumatic brain injury patients. This is to identify ocular injuries that have potential to cause disabilities like physical disfigurement or vision impairment.