Validation of ocular trauma score as a prognosticator of visual outcomes in open and closed-globe injuries at Kaduna, Nigeria

Background Prognostic tools, including the ocular trauma score, are critical for clinicians in guiding management decisions and counseling patients about visual prognosis. This concern is especially relevant in developing communities with a high burden of visual impairment and blindness due to ocular trauma. This study compared the predictive value of the ocular trauma score (OTS) with actual visual outcomes following closed and open-globe injuries. Method A prospec​tive comparative analysis of Kuhn et al.’s ocular trauma score-predicted visual acuity and final visual outcome was conducted. Patients with mechanical ocular trauma managed at a tertiary care facility in Nigeria were enrolled. Ocular injuries were classified according to the Birmingham Eye Trauma Terminology System (BETTS). The primary outcome was final visual acuity at 3 months post-presentation. The association between presentin​g and final visual acuity and the correlation between the ocular trauma score predicted and final visual acuity were analyzed. Result Seventy-nine patients participated, with 34.2% sustaining open-globe injuries and 65.8% closed-globe injuries; the male-to-female ratio was 2.8:1. The mean age was 21.16 years (SD ± 12.63). Approximately 31.6% presented within 24 h of injury. Injury types included contusions (59.5%), penetrating injuries (16.5%), ruptured globe (13.9%), lamellar lacerations (6.3%), and intraocular foreign bodies (3.8%). Zonal distribution was 30.4% in Zone 1, 48.1% in Zone II, and 21.5% in Zone III. Medical management was provided to 49.3% of patients, while 38% un​derwent surgical intervention. Presenting visual acuity was hand motion or worse in 48.7% of patients and 6/12 or better in 23.1%. Final visual acuity was 6/12 or better in 58% of patients. The presenting visual acuity showed association ( p < 0.001) and correlation (Spearman’s r = 0.53, p = < 0.001, 95% CI [0.32, 0.69]) with the final visual acuity. The ocular trauma score predicted and the final visual outcomes were not statistically different ( p = 0.835) but showed positive correlation (Spearman’s r = 0.60, p = < 0.001, 95% CI [0.42, 0.74]). Conclusion The visual acuity trends predicted by the ocular trauma score were consistent with the outcomes observed in this study. The ocular trauma score is a valuable predictor of final visual outcome three months after open- and closed-globe injuries. Clinical trial number Not applicable.