Abstract
Objective
Subconjunctival hemorrhage (SCH) is a common presentation in patients with orbital
trauma and often warrants investigation of underlying ocular pathology. Our study
aims to assess the significance of SCH severity, graded in a spatial 0–360° manner,
as a predictor for ocular pathology in patients with orbital fracture.
Design
Retrospective chart review.
Participants
Patients with fractured orbits (n = 265) presenting to a level 1 trauma centre between
August 2015 and January 2018.
Methods
Key elements of ophthalmic assessment, including visual acuity, SCH (0–360°), anterior-
and posterior-segment examination, Hertel exophthalmometry, and ocular pathology,
were recorded. Simple logistic regression assessed for association between SCH severity
and ocular pathology. Odds ratios (ORs) were calculated with 95% CI.
Results
Among the 265 fractured orbits, 158 (59.6%) presented with no SCH, and 107 (40.4%)
had some degree of SCH. Ocular pathology was noted in 24 fractured orbits (9%). Most
common pathologies included entrapment (22.2%), hyphema (16.7%), traumatic optic neuropathy
(8.3%), and commotio retinae (8.3%). Simple logistic regression revealed a higher
incidence of ocular pathology with increasing severity of SCH from 0–360° (OR = 1.004;
95% CI 1.001–1.007; p = 0.0085). In addition, χ2 analysis demonstrated a higher proportion of ocular pathology in 181–270° (25.0%;
p = 0.0466) and 271–360° SCH subgroups (26.3%; p = 0.0031) compared with the 0° SCH subgroup (6.3%).
Conclusions
Our findings suggest that there is some correlation between the extent of SCH and
ocular pathology. However, patient care and investigations should continue to be directed
by a full clinical assessment of patients with orbital trauma.
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Article Info
Publication History
Published online: March 09, 2022
Accepted:
February 3,
2022
Received in revised form:
January 5,
2022
Received:
October 11,
2021
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
