Eagling et al reported a grading scheme for perforating injuries of the eye. The author is from the Birmingham and Midland Eye Hospital.
Patient selection: perforating injury to the globe
Features
Grade
laceration of the cornea or anterior sclera with or without uveal prolapse but no damage to lens
1
laceration of the cornea or anterior sclera with lens damage
2
posterior segment with vitreous loss
3
both anterior and posterior segment involved
4
Patients with Grade 1 tinjuries tended to have a good outcome while most patients with Grade 4 injury had a bad outcome (poor light perception)
Problems contributing to poor outcomes:
(1) endophthalmitis
(2) traction retinal detachment
(3) sympathetic ophthalmitis
Grade 1 injuries were associated with wound astigmatism if a corneal laceration exceeds one third of the corneal diameter. This may be related to corneal flattening along the wound.
Grade 2 injuries can have a poor outcome in children under 8 years of age because of the development of squint and amblyopia.
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