Patient: age >= 15 years with orbital fracture (a patient < 15 years old should have a full ophthalmologic exam regardless of findings)
Substantial ocular injury: any injury requiring urgent care or close follow-up
Exam items:
(1) blunt trauma with foreign object (odds ratio 19.4)
(2) inability to count fingers at 1-2 feet (odds ratio 10.1)
(3) roof fracture (odds ratio 9.1)
(4) diplopia on primary gaze (double vision when looking straight ahead; odds ratio 6.7)
(5) subconjunctival hemorrhage or chemosis (odds ratio 4.2)
score =
= SUM(number of items present)
Interpretation:
• minimum score: 0
• maximum score: 5
• A score >=1 is an indication for urgent ophthalmologic exam.
• A score = 0 indicates the need for an ophthalmologic exam within 1 week.
Performance:
• The negative predictive value was 96.8%. The positive predictive value was 32%.
