preprint · medRxiv
A study at Mulago National Referral Hospital in Uganda investigated the prevalence and patterns of ocular injuries among adult patients admitted with head trauma. Researchers conducted a cross-sectional study from May to July 2025, evaluating 383 patients aged 18 and above with confirmed head injuries. The ophthalmic evaluation included visual acuity, tonometry, slit-lamp examination, dilated fundus examination, pupillary and ocular motility assessment, confrontation visual fields, and review of craniofacial CT scans. Road traffic accidents were the primary cause of injury, and most patients had mild head injuries. The study found that 70% of head injury patients sustained at least one ocular injury, with adnexal injuries being the most common, followed by orbital fractures. Closed globe injuries were also noted in a significant proportion of patients.
This research highlights a significant issue in trauma care: ocular injuries often accompany head trauma but are frequently overlooked. Recognising their high prevalence and specific patterns can lead to better diagnostic practices, ensuring timely intervention and potentially preventing permanent vision loss for many patients.
The abstract does not indicate an application pathway for commercialisation, as it focuses on identifying a clinical problem and recommending an improvement in existing medical assessment protocols.
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Abstract Background Ocular injuries concomitantly occur among patients with head trauma because of the close anatomical relationship between the cranium and the orbit. Unfortunately, they are often overlooked during acute trauma care and may result in preventable visual loss. There is a dearth of data describing the burden and spectrum of ocular injury among head injury patients in sub-Saharan Africa. We conducted a hospital-based cross-sectional study to determine the prevalence and describe the patterns of ocular injury among adults admitted with head injury at the Accidents and Emergency Unit of Mulago National Referral Hospital, Uganda, from 1 st May 2025 to 30 th July 2025. Methods Consecutive patients aged 18 years and above with a confirmed head injury diagnosis underwent a structured ophthalmic evaluation comprising visual acuity testing, tonometry, slit-lamp and dilated fundus examination, pupillary and ocular motility assessment, confrontation visual fields, and review of craniofacial computed tomography. Ocular injuries were classified by anatomical site and injury type, and the prevalence was reported with a 95% confidence interval. Results Of 383 patients evaluated (mean age 32.7 ± 12.3 years; 89.3% male), road traffic accidents were the leading mechanism of injury (68.9%) and most patients had mild head injury (72.3%). Overall, 268 patients (70.0%; 95% CI 65.1-74.5) sustained at least one ocular injury. Adnexal injuries were most frequent (64.0%), dominated by periorbital oedema (45.2%), subconjunctival haemorrhage (42.3%) and eyelid ecchymosis (33.2%); orbital fractures occurred in 27.4%. Closed and open globe injuries were present in 13.8% and 0.8% of patients, respectively, and abnormal confrontation visual fields in 28.2%. Conclusion Ocular injury is highly prevalent among patients admitted with head injury in this setting, with adnexal and orbital structures most commonly affected. Routine ophthalmic assessment should be integrated into the initial evaluation of all head injury patients to reduce missed injuries and prevent avoidable visual morbidity.
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DOI: 10.64898/2026.08.06.26359857
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