Clinical Profile, Anatomical and Visual Outcomes of Ocular Trauma by Animal Horn: A Prospective Case Series

Clinical Relevance: Ocular trauma caused by animal horns is a frequent cause of globe rupture in urban India. Eyes that sustain animal horn injuries often have a poor visual prognosis. However, proper assessment and management strategies can lead to significant improvements in anatomical and functional visual outcomes in such cases. Background: Various injuries caused by animal horns have been reported due to traditional cattle breeding practices, and are one of the leading causes of visual impairment worldwide. Materials and Methods: A prospective Observational case series at a tertiary eye care center from January 2018 to January 2019 in central India was conducted after institutional board approval. Patient data including age, sex, occupation, laterality, mechanism of injury, type of animal, history of cataract surgery, and best-corrected visual acuity at the time of presentation were taken. Tear location, size, shape, pattern, extension into the sclera, muscle involvement, and lens status were recorded pre- or intraoperatively. Visual and anatomical outcomes were categorized into favorable and unfavorable outcomes. Results: Thirty-seven patients with mean age 50.53 ± 13.65 years most which were farmers ( n = 20; 54%). The mean time of presentation was 4.37 days (1–15 days). 29 had Open Globe Injuries (OGI), and eight had Closed Globe Injuries (CGI). In the OGI group, 26 patients had ruptures, and 3 had penetrating injuries, while in the CGI group, seven patients had contusions, and 1 had lamellar laceration. Twenty-one were phakic, and 8 were pseudophakic. Visual acuity reached 4/200 or better in 37.9% of the eyes with OGI and in 75% of the eyes with CGI. Visual acuity was 4/200 or better in 42.85% of phakic and 55.55% of pseudophakic eyes. Conclusions: Ruptured animal horn injuries with previous surgical wounds have better functional and anatomical outcomes. Educating the rural population and creating awareness can help reduce the burden of blindness.