ABSTRACT
Background: Eyelids are important structures and play a role in protecting the globe from trauma,
brightness, in maintaining the integrity of tear films and moving the tears towards
the lacrimal drainage system and contribute to aesthetic appearance of the face. Ophthalmic
trauma is an important cause of morbidity among individuals and has also been responsible
for additional cost of healthcare. Periocular trauma involving eyelids and adjacent
structures has been found to have increased recently probably due to increased pace
of life and increased dependence on machinery. A comprehensive classification of periocular
trauma would help in stratifying these injuries as well as study outcomes. Material and Methods: This study was carried out at our institute from June 2015 to Dec 2015. We searched
multiple English language databases for existing classification systems for periocular
trauma. We designed a system of classification of periocular soft tissue injuries
based on clinico-anatomical presentations. This classification was applied prospectively
to patients presenting with periocular soft tissue injuries to our department. Results: A comprehensive classification scheme was designed consisting of five types of periocular
injuries. A total of 38 eyelid injuries in 34 patients were evaluated in this study.
According to the System for Peri-Ocular Trauma (SPOT) classification, Type V injuries
were most common. SPOT Type II injuries were more common isolated injuries among all
zones. Discussion: Classification systems are necessary in order to provide a framework in which to
scientifically study the etiology, pathogenesis, and treatment of diseases in an orderly
fashion. The SPOT classification has taken into account the periocular soft tissue
injuries i.e., upper eyelid, lower eyelid, medial and lateral canthus injuries., based
on observed clinico-anatomical patterns of eyelid injuries. Conclusion: The SPOT classification seems to be a reliable system to address eyelid injuries.
This classification scheme would guide the ophthalmic and facial reconstructive surgeons
to provide optimal outcomes in eyelid injuries. Based on the classification scheme
and review of existing literature, an algorithm is presented to facilitate repair
and reconstruction.
KEY WORDS
Algorithm - eyelid injures - eyelid repair - eyelid trauma treatment - injury classification
- ocular injuries - periocular trauma - System for peri-ocular trauma classification
