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. 2022 Aug 1;140(8):819-826.
doi: 10.1001/jamaophthalmol.2022.2594.

Globe and Adnexal Trauma Terminology Survey

Annette K Hoskin  1 , Michael J Fliotsos  2 , Andrés Rousselot  3 , Sean Ming Sheng Ng  4 , Grant A Justin  5 , Richard Blanch  6   7   8 , Marcus H Colyer  9 , Bhartendu Shukla  10   11   12 , Sundaram Natarajan  13 , Ferenc Kuhn  14   15 , Gangadhara Sundar  16   17 , Fasika A Woreta  2 , Stephanie L Watson  1 , Rupesh Agrawal  4   18   19 ; International Globe and Adnexal Trauma Epidemiology Study (IGATES) Ophthalmic Trauma Terminology Consensus Group
Collaborators, Affiliations

Globe and Adnexal Trauma Terminology Survey

Annette K Hoskin et al. JAMA Ophthalmol. .

Abstract

Importance: Ocular trauma terminology should be periodically updated to enable comprehensive capturing and monitoring of ocular trauma in clinical and research settings.

Objective: To update terminology for globe and adnexal trauma.

Design, setting, and participants: A 2-round modified Delphi survey was conducted from January 1 to July 31, 2021, using an expert panel, including 69 ophthalmologists identified through their membership in ophthalmology (globe and adnexal trauma) societies. Consensus was defined as at least 67% expert agreement. A steering committee developed questions after identifying gaps in the current terminology via a targeted literature review. Round 1 sought consensus on existing and newly proposed terminology, and round 2 focused on unresolved questions from round 1. Experts included ophthalmologists who had managed, on average, 52 globe or adnexal trauma cases throughout their careers and/or published a total of 5 or more globe or adnexal trauma-related peer-reviewed articles.

Main outcomes and measures: Expert consensus on ocular and adnexal terms.

Results: A total of 69 experts participated in and completed round 1 of the survey. All 69 participants who completed round 1 were asked to complete round 2, and 58 responses were received. Consensus was reached for 18 of 25 questions (72%) in round 1 and 4 of 7 questions (57%) in round 2. Existing Birmingham Eye Trauma Terminology system terminology achieved consensus of 84% (58 of 69 experts) in round 1 and 97% (56 of 58 experts) in round 2. Experts agreed on the need for further refinement of the definition of zones of injury (55 of 69 [80%]), as the zone affected can have a substantial effect on visual and functional outcomes. There was consensus that the mechanism of injury (52 of 69 [75%]) and status of the lacrimal canaliculi (54 of 69 [78%]), nasolacrimal ducts (48 of 69 [69%]), lens (46 of 58 [80%]), retina (42 of 58 [73%]), and central and paracentral cornea (47 of 58 [81%]) be included in the revised terminology.

Conclusions and relevance: There was consensus (defined as at least 67% expert agreement) on continued use of the existing Birmingham Eye Trauma Terminology system definitions and that additional terms are required to update the current ocular trauma terminology.

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Conflict of interest statement

Conflict of Interest Disclosures: Ms Hoskin reported being an employee of Essilor Luxottica. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Data Flow for the International Globe and Adnexal Trauma Epidemiology Study (IGATES) Ocular Trauma Terminology Survey
APOTS indicates Asia Pacific Ophthalmic Trauma Society; ASOT, American Society of Ophthalmic Trauma; COTS, Chinese Ocular Trauma Society; ISOT, International Society of Ocular Trauma; OTSI, Ocular Trauma Society of India; PSOT, Pan-American Society of Ocular Trauma.
Figure 2.
Figure 2.. Revised Globe and Adnexal Trauma Terminology
CGI indicates closed-globe injury; IOFB, intraocular foreign body; OGI, open-globe injury.
See this image and copyright information in PMC

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