Ocular Trauma Score (Visual Outcome After Eye Injury)
The OCULAR TRAUMA SCORE (Kuhn and colleagues 2002) estimates the DISTRIBUTION of visual outcome six months after serious eye injury WITH OPTIMAL MANAGEMENT.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Initial visual acuity
- 20/200 to 20/50
- Globe rupture
- No
- Endophthalmitis
- No
- Perforating injury
- No
- Retinal detachment
- No
- Relative afferent pupillary defect
- Yes
Result: 3
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Ledger
- THE INITIAL VISUAL ACUITY IS THE ONLY TERM THAT ADDS. Base 60 to 100; the five findings deduct 75 in total.
- Base
- No light perception 60; light perception or hand movements 70; 1/200 to 19/200 80; 20/200 to 20/50 90; 20/40 or better 100.
- Deductions
- Globe rupture -23; endophthalmitis -17; perforating injury -14; retinal detachment -11; afferent pupillary defect -10.
- 0 to 44
- OTS 1. At six months: NLP 73%, PL/HM 17%, 1/200-19/200 7%, 20/200-20/50 2%, 20/40 or better 1%.
- 45 to 65
- OTS 2. NLP 28%, PL/HM 26%, 1/200-19/200 18%, 20/200-20/50 13%, 20/40 or better 15%.
- 66 to 80
- OTS 3. NLP 2%, PL/HM 11%, 1/200-19/200 15%, 20/200-20/50 28%, 20/40 or better 44%.
- 81 to 91
- OTS 4. NLP 1%, PL/HM 2%, 1/200-19/200 2%, 20/200-20/50 21%, 20/40 or better 74%.
- 92 to 100
- OTS 5. NLP 0%, PL/HM 1%, 1/200-19/200 2%, 20/200-20/50 5%, 20/40 or better 92%.
- Below 0
- REACHABLE AND UNCLASSIFIED. No light perception with rupture, endophthalmitis, retinal detachment and an APD is -1. No category is returned rather than clamping to OTS 1.
- Distribution
- The output is a DISTRIBUTION, not a predicted acuity. Quoting the category alone throws the result away.
- Extremes
- Neither is certain: OTS 1 still reaches 20/40 or better in 1%, and OTS 5 still lands at light perception or hand movements in 1%.
- Bands
- They narrow as prognosis improves - 45, 21, 15, 11, 9 points wide - so a point matters more near the top.
- Scope
- Group-level, six months, after OPTIMAL management. Does not diagnose, does not decide surgery, and never supports enucleation or withholding repair.
What you enter
- Initial visual acuity - THE ONLY TERM THAT ADDS.
- Globe rupture.
- Endophthalmitis.
- Perforating injury.
- Retinal detachment.
- Relative afferent pupillary defect.
Full field descriptions
- Initial visual acuity - THE ONLY TERM THAT ADDS [nlp = No light perception, 60 points; pl-hm = Light perception or hand movements, 70 points; 1-200 = 1/200 to 19/200, 80 points; 20-200 = 20/200 to 20/50, 90 points; 20-40 = 20/40 or better, 100 points].
- Globe rupture. Deducts 23 points if present.
- Endophthalmitis. Deducts 17 points if present.
- Perforating injury. Deducts 14 points if present.
- Retinal detachment. Deducts 11 points if present.
- Relative afferent pupillary defect. Deducts 10 points if present.
How this is calculated
Kuhn F, Maisiak R, Mann L, Mester V, Morris R, Witherspoon CD. The Ocular Trauma Score (OTS). Ophthalmol Clin North Am. 2002;15(2):163-165. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.