Abstract
BackgroundTo document characteristics and treatments of ocular blast injury from a fire and explosion.MethodAuthors retrospectively evaluated 116 patients with 166 eye injuries from six hospitals. Terminology of ocular injury referred to Birmingham Eye Trauma Terminology, and best-corrected visual acuity (BCVA) was categorized with the ocular trauma score (OTS) grading system. Incidence, preoperational and follow-up BCVA, treatment of severe ocular blast injuries were surveyed.ResultsOculoplastic injuries accounted for the majority of eye injuries, while globe injuries were presented in 52 eyes with median baseline OTS 70 ranging from 26 to 100. No endophthalmitis occurred. The mean timing of the first-stage operations was 9.4 ± 6.4 h after blast, while second-stage operations were performed on average 14.7 ± 0.9 days post blast. Final BCVA of 68.8% of eyes achieved 20/200 or better as followed, 7 open globe injuries had a BCVA of no light perception. Additionally, eyes presenting rupture, retinal detachment, vitreous hemorrhage, choroidal injury and initial BCVA less than 20/200 had worse final visual outcomes, while globe penetration was not associated with poor visual acuity.ConclusionVarious ocular injuries were commonly in the casualties of blast, in which open-globe injuries have worst visual prognosis. OTS is a valid approach for evaluation of prognosis and optimizing the therapeutic strategies subsequently in the massive casualty. Intense rescue and careful examination, proper surgery should be performed correctly to rescue patients.
Highlights
To document characteristics and treatments of ocular blast injury from a fire and explosion
Oculoplastic injuries accounted for the majority of eye injuries, while globe injuries were presented in 52 eyes with median baseline ocular trauma score (OTS) 70 ranging from 26 to 100
Eyes presenting rupture, retinal detachment, vitreous hemorrhage, choroidal injury and initial best-corrected visual acuity (BCVA) less than 20/200 had worse final visual outcomes, while globe penetration was not associated with poor visual acuity
Summary
To document characteristics and treatments of ocular blast injury from a fire and explosion. Injuries resulting from explosions are classified into four parts [5, 6]. The detonation wave itself can cause the primary injury to some extent; Secondly, fragments propelled by the explosion, like glass, dust, masonry from some constructions damaged; Thirdly, acceleration of body resulting from blast wind caused displacement on victims; the tremendous and temporary heat produced by the explosion results in some thermal injuries. Based on the distance to the explosion, severity and source of the explosion, the types of the injuries vary [7]. Ocular injury occurs at a high incidence in the terrorist blast victims due to the eye superficial exposure [8]
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