Cases Of Ocular Trauma Research Articles

Study of epidemiology, clinical profile, visual outcome and prognostic factors of blunt ocular trauma in a teaching hospital

To describe the epidemiology, patterns of ocular trauma, clinical presentation, visual outcome and prognostic factors of blunt ocular trauma.A teaching hospital based prospective observational study was conducted over a period of 4 years from March 2012 to Feb 2016. 226 patients of all age group fulfilling the various inclusion and exclusion criteria were included in the study. All patients underwent detailed protocol based workup including a comprehensive ocular examination along with relevant radiological tests. Data regarding demographic profile, etiology, circumstances of the injury, traumatic agents, mode and mechanism of injury, extent and severity of injury, clinical features, management and visual outcome was analyzed and prognostic factors including ocular trauma score were evaluated.Out of 402 total cases of ocular trauma, 226 caused by blunt objects were included in this study. 181 (80.1%) were male rest 45(19.9%) were female. The mean age was 42.6 ± 18.8 years. Blunt trauma was more prevalent in age group 16-25yrs (24.3%) followed by 26-35 years (23.9%). Majority (68.6%) of victims belonged to rural background. Most of the patients sustained trauma at road /street (30.5%) and home (27.9%). The most common cause of blunt trauma was road traffic accident (26.5%) followed by sports related injury (22.6%) and physical assault (21.7%). The most frequent traumatic agent was wooden object (26.0%) followed by stone / brick (25.2%) and metallic object (23.1%). Only 32.3% of patients had isolated ocular injuries, rest had associated polytrauma. 93.3% victims had unilateral ocular injury. Left eye (52.3%) was predominantly involved. Majority of injured eyes had more than 3 ocular structure involvement. Out of 241 injured eye 14.0% eyes had only globe injury while 61.4% eyes had simultaneous globe and adnexal injuries. 55.6% eyes had closed globe injury while 19.9% eyes had globe rupture. 20.7% eyes had purely posterior segment injury, while 23.2% eyes had both anterior and posterior segment injury. Most common clinical finding was corneal abrasion (45.6% eyes) followed by hyphema (44.0% eyes), traumatic mydriasis (35.7%), vitreous hemorrhage (33.2%) retinal detachment (20.3%), lens dislocation (22.8%) and traumatic cataract (17.4%). At the time of initial presentation 33.2% eyes had visual impairment and 35.7% eyes had blindness. 14.5% eyes with closed globe injury and 5.0% eyes with open globe injury had zone III injury. Ocular trauma score was in Category I in 14.9% injured eyes and in category II in 7.1% eyes. After 6 months 14.5% of the right eye and 24.2% of the left eye showed blinding outcome.Blunt trauma is the commonest mode of ocular injury. Young adult males are more vulnerable. Intraocular hemorrhage, zone III injury, posterior segment involvement and low ocular trauma score are poor prognostic factors.

A PROSPECTIVE STUDY TO EVALUATE THE STRUCTURAL AND FUNCTIONAL LOSS IN EYES DUE TO ROAD TRAFFIC ACCIDENTS

Purpose To evaluate the structural and functional loss in eye due to road trafc accidents (RTA), and secondarily to study the pattern of ocular injuries and demographic prole of ocular injuries due to RTA. This is a prospective,Methods observational, hospital based study, conducted on 50 patients with ocular injuries following RTA. A detailed demographic data and details of the injury was obtained. Information regarding time, location, type and mechanism of eye injury and use of protective eye wear was recorded.Complete ophthalmic examination was done and B scan, CT orbit and other investigations were done wherever required. Of these 50 patients were followed up at 1stweek, 3rd week, 2 months and 6 months. Maximum cases were seen in age group 21- 30 years (33%), moreResult in males (82%) and two wheelers and adnexal injury was more common. At the end of 6 months, there were 14% (n=07) cases with residual functional loss. These were associated with severe impairment in visual acuity (nger count, perception of light, loss of light perception). Conclusion Evaluation of ocular trauma cases quantitatively would help in measuring precisely the improvement and deterioration in each case and helps to know the progress of the case and effect of treatment. So far in assessment of damage, only eye ball is considered whereas in this method damage to ocular adnexa is also calculated. In future, more studies should be conducted to check the utility of this concept.

The epidemiology of ocular trauma in the Northern Cape, South Africa

Background: Ocular trauma represents a significant public health burden and has considerable global epidemiological variation. The epidemiology of ocular trauma in the Northern Cape province of South Africa has not been previously described.Aim: This study aimed to quantify the burden and describe the distribution and determinants of ocular trauma in the Northern Cape province.Setting: The Northern Cape province is the largest, but least populous, of the nine South African provinces. Published data on the health of the Northern Cape population are scarce. Robert Mangaliso Sobukwe Hospital (RMSH) is the only public ophthalmic referral centre in the province.Methods: Hospital record review of all adult cases of acute ocular trauma seen at RMSH over a period of one year (August 2018 – July 2019).Results: Young men comprised the majority of the 240 included cases. Ocular injuries were most likely to occur in the home (n = 115, 47.9%) and on the weekend (n = 159, 66.3%). More than half (n = 135, 56.3%) of all trauma was non-accidental in nature and significantly associated with alcohol use. Accidental trauma (n = 105, 43.8%), predominantly as a result of occupational injuries sustained at work (n = 47, 44.8%) and in the home (n = 45, 42.9%), was deemed largely preventable. Differences in the timing, location and severity of non-accidental and accidental ocular injuries were observed.Conclusion: Ocular trauma in South Africa follows distinct epidemiological trends and is largely because of interpersonal violence, which places strain on limited state healthcare resources.

English

Ocular trauma has been described as one of the major aetiologies of monocular and non-congenital visual impairment and blindness in all parts of the world. Eye trauma constitutes 7% of all bodily injuries and 10%–15% of all eye diseases.1 Over 2.4 million eye injuries occur each year in The United States of America.2 Globally, there are approximately 1.6 million people who are blind from eye injuries, 2.3 million are bilaterally visually impaired, and 1.9 million have unilateral visual loss.3,4 Ocular trauma can be classified as closed and open globe injuries. Open globe injuries can be a rupture, penetrating injury, perforating injury or intra ocular foreign body.5 A perforating injury is defined as an injury that consists of two full thickness wounds - one entry and one exit wound.6 It usually occurs due to a projectile object travelling at a high velocity and kinetic energy that is capable of penetrating two opposite coats of the globe. Perforation injuries are common and cause severe visual impairment. Panda et al. presented a profile of ocular trauma in Delhi in which they observed that among the type of injuries, perforating injuries accounted for 75.3%, blunt injuries for 20.5% and extra- ocular for 4.2% of the total number of ocular trauma cases. Further the visual outcome in perforating injuries was > 6/12 in 14 %; 6/18- 6/60 in 14% and less than 6/60 in 55.2% of the cases. 7 Profile of ocular trauma varies with country, geography, industrialisation and development of the place. These injuries do not occur as random events and there is evidence that some individuals are at increased risk because of exposure to hazards and/or inability to avoid or detect hazards.8 Some individuals are at increased risk of eye injury as a result of their occupation. Small scale and large-scale industrial workers constitute a group of individuals at high risk. These workers are exposed to such hazards as flying metal chips, burns in the eye and injury from radiation.9 Ludhiana and neighbouring areas are heavily industrialised mainly, with metalrelated products and therefore, there are more chances of industrial ocular trauma. We are reporting two unusual cases related to ocular trauma. The first one is that of an alleged accidental injury to the right eye with a piece of hack saw blade whereas the second case report is that of a dental student who injured his eye by orthodontic wire which is used for making braces.

Role of B-scan in management of ocular trauma

The present study aimed to study the effectiveness of B scan in assessing the posterior segment in patients with ocular trauma, so that further treatment plan can be decided and prognosis can be improved. The study was conducted as a cross-sectional study at tertiary care centre during the study period of 1 year on 42 patients presenting with history of ocular trauma. Patients were subjected to detailed history and ocular examination followed by B scan ultrasonography for ruling out posterior segment pathology. Mean age of 42.7±20.2 years and 45.2% patients belonged to 41 to 60 years of age. About 54.8% cases were females. About 50% cases had one or the other posterior segment finding. Retinal detachment followed by vitreous hemorrhage were the most common findings, observed in 19% and 11.9% cases respectively. Avulsion of optic nerve was the least common finding (2.4%). B scan ultrasonography plays an important role in management of patients with ocular trauma for the detection of hidden posterior segment lesions. B scan must be performed routinely in all the cases of ocular trauma for early diagnosis and appropriate management of each case and to reduce the ocular morbidities.

Ocular trauma

Background: According to the WHO, ocular injury results in 19 million people to become unilateral blind and 1.6 million to become bilateral blind. Ocular trauma constitutes a major part of preventable blindness. The following study was done to identify the demographic profile of the patients and nature of ocular trauma for developing acceptable methods for better management and early visual rehabilitation of patients. Aim: The aim was to study various demographic patterns and manifestations of ocular injuries. Methods: This hospital-based prospective study was carried out in the Department of Ophthalmology. One hundred cases of ocular trauma were included, and written consents were obtained. A detailed history specific to age, occupation, time of injury, type of object causing injury, and socioeconomic status of the patient was obtained through prestructured pretested pro forma. A detailed ocular examination along with a systemic examination was carried out. Results: In the present study, 24% of the cases were in the age group of 40–50 years. Sixty-five percent of the population was male. Thirty-one percent of the population presented within 24 h of trauma, 61% within 3 days, and 25% presented after 7 days. Ninety-five percent of the patients had unilateral trauma and 5% had bilateral trauma. Sixty-two percent of the patients had suffered from road traffic accidents, 25% had work-related trauma, whereas, in 13% of cases, trauma was at home. Blunt objects, foreign bodies, and sharp objects were the top three causes of trauma, accounting for 26%, 23%, and 15% of trauma cases, respectively; it was found that the anterior segment was involved in 74% of cases, the posterior segment in 4% of cases, and combined injury was in 22% of the cases. Conclusion: Most of the eye injuries can be prevented by educating people on various modes of ocular trauma, the need for early treatment, and importance of wearing safety eye gear. This study highlights on the epidemiology of ocular trauma as well as various preventive strategies.

Clinico-epidemiological profile of ocular injuries during COVID-19 lockdown at a tertiary care center in Western Odisha: An observational study

Purpose To study the effect of COVID-19 lockdown on clinico-epidemiological profile of ocular trauma. Materials and Methods This was a retrospective, cross-sectional study of the hospital records from the emergency and ophthalmology department of the institution related to ocular injury during the lockdown period imposed in India (March 23, 2020, to May 30, 2020). Data entry and cleaning were done using Microsoft Excel 2016, and statistical analysis was carried out by SPSS V23 (IBM, Armonk, NY, USA). Results During the period of first lockdown in India, out of 7357 overall trauma cases, 130 (1.76%) ocular trauma cases were recorded. So far the type of ocular injury is concerned, 54 (42%) reported with ecchymosis, 33 (24.6%) with subconjunctival hemorrhage, 25 (19%) with lid laceration, 14 (10.4%) with traumatic mydriasis, 11 (8.4%) with corneal rupture, 4 (3%) with orbital floor fracture, and 7 (5%) with traumatic hyphema and traumatic cataract. A total of 39 (30%) injured persons reported of domestic violence, 26 (28%) RTA, 19 (15%) some form of assault (nondomestic), and 17 (13%) injury due to fall. So far the mechanism of injury involved in the domestic violence cases is considered, 18 (46.3%) reported with fist/punch blow, 9 (23%) reported with slapping, 6 (15.4%) reported with assault by belt, and 5 (12.8%) reported with injury by sticks. Conclusions Lockdown of financial and social activities during the COVID-19 pandemic resulted in reduced reporting of ocular injuries due to causes such as RTA, occupational hazards, and sports-related events.

Etiology, presentation and treatment of ocular trauma in paediatric population.

Objective: To determine the etiology, presentation and treatment of ocular trauma in paediatric population. Study Design: Cross Sectional Study. Setting: Institute of Ophthalmology, Liaquat University Hospital Jamshoro. Period: January, 2020 to December 2020. Material & Methods: Data was collected using a questionnaire having age, sex, cause of injury and time at presentation to the emergency. It also focused on which structures were damaged due to injury, investigations being used, and treatment performed. Results: In our study we found 80 cases of ocular trauma in pediatric population visiting the ophthalmology department. Gender distribution of the study group which includes 72.5% (n=58) males and 27.5% (n=22) females. It was found during playing 86.3% of children had ocular trauma followed by injury due to domestic stuff like glass, bleach cleaners in 7.5% of the study group. The most frequently occurring ocular trauma was found to be corneal tear occurring in 25% of the study group. Conclusion: Ocular trauma in children can be prevented by simple measures like supervising children and educating parents and teachers for potential hazard substances. It is important to address like healthcare issue as ocular trauma can lead to lifelong blindness along with psychological and financial burden for the caretaker and children themselves.

Clinical Profile, Etiology, and Management Outcomes of Pediatric Ocular Trauma in Saudi Arabia.

To evaluate cases of pediatric ocular trauma at a tertiary eye hospital in central Saudi Arabia and determine the demographics, causes, ocular injuries, and visual status before and after management. A retrospective review was performed of health records of children younger than 16 years with ocular trauma managed from January 1998 to December 2019. Data were collected on patient demographics, eye involved, cause of trauma, the presenting and final vision, and the duration of follow-up. Best-corrected visual acuity at the last follow-up was compared between open and closed eye injury groups. The Birmingham Eye Trauma Terminology was used to classify the ocular injuries. Among 1003 patients, 728 (72.6%) had open globe and 275 (27.4%) had closed globe injuries. The main causes of trauma were unsafe playing-related activities (n = 394; 39.3%), unsafe home environment (n = 158;15.8%) and injury by metallic objects (n = 166; 16.6%). Gunshot-related ocular trauma was noted in 62 (6.2%) children. Presenting vision less than 20/400 was noted in 292 (40.1%) eyes with open globe injuries and 110 (40%) eyes with closed globe injuries (P = 0.4). After a median follow-up of 13.3 months, best-corrected visual acuity was 20/20 to 20/200 in 393 (53%) eyes with open globe injuries and 137 (49.8%) eyes with closed globe injuries (P = 0.03). Despite proper management, children in this study sustained significant permanent visual loss secondary to ocular trauma. Public health efforts in Saudi Arabia are needed to reduce preventable injury-related childhood blindness.

The study of simultaneous bilateral ocular trauma in Northern India: clinical presentation, epidemiology and patterns of injury.

This study isaimed to determine the frequency, sociodemographic profile, clinical presentation, patterns of injury, treatment and outcomes of cases of simultaneous bilateral ocular trauma treated in a teaching hospital of Northern India. This retrospective study was conducted from May 2015 to April 2019. The medical records of patients presenting with bilateral ocular injuries were reviewed. Among the 402 patients presenting with ocular injuries, 34 (8.5%) had simultaneous bilateral ocular trauma. The majority were male (70.6%), and the mean age was 26.82 ± 15.86years (range: 2-70years). The most frequently affected age group has been 16-25years (35.3%). Most injuries occurred away from home (64.7%), mainly on roads (32.4%) or playgrounds (14.7%), and the vast majority (91.2%) were non-occupational in nature. Mechanical injuries were most frequent (47.1%), followed by cracker (17.7%), chemical (17.7%) and thermal (11.8%) injuries. Most cases occurred due to assault (26.5%), road traffic injury (20.6%) or sports/recreational activities (17.7%). The majority of victims were not using protective devices at the time of injury (82.4%) and had associated polytrauma (58.8%). Closed and open globe injuries accounted for 29.4% and 14.7% of cases, respectively, mostly involving zones I (55.0%) and II (40.0%). Orbital fractures occurred in 27.9% of eyes. Category I and II ocular trauma scores were noted in 5.9% and 7.4% of eyes, respectively. Overall, 13.2% were blinded as a result of the trauma. Simultaneous bilateral ocular trauma is rare and occurs mostly following roadtraffic accidents, assault or recreational activities. In particular, young-adult males are more prone to bilateral ocular injuries, the majority of which are severe and associated with poor outcomes. The study also highlights that poor initial visual acuity, multiple ocular structure involvement, large open globe injury, presence of intraocular hemorrhage, posterior segment injury, multiple orbital fractures and lower OTS were the poor prognostic factors.

Penetrating Injury Into The Orbit By A Needle Fish: An Unusual Case of Ocular Trauma

Ocular trauma is the most common cause of monocular blindness worldwide. Some cases of ocular trauma can be challenging to diagnose and manage due to their unique presentation as in this case where a 12 years old boy presented to our hospital with symptoms mimicking orbital cellulitis. The patient had no obvious signs of injury at presentation and was not improving on routine treatment. Later on, the patient was found to have an intra-orbital foreign body on radiological investigations and was managed accordingly. The foreign body was correlated to be a broken needlefish beak which injured him while swimming in a pond.

Clinical Profile, Aetiology, and Management Outcomes of Paediatric Ocular Trauma in Saudi Arabia

Purpose: To evaluate cases of paediatric ocular trauma at a tertiary eye hospital in central Saudi Arabia and determine the demographics, causes, ocular injuries and visual status before and after management. Methods: A retrospective review was performed of health records of children younger than 16 years with ocular trauma managed from January 1998 to December 2019. Data were collected on patient demographics, eye involved, cause of trauma, the presenting and final vision and the duration of follow up. Best-corrected visual acuity (BCVA) at the last follow up was compared between open and closed eye injury groups. The Birmingham Eye Trauma Terminology (BETT) was used to classify the ocular injuries. Results: Among 1,003 patients, 728 (72.6%) had open globe and 275 (27.4%) had closed globe injuries. The main causes of trauma were, unsafe playing-related activities (394 patients;39.3%), unsafe home environment (158 patients;15.8%) and injury by metallic objects (166 patients;16.6%). Gunshot-related ocular trauma was noted in 62 (6.2%) children. Presenting vision <20/400 was noted in 292 (40.1%) eyes with open globe injuries and 110 (40%) eyes with closed globe injuries. ( P =0.4). After a median follow up of 13.3 months, BCVA was 20/20 to 20/200 in 393 (53%) eyes with open globe injuries and 137 (49.8%) eyes with closed globe injuries. ( P =0.03). Conclusions: Despite being very well-managed, Saudi children seem to be at risk of visual disability due to ocular trauma. The risk factors for ocular trauma require preventative action through public health education that could reduce the incidence of childhood blindness. Funding: None to declare Conflict of Interest: None to declare. Ethical Approval: This study was approved by the Hospital Institutional Review Board (1310-R).

A prospective study on the pattern of traumatic ocular injuries in Central Karnatakaand their forensic aspects

Total or partial blindness is a serious public health issue that affects a person's quality of life. Ocular trauma is one such leading cause of blindness, especially monocular blindness. Ocular injuries hold forensic importance when there is a significant loss in visual acuity as a result of an unnatural cause and expert opinion is needed to establish causation between the nature and extent of permanent impairment and injury. The prospective study conducted at a teaching hospital from January 2019 to December 2019, involving 48 cases, aims to analyse the pattern of traumatic ocular injuries and emphasize on the forensic issues involved. There was a preponderance of male patients (64.5%) over the female patients. 75% of cases were from the rural population and the common age group affected was 21–30 years among both sexes. Maximum injuries were inflicted at home (47.91%). Road traffic accidents (29.16%) were the most common mode of accidental injury. Closed globe injuries were seen in 22 cases (45.83%) and open globe injuries in 8 cases (16.66%). Permanent and partial loss of vision was seen in 22 cases of ocular trauma. Permanent and complete loss of vision was seen in one case. Ocular traumas are preventable through public awareness programmes and strict legislation for the use of personal protective devices that can help reduce the occurrence of such injuries. The study indicates that there is an urgent need to step up safety precautions to prevent disabling eye injuries and enlightens health care workers on the medico legal issues involved.

Visual outcome of pediatric ocular trauma in a Latin American population

Objective: The aim is to assess associated factors regarding the type of pediatric ocular trauma and final visual acuity (VA) of the patients received ophthalmology service at tertiary care facility between 2013 and 2018. Methods: Retrospective cohort study. The clinical history of patients between 0 and 15 years of age diagnosed with ocular trauma was examined. The exposure variable was the type of ocular trauma (open or closed). Other variables related to ocular trauma were studied. Results: A total of 183 ocular trauma cases were studied. The median age was 9 years (interquartile range: 5–12), most patients were males (65.5%), blunt and sharp objects were the most frequent causes of ocular trauma (41% and 33.3%, respectively). Closed ocular trauma was found in 82.5% of the cases and zone 1 was the most frequently involved (76,5%). Sixty-four percent of cases required surgical management and 26% presented complications at the final follow-up. About 78.7% of the patients had VA equal or higher than 20/40. The risk factors associated with worse visual outcome (worse than 20/40) was found to be open ocular trauma (relative risk [RR] = 5.5; 95%IC: 3.3–9.2), the affected zone (higher risk in zone 3 with RR = 7.62; 95% confidence interval: 7.61–7.63) and time elapsed between the moment of trauma and receiving ophthalmological treatment (RR = 1.01; 95%IC: 1.01–1.01). Conclusion: Most patients that presented with ocular trauma had satisfactory final VA, considering that closed ocular trauma was more frequent. Open ocular trauma, the affected zone, and the time elapsed before starting treatment were associated with worse VA outcomes in our study.

Ocular trauma by kinetic impact projectiles during civil unrest in Chile.

BackgroundThe use of kinetic impact projectiles (KIPs) for crowd-control has increased worldwide. Despite having been created as non-lethal weapons, significant damage to several organs, including the eye, has been reported. In this study, we investigated cases of ocular trauma from KIPs during the civil unrest in Chile. To our knowledge, this is the largest case series recorded in international literature.MethodsWe included all patients who sought care or were referred to the Eye Trauma Unit, a national referral centre in Santiago, Chile, during the civil unrest from October 18 to November 30, 2019. We reviewed paper medical records and extracted data on suspected cause of trauma, type of trauma, visual acuity and sociodemographic data.ResultsWe included 259 patients, out of which in 182 cases (70.5%) KIPs were the suspected cause. Cases by KIPs were predominantly male (86.6%), young (median age 26.3, interquartile range 22.0–31.4) and living in the Metropolitan Region. Eighty-nine patients (48.9%) had severe visual impairment or were blind at the first examination. The trauma was an open-globe injury in 20.3% of cases and 13 cases required evisceration of the ocular content. Compared to other causes of ocular trauma, KIPs were related to a more severe loss of visual acuity and a higher frequency of open-globe injuries.ConclusionsThe use of KIPs during a period of civil unrest in Chile resulted in severe ocular trauma, visual impairment and permanent disability. KIPs should be avoided as a method of crowd-control.

To Study the Pattern of Ocular Trauma and Predict-ing the Final Visual Outcome in Paediatric Ocular Trauma Cases in a Tertiary Eye Care Centre of Eastern India

Aim: The study was done to identify causes, demographic and clinical profile and to evaluate factors influencing visual outcome in paediatric ocular trauma patients (up to 15 years).&#x0D; Study Design: It was a prospective interventional study&#x0D; Place and Duration of the Study: The study was done in a tertiary eye care centre of eastern India between January 2019 to February 2020.&#x0D; Materials and Methods: The study was done from January 2019 to February 2020 on children between 1 year to 15 years of either sex with ocular trauma. Demographic details, cause of injury, presenting visual acuity were noted. Follow up was done till 2 months after carrying out appropriate intervention.&#x0D; Results: A total 106 eyes of 106 patients were evaluated and it was observed that children who were of 7 yrs and above were more affected (67%) than below (33%). Male children (59%) were more affected than female (41%). Injuries to Adnexa were found in 52% eyes, 40% injury cases were due to closed injury while open globe injuries comprised 8% of total cases. Common causes of injury were found to be mainly blunt objects and projectile objects. Maximum correction in visual acuity (VA) of more than 6/18 was achieved in 66% eyes, 6/18-6/60 in 11% eyes, &lt;6/60-counting finger at 1 meter in 10% eyes. &#x0D; Conclusion: Late reporting, poor initial visual acuity, involvement of posterior segment, and no immediate primary intervention at time of injury adversely affect visual outcome. Early intervention and globe salvaging repair should be done in all eyes of trauma.

Head and neck injuries after a bomb explosion: Diagnostic findings and treatment approaches.

To identify the types and severity of head, face and neck (HFN) injuries, which occurred as a result of a bomb explosion and reached serious life-threatening levels, using radiological imaging methods, and to discuss the options of treatment at the time of presentation. Of the 16 patients brought to the emergency department, 14 with HFN injuries were included in the study. Computed tomography (CT) and radiography scans were performed at the time of presentation in all patients, except for one. The injuries were divided into three groups according to their localization as head, face, and neck. A subgaleal hematoma was seen in 10 of 11 (78.5%) patients with head injuries. Eight (57.1%) of nine patients with facial injury had fractures and/or ocular injury in the orbital wall, and seven (50%) patients had maxillofacial bone fractures. Among ocular trauma cases, open-globe injuries were detected in three patients (21.4%), closed-globe in two (14.2%), and both types in three (21.4%). Of the five (35.7%) patients with secondary blast injuries in the neck, three (21.4%) had laryngeal trauma (Zone 2) due to shrapnel, localized in the false vocal cord, epiglottis, and thyrohyoid membrane, respectively. Emergency surgery was performed on a patient with a specific laryngeal injury. We consider that in patients presenting to the emergency department with blast HFN injuries, after providing airway patency and hemodynamic stability, CT and CT angiography should be performed because these modalities guide the treatment accurately and promptly.

Party Poppers and Balloons: Fun and Games or Lives and Limbs?

Abstract&#x0D; We report two cases of ocular trauma caused by recently popular party poppers and LED balloons, commonly used in parties nowadays. One case depicted a closed globe injury as a result of a party popper spray over the eye. The pressure of the spray resulted in a blunt trauma causing full thickness macular hole which was later treated with Pars Plana Vitrectomy (PPV) surgery. The second case is an example of an open globe injury caused by the bursting of LED balloon over the eye of a young child resulting in corneal perforation, traumatic cataract, vitreous hemorrhage with an intraocular foreign body (IOFB). It was successfully treated with corneal suturing, lens extraction, PPV surgery and removal of IOFB followed by a secondary lens implantation. Both of the sustained injuries were completely avoidable hence emphasizing the requirement of eye safety awareness programs and diligence in the use of these gadgets in everyday lives.

Visual Outcome of Ocular Trauma Presenting in a Tertiary Care Hospital in Sahiwal

Purpose: To find the visual outcome of ocular trauma presenting in a tertiary care hospital in Sahiwal.&#x0D; Study Design: Descriptive observational study.&#x0D; Place and Duration of Study: This study was conducted at District Headquarter Teaching Hospital affiliated with Sahiwal Medical College, Sahiwal from January 2016 to June 2019.&#x0D; Material and Methods: Four hundred and thirty five patients were included in the study by convenient sampling technique. Patient’s age, gender, occupation, activity at the time of injury, nature of object causing trauma, duration of trauma, visual acuity at the time when patient reported to hospital, the time delay before coming to the hospital were recorded. Ocular injuries were classified according to Birmingham ocular trauma terminology. Detailed ocular examination was performed. Patients were managed and post-management visual acuity at three months was recorded.&#x0D; Results: Mean age of patients was 29.07 ± 12.53 years. There were 219 (50.3%) closed globe and 216 (49.7%) open globe injuries. In 59 (13.6%) cases, cause of injury was metal object. In 146 (33.6%) cases injury was classified as contusion. In 164 (37.7%) cases cornea was involved. Majority of the patients were male. Eighty-seven patients presented within 1 day after trauma. In 154 (35.4%) patients, visual acuity at the time of presentation was 6/12 or better while in 171 (39.3%) cases it was less than 6/60. Chi-square test was used to calculate the difference between pre and post-management visual acuity. This difference was statistically significant with p-value less than 0.05&#x0D; Conclusion: Ocular trauma cases, if properly and timely managed, have a statistically significant increase in visual acuity.

Analysis of traumatic glaucoma in children

Objective To analyze the clinical characteristics of traumatic glaucoma in children. Methods This is a retrospective study.The data of 67 eyes of 67 cases with secondary glaucoma in 425 children with ocular trauma, aged 1 to 14 years, from Jan. 2014 to Dec. 2018 in First Affiliated Hospital of Zhengzhou University were analysed retrospectively. There were 52 eyes of 52 cases with secondary glaucoma caused by closed ocular trauma in closed ocular trauma group, and 15 eyes of 15 cases with secondary glaucoma caused by open ocular trauma in open ocular trauma group. The clinical characteristics, treatment methods and efficacy of treatment of the two groups were analyzed. The follow-up time was 1 month- 2 years. Results There were 251 cases of closed ocular trauma and 174 cases of open ocular trauma in children. The incidence of secondary glaucoma caused by closed ocular trauma (20.72%, 52/251) was higher than that of open ocular trauma (8.62%, 15/174), and the difference was statistically significant (χ2=11.323, P=0.001). The onset time of secondary glaucoma caused by closed ocular trauma was earlier than that of open ocular trauma. Hyphema (40.38%, 21/52) was the main cause of secondary glaucoma due to closed ocular trauma, and the mixed mechanism was the main cause of secondary glaucoma due to open ocular trauma (73.33%, 11/15). The two groups received conventional medicine first, and 22 cases (42.31%, 22/52) of closed ocular trauma group and 3 cases (20.00%, 3/15) in open ocular trauma group were converted to surgery because of lose control of IOP. The difference in surgery rate was not statistically significant between the two groups(χ2=2.477, P=0.116). At the last follow-up, the mean IOP of closed ocular trauma group was higher than that of open ocular trauma group (t=2.828, P=0.006). There was no statistical significance in BCVA between the two groups at the last follow-up (t=-1.244, P=0.218). Conclusion Secondary glaucoma caused by closed ocular trauma is more common than open ocular trauma. Treatment with medicine is still the first choice, but filtering surgery is an effective way to control secondary glaucoma with closed ocular trauma. Key words: Glaucoma, traumatic, children; Trauma, ocular, closed; Trauma, ocular, open