Cases Of Ocular Trauma Research Articles

Severe ocular trauma cases: types and incidence

Abstract Purpose Presentation of severe traumatic ocular injuries during the year 2008 at Ophthalmology Department of Hippokration General Hospital in Thessaloniki Methods The study included patients who came at our clinic with severe ocular trauma and needed admission for observation and/or surgical treatment (total number 26) Results Included cases were: I) 9 (34,6%) cases of blunt trauma (4 with hemophthalmia and 5 with hyphaema), only 2 needed surgical evacuation. II) 6 (23,1%) corneal penetrating traumas with intraocular foreign body, all of which surgically treated, with mild visual impairment in 3 cases. III) 8 (30,7%) cases of corneal penetrating trauma without intraocular foreign body, 6 surgically treated, with good visual outcome in 6 cases, IV) 3 (11,6%) cases of scleral laceration without intraocular foreign body, all surgically treated, 1 of them with severe visual impairment Conclusion Severe traumatic ocular injuries are frequent at Ophthalmology Department of Hippokration General Hospital (most frequent blunt trauma followed by corneal penetrating trauma) and with timely treatment the majority of cases had good visual outcome.

An epidemiology study on cause of ocular trauma in Zambia.

Objective By investigating the epidemiology material, find out the causes and character of the ocular trauma. Methods The patients from 09/21/06 to 05/30/08 were collected in Kabwe General Hospital of Zambia. Results In 735 cases of ocular trauma , kind of injury , traumatic type and the time of seeing doctor, etc, all of them has specificity of Africa. Conclusion The incident rate of children＇ s ocular trauma is the highest, many factors are related the high incident rate of ocular trauma, Enhancing prevention and right treatment on time are the most important thing to reduce the high incident rate of the ocular trauma. Key words: ocular trauma; epidemiology; Kabwe of Zambia

Ocular injury requiring hospitalisation in the South East of Ireland: 2001–2007

Aim To investigate whether recent socio-demographic changes and recent health and safety measures have impacted on the trends of ocular trauma in the South East of Ireland. Methods We retrospectively reviewed all cases of ocular trauma admitted to our department between October 2001 and September 2007, and the following data were retrieved: demographic details; mechanism of injury and nature of injury. Results During the study period, 517 patients were admitted with ocular trauma. Work-related and home-related activities were the commonest causes of admission, and accounted for 160 (31.8%) and 145 (28.4%) cases, respectively. In 2006/2007, and following the influx of migrant workers from the 10 new EU accession states (EUAS), the incidence of hospitalised ocular injuries per 100,000 was 89 in persons from the EUAS versus 18 in those of Irish origin, P ≤ 0.0001. After adding the offence of not wearing a seat belt to the traffic penalty point system in Ireland, the proportion of road traffic accident (RTA)-related ocular injuries dropped significantly from 6.7% to 2.4%, P = 0.03. Conclusion The inclusion of the offence of not wearing a seat belt in the traffic penalty point system may have contributed to the significantly lower proportion of hospitalised ocular injuries attributable to RTAs. Also, the demographic profile of patients admitted because of ocular trauma has changed over the last 6 years, reflected in an increasing proportion of these injuries in persons from the EUAS. These data will inform healthcare providers, and those involved in developing health and safety guidelines for the workplace.

Clinical analysis of hypotension on ocular trauma with vitrectomy

目的 探讨复杂性眼外伤玻璃体切除术后发生低眼压的危险因素.方法 对208例(208眼)复杂性眼外伤行玻璃体切除手术的临床资料进行回顾性分析,低眼压标准为≤5 mmHg持续1个月以上.结果 208眼中,术后1年低眼压的发生率为19.71%.进行卡方检验表明:无晶状体眼和有晶状体眼术后低眼压的发生率分别为21.45%和17.07%,差异有统计学意义;视网膜切除和不切除术后低眼压的发生率分别为35.48%和13.00%,差异有统计学意义;玻璃体基底部切除干净与不干净术后低眼压的发生率分别为11.51%和36.25%,差异有统计学意义;术前低眼压与非低眼压术后低眼压的发生率分别为30.77%和13.08%,差异有统计学意义;术前有眼内炎与无眼内炎术后低眼压的发生率分别为33.33%与16.86%,差异有统计学意义;术前有视网膜脱离和无视网膜脱离术后低眼压的发生率分别为39.58%和13.75%,差异有统计学意义;有无睫状体破裂术后低眼压的发生率分别为35.14%和11.19%,差异有统计学意义;有无眼内异物术后低眼压的发生率分别为35.48%和41.30%,差异有统计学意义.结论 术前低眼压、睫状体破裂、视网膜脱离、眼内炎、术中晶状体切除(或术前无晶状体)、视网膜切除以及玻璃体基底部残留较多是复杂眼外伤玻璃体切除术后低眼压发生的危险因素。

A five-year retrospective study of the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in a Mediterranean area

BackgroundTo determine the epidemiological characteristics and visual outcome of ocular trauma in southern Italy.MethodsAll cases of ocular trauma admitted to Department of Ophthalmology of Palermo University, Italy, from January 2001–December 2005 were retrospectively reviewed for open- or closed-globe injury (OGI or CGI). Data extracted included age, sex, residence, initial and final visual acuity (VA), cause and treatment of injury, hospitalization. The injuries were classified by Ocular Trauma Classification System (OTCS) and Birmingham Eye Trauma Terminology (BETT). We also referred to the Ocular Trauma Score (OTS) in evaluating the final visual outcome.ResultsOf the 298 eyes, there were 146 OGI and 152 CGI. Fifty eyes (16.8%) had an intraocular foreign body (IOFB). The annual incidence of eye injuries was 4.9 per 100,000. Most injuries occurred in men (84.6%, p < 0.0005), with an average age of 33.0 vs. 49.9 for women (p = 0.005). Cause of injury differed significantly by gender (p = 0.001) and urban vs. rural location (p = 0.009). The most frequent causes in men were outdoor activities related injuries (30.9%), work-related (25.4%), and sport-related (17.5%), and in women were home-related (52.2%) and outdoor activities related injuries (30.4%). In urban areas, road accidents were more frequent; in rural areas, work-related injuries were more frequent with a greater rate of IOFBs than in urban areas (p = 0.002).The incidence of OGI and CGI differed in work-related injuries (p < 0.0005), sport-related injuries (p < 0.0005), and assaults (p = 0.033). The final visual acuity was 20/40 (6/12) or better in 144 eyes (48.3%), 20/40–20/200 (6/12–6/60) in 90 eyes (30.2%), and <20/200 (6/60) or less in 46 eyes (15.5%). Eighteen eyes (6%) had a final acuity of no light perception. Of those eyes that presented with hand motion vision or better, 220 (86.6%) had a final vision of better than 20/200 (6/60). Initial visual acuity was found to be correlated with final visual acuity (Spearman's correlation coefficient = 0.658; p < 0.001). The likelihood of the final visual acuities in the OTS categories was correlated to that of the OTS study group in 12 of 14 cases (85.7%).ConclusionThis analysis provides insight into the epidemiology of patients hospitalized for ocular trauma. The findings indicate that ocular trauma is a significant cause of visual loss in this population.

Ophthalmology: the good, the bad and the ugly

This article describes procedures and common complications relating to some aspects of eye surgery. Most ophthalmic claims divide into three groups: the first, where the surgery and general care of the patient is not at fault but the patient is dissatisfied with the result or simply dislikes the surgeon; the second is where substandard care and clinical negligence has occurred and the patient has had a bad result; and the third is where a surgical disaster has occurred. Medicolegal issues in cataract surgery often concern the preoperative consenting and counselling process, when an individual claims not to have been warned about a particular complication when the result is not as good as the patient expects. Vitreoretinal procedures for retinal detachments and macular disease do not attain the same excellent surgical outcomes as cataract surgery, though patient expectation is often as high. Common cases in this group involve chronic retinal detachments that have blinded an eye over several months and not been diagnosed by an optician. Another recurring theme is the negligent use of intraocular gas where an unintended expansile volume is injected into the eye or if the patient is not warned about high altitudes or the effect of anaesthetic gases that make the bubble expand in the eye to cause a very high pressure with excrutiating pain and blindness from occlusion of the central retinal artery. Ocular trauma cases often centre on inadequacies of ocular protection, the lack of prophylactic antibiotic cover and not warning patients about sympathetic ophthalmia after penetrating ocular injuries.

Early vitrectomy for open complex ocular trauma

目的 探讨早期应用玻璃体切除手术对复杂的开放性眼外伤的临床治疗效果.方法 86例86眼复杂的开放性眼外伤,在早期进行伤口修复、晶状体摘出、视网膜脱离复位术及眼内异物摘出时,联合施行玻璃体切除术的效果作回顾性分析.结果 本组86眼中术后20眼视力≥0.5(23.26%),50眼视力0.05～0.4(58.14%),16眼视力＜0.04(18.60%).结论 早期玻璃体切除术治疗复杂的开放性眼外伤是较好的方法,可使多次手术一次完成,保存和提高视力的效果较为满意。

Laceration and Partial Dislocation of LASIK Flaps 7 and 4 Years Postoperatively With 20/20 Visual Acuity After Repair

To report two cases of late ocular trauma resulting in laceration of corneal flaps 7 and 4 years (cases 1 and 2, respectively) after LASIK. A 49-year-old man sustained laceration of the flap and interface foreign body debris from construction material in the right eye 7 years after uneventful LASIK (case 1). A 33-year-old man had partial dislocation of the flap 4 years after LASIK in the left eye (case 2) due to a penetrating wood chip accident. Surgical procedures were performed to remove the foreign bodies and reposition the flaps. In case 1, postoperative uncorrected visual acuity (UCVA) was 20/25 with manifest refraction of -0.50 -0.50 x 110 corrected to 20/20. In case 2, UCVA was 20/20 with piano refraction after LASIK retreatment. Corneal LASIK flaps are susceptible to penetrating trauma, which can occur >7 years after the procedure. Proper everamanage ment of the trauma and LASIK flap can restore excellent visual acuity.

Analysis of retinal artery occlusion after vitrectomy with gas tamponade in cases of ocular trauma

目的 分析玻璃体切除联合注气术后发生视网膜动脉阻塞的原因.方法眼外伤7例(7眼)均行玻璃体切除联合注入C3F8.术后观察视力、视野、眼压、前房反应及眼底.结果术后眼压2例较低,5例正常;7例术后发生视网膜动脉分枝阻塞6例及中央动脉阻塞1例.结论玻璃体切除联合注入C3F8后发生视网膜动脉阻塞的原因是多方面的。

Ocular trauma by spray gun in 45 cases

目的 探讨45例(77眼)压力喷枪致眼外伤的病因、临床表现及治疗.方法通过对45例(77眼)压力喷枪所致眼外伤的病因、临床表现及治疗进行分析.结果压力喷枪致眼外伤引起异物伤、化学伤、眼挫伤,经过治疗45例(77眼)全部治愈,视力无明显影响.结论针对异物伤、化学伤及眼挫伤进行治疗,收到良好的效果.

Analysis on 425 cases of ocular trauma of collegers in the campus

目的 对在校大学生眼外伤的相关因素作统计分析,探讨大学生眼外伤的防治方法.方法对425例(482眼)大学生眼外伤的年龄、性别、就诊时间、受伤眼别、地点、致伤原因、性质、眼部主要临床表现、治疗及结果作统计分析.结果年龄18～25周岁,男:女=4.33:1.就诊多在2小时内.左眼:右眼=1.3:1.受伤地点386例(90.82%)在校内.主要致伤原因是运动228例(53.65%)及玩耍66例(15.53%).致伤性质依次为眼挫伤215眼(44.61%)、角膜上皮擦伤89眼(18.46%)、眼睑皮肤裂伤83例(17.22%).眼部主要表现为球结膜下出血、角膜上皮擦伤、眼睑皮肤裂伤.治疗后视力下降者10眼(2.08%),其中眼球摘除1眼.结论应对在校大学生加强预防眼外伤防治的发生。

Fishing-related ocular trauma

To evaluate the characteristics of fishing-related ocular injuries. Retrospective observational analysis of a computerized databank. The United States Eye Injury Registry was used to analyze 143 patients with fishing-related ocular injury. Epidemiologic and clinical information was evaluated including the age and gender of the subjects, classification of ocular trauma, surgical management, and final visual acuity. Of the 732 cases of sport-related ocular trauma, 143 (19.54%) occurred while fishing; of these, 79% were male patients who ranged in age from 6 to 68 years (mean, 37 years). Corneal laceration, globe rupture, and hyphema were the most common diagnoses at presentation and were caused by fishing hooks, lures, and weights. Thirty-five bystanders are included in the study. Thirty-eight percent of patients had visual acuity less than 20/50, and 21% had a visual acuity of less than 20/200. Open globe injuries portended a poor visual outcome compared with closed globe injuries. Fishing-related ocular injuries represent a large percent of sports-related trauma, often resulting in significant visual loss. Preventive measures such as the use of protective eyewear should be advised in this activity.

Analysis of 1511 admission cases of ocular trauma in 10 years

目的 了解眼外伤的致盲原因及盲目率.方法对近十年来我院收治的眼外伤1511例进行临床分析.结果1511例1635受伤眼中,其中开放性眼球损伤917眼,占56.08%,盲目率(治疗后视力在0.05以下)519眼,占56.6%;眼挫伤340眼,占20.80%,治疗后的盲目率12.05%.结论眼外伤发病率高,并发症多,积极预防和及时正确处理,可有效地降低眼外伤的发生率及盲目率。

EYE TRAUMA. OPEN GLOBE INJURY MANAGEMENT

Background. Ocular trauma is important cause of blindness. Birmingham Eye Trauma Terminology allows us to use a standardized eye injury terminology which permits an unambigous interpretation. The Eye Injury Registry enables the analysis of medical, epidemyologic and social data. The most frequent ocular injury ocular contusion has a relatively good prognosis. An adequate primary ocular repair and correct timing of pars plana vitrectomy are very important in open globe injury management. There still exist some controversial issues concerning the role of posterior segment surgery in open globe injuries. These include timing of surgery, prophylactic scleral buckle placement and a proper use of systemic and intravitreal antibiotics. Conclusions. With adequate primary ocular repair, the use of systemic, intravitreal antibiotics, scleral buckling and proper timing for pars plana vitrectomy the prognosis for ocular trauma cases can be better.

The Bhaktapur eye study: ocular trauma and antibiotic prophylaxis for the prevention of corneal ulceration in Nepal

AIMSTo determine the incidence of ocular trauma and corneal ulceration in the district of Bhaktapur in Kathmandu Valley, and to determine whether or not topical antibiotic prophylaxis can prevent the...

Hypobaric ocular trauma from a Popper

We have observed 3 cases of ocular trauma in children that were caused by an atypical, hypobaric mechanism induced by a toy called a Popper. When we initially notified the United States Consumer Product Safety Commission in 1990, Poppers disappeared from store shelves. We are concerned that this potentially harmful toy is making a comeback in 1998 (Smilemakers Inc, Spartanburg, SC; June-July 1998 catalog, p. 57). In 1990, packaged poppers cautioned against applying to face or skin; we are not sure that such warnings accompany current Poppers.

Epidemiology of eye injuries in rural Tanzania

In the developing world, ocular trauma is an important cause of monocular blindness. However, little is known about the epidemiology of eye injuries in rural Africa. This study presents five- year data on hospitalized ocular injuries in a rural region in Tanzania. Data were collected from Mvumi Hospital, a tertiary hospital serving rural Dodoma, and the only hospital during this time period able to care for serious trauma. All in-patient charts from January 1, 1985 to December 31, 1989 were reviewed for cases of ocular trauma who presented within 30 days of injury. Data on demographics, cause of injury, visual acuity, and current diagnosis were ed. A total of 157 cases were recorded, of whom 69% were male. A third of the injuries occurred in those less than age 20. Injury with a stick was the most common cause, accounting for 67% of the cases. A third of the cases presented to the hospital 8 or more days after the injury, and most had poor visual acuity in the affected eye. In those age 20 or younger, 82% of females and 67% of males presented with visual acuity <3/60. Ruptured globe and uveitis were the most common diagnosis made at presentation. Preventive ophthalmology efforts in this area should focus on decreasing stick-related ocular injuries and improving rapid access to appropriate care when injuries occur.

Simultaneous posterior chamber intraocular lens implant combined with vitreoretinal surgery for intraocular foreign body injuries.

To evaluate the safety of simultaneous posterior chamber intraocular lens (IOL) implant combined with complex vitreoretinal surgery for ocular trauma due to intraocular foreign body (IOFB). We undertook a retrospective analysis of 10 patients who had undergone simultaneous cataract extraction, vitreoretinal surgery, removal of IOFB and posterior chamber IOL implant, for ocular trauma due to IOFB. The visual outcome and complications were noted. The surgical procedure is described. Ten young, male patients were followed for 5-30 months post-operatively. The post-operative visual acuity in the operated eye remained the same or improved as compared with their pre-operative vision. Eight patients had a visual acuity of 6/9 or better. One patient developed post-operative infective endophthalmitis. Three patients had retinal detachment post-operatively. The IOL was stable in all patients. Simultaneous posterior chamber IOL implant with vitreoretinal surgery is safe in selected cases of severe ocular trauma due to IOFB. It allows early visual rehabilitation of young, working patients.

The use of immunohistochemistry and the polymerase chain reaction for detection of feline leukemia virus and feline sarcoma virus in six cases of feline ocular sarcoma.

Ocular sarcoma was diagnosed by light microscopic examination in enucleated globes (n = 4), orbital tissue biopsy (n = 1) and ocular evisceration contents (n = 1) from six cats. To determine if feline leukemia virus (FeLV) or a replication-defective FeLV, feline sarcoma virus (FeSV), was present in these ocular sarcomas, immunohistochemistry (IHC) and polymerase chain reaction (PCR) for FeLV were utilized. Immunohistochemical staining for FeLV glycoprotein 70 (gp70) was performed on all six formalin-fixed, paraffin-embedded tumors using an avidin-biotin complex technique. DNA was extracted from each specimen and a 166 bp region of the FeLV long-terminal repeat (LTR) was amplified by PCR. All tumors were composed primarily of spindle cells; two neoplasms had PAS-positive basement membrane enveloping areas of spindle cells. All tumors involved the uvea and five of six tumors showed transcleral extension, one of which invaded the optic nerve. Immunohistochemical staining for FeLV gp 70 was negative. PCR to amplify a portion of the FeLV LTR was negative. Based on these findings of these limited number of cases, FeLV/FeSV may not play a role in the tumorigenesis of feline ocular sarcomas. However, additional tumors representing all morphological subtypes should be investigated for the presence of viral antigen and DNA. It is important to determine the etiology and pathogenesis of these malignant ocular sarcomas. If the cell of origin and pathogenesis involve ocular and lenticular injury, and FeLV/FeSV is not present, then the clinical management of cases of feline ocular trauma, uveitis and glaucoma may prevent the development of this tumor.

Air bag-related ocular trauma

Automobile air bags have recently gained acceptance as an effective measure to reduce the morbidity and mortality associated with motor vehicle accidents. This report describes 11 cases of air bag-related ocular trauma and reviews cases previously reported in the literature, for a total of 32 patients and 39 eyes. This is the first comprehensive report on various types of ocular trauma related directly to air bag deployment. The most common type of ocular injuries seen are to the eyelids (23 patients, 28 eyes), conjunctiva (21 patients, 25 eyes), and cornea (23 patients, 28 eyes). Hyphema was frequently seen (10 patients, 11 eyes). Several serious cases of vision-threatening injuries, including retinal detachment, retinal dialysis, scleral rupture, and dislocated lens, were also reported. The following patterns were found: 55% of patients were male and 45% female; ages ranged from 2 to 81 years with a mean age of 36 years; the right eye was involved in 35% of cases, the left in 38%, and 27% were bilateral. Based on these findings, it is recommended that all patients who present with air bag-related ocular trauma undergo a complete ophthalmologic examination because the high-velocity blunt trauma causes ocular injuries that may be more serious than they initially appear. Further refinements in design and deployment need to be made to reduce the frequency and severity of air bag-related ocular injuries.