Open Globe Eye Injury Research Articles

Iatrogenic open globe eye injury following sinus surgery

Purpose To report a case of iatrogenic open globe eye injury occurring during endoscopic sinus surgery. Design Case report and literature review. Methods A 10-year-old boy presented with periorbital swelling and subconjunctival hemorrhage of the left eye following bilateral nasal adenoidectomy. Funduscopic examination showed evidence of a full-thickness open globe injury at the equator in the inferior nasal midperiphery. Results The injury most likely was secondary to inadvertent perforation of the lamina papiracea with entrance into the orbit and subsequent penetration of the globe. Conclusion Sinus surgery has been reported previously in association with severe orbital complications. We are unaware of previous reports of open globe injury following sinus surgery.

Epidemiology of open globe injuries

Severe open globe injuries are frequent emergencies in an ophthalmologic clinic and required immediate operation. The extent of these injuries is various depending on the mechanism of the injury and involvement of ocular tissue. In many cases a full visual rehabilitation can be achieved but in a lot of cases blindness results. To prevent such severe eye injuries it is important to judge the leading injury mechanisms. For this we collected our data about open globe injuries. Retrospectively we collected the data from 103 consecutive patients in the year 1996 and 1997, presenting with an open globe eye injury followed by operation. The data contained personal patients data, information about mechanism of injury, visual acuity, operation and rehabilitation. Statistical analysis was performed using binomimal-test and t-test for paired and unpaired samples (p < 0.05). 85.4% were male. Most of the injuries happened at home (38%) and at the working place (31%). Assaultive injuries happened in 6.8%. 35% of all patients were craftmen (mechanics, electricians, or the locksmith were preferred). Pensioners were affected in 14.6% of all cases followed by small children (7.8%) and school children (7.8%). In 50% of all cases metal and glass were responsible for the trauma, explosions were noticed in 8.7%. An intraocular foreign body was found in 37.9%. In 62% of all cases no second operation was necessary. An enucleation during the follow-up was performed in 2 cases. At least a third of all severe eye injuries would have been preventable. Concerning the non-preventable injuries accidents at home and in children were predominating. The rate of the open globe injuries was 2.32 in 100.000 people, which is about the same like in US-American studies. Most of the injuries happened at home because of carelessness and would have been avoidable. The rate of injuries at the working place is significantly higher than in the USA but there were significantly more gun-shot-injuries or offensive accidents abroad. The rate of accidents at home and in traffic were the same. We think that public campaigns and prevention strategies can help to reduce the potential risk of severe eye injuries.