Showing papers on "Eye injuries published in 1976"

Perforating injuries of the eye

Abstract: This review was undertaken to evaluate the outcome of the current management of perforating eye injuries in order to determine reasons for failure to achieve a satisfactory result, and to see where further improvement may be possible. Since the advent of microsurgical techniques, better wound closure and re-formation of the anterior chamber have led to a greatly improved prognosis for perforating eye injuries (Roper-Hall, 1959). Attention has subsequently been directed towards the management of intraocular damage: the safety of repositing an iris prolapse with an improved visual and cosmetic result has been reported by Callaghan (1956) and by Stein (1958), while immediate aspiration of a damaged lens was recommended (Roper-Hall, I959) to reduce subsequent intraocular inflammation. More recently, Coles and Haik (I972) stressed the importance of performing an extensive anterior vitrectomy in badly injured eyes to limit the development of intraocular fibrosis leading to phthisis and retinal detachment. In this present study, 228 patients with perforating eye injuries (nine bilateral) have been reviewed; all were admitted to the Birmingham and Midland Eye Hospital between 197I and I974. This study does not include patients with small intraocular foreign bodies and a sealed entry wound, as these constitute a different clinical problem. Since the complications of perforating eye injuries are now determined largely by the extent of intraocular damage, a simple classification on this basis was adopted. Injuries were divided into four groups as follows: Grades I and 2 were injuries confined to the anterior segment; lacerations of the cornea or anterior sclera, with or without uveal prolapse, were classified as Grade i, but if lens damage was also present, they were classified as Grade 2. Injuries involving the posterior segment with vitreous loss were classified

Prognosis of perforating eye injury.

Abstract: The assessment of visual function in a series of 130 consecutive patients of perforating eye injuries, revealed that visual acuity of 6/12 or better was regained in 63 per cent, between 6/60 and 6/18 in 9-2 per cent, less than 6/60 in 15-3 per cent, and enucleation was necessary in 9-2 per cent. In 3 per cent, the eyes were retained as blind, symptomfree, and cosmetically satisfactory organs. Two eyes were found to develop complete traumatic aniridia. None in the series was found to have sympathetic ophthalmitis.

Perforating ocular shotgun injuries: relationship of ocular findings to pellet ballistics.

Abstract: A retrospective study of 20 cases of perforating ocular injuries due to shotgun pellets revealed visual acuity of hand motions or worse in 85%. Massive persistent vitreous hemorrhage was present in 75%. Double perforation of the globe was present in 60% of the involved eyes. Product safety measures are recommended.

Treatment of acute eyelid trauma to prevent late complications.

Abstract: A checklist for preventing late complications of acute eyelid trauma should include recognizing injury to the globe, preventing infection, and achieving proper coaptation of the wound margins. Recognition and immediate management of lacrimal, canthal, and levator injuries and occult orbital foreign bodies may prevent late complications that are more difficult to repair.

Tennis Players and Eye Injuries-Reply

Abstract: The patients described in our article did return to playing tennis, although somewhat hesitantly at first. However, after a few months they were playing fairly regularly again. A few of the patients did begin to wear eye protection such as the device shown in the article. Others decided not to wear any sort of protective device at all. We have encouraged all of them to wear either impact resistant glasses or some other type of eye-protective device in order to prevent another injury. We are hopeful that more players will wear these protective devices, so that the number of injuries will be kept to a minimum.

Antibiotic prophylaxis in penetrating injuries of the eye.

Abstract: In a specially developed experimental model of an infected penetrating eye injury the importance of time and mode of antibiotic administration in the prophylaxis of post-traumatic eye infection was evaluated. It was concluded that the early administration of an antibiotic to which infecting organisms are sensitive can prevent the development of an inflammatory reaction in the majority of injured eyes. The late administration of the same antibiotic (6 h after injury) has no effect at all. Subconjunctival injection was found to be superior to intramuscular if the antibiotic was given at a similar time after injury. The results of this experiment stress the importance of very early antibiotic administration in the prophylaxis of an infection in penetrating eye injuries.

Office treatment of eye injury. 2. Injury from sharp instruments or blunt trauma.

Abstract: Eye injuries caused by sharp instruments range from superficial scratches of the corneal epithelium to serious lacerations of the globe of the eye. Scratches, conjunctival lacerations, and some eyelid lacerations can be dealth with by the primary physician in the office, but damage to the globe requires immediate referral to an ophthalmologist. Among possible results of blunt trauma to the area of the eye are ecchymosis, hyphema, blow-out fracture, subluxation or dislocation of the lens, or retinal detachment. Most of thes require thoroguh ophthalmologic examination and specialized treatment. The primary physician may be the first to examine a patient with serious head injury. For future reference the status of each eye should be carefully documented as soon as possible after injury.

I Eye Injuries: Underwater Vision

Abstract: larly with occupational diseases which were, or perhaps should be, prescribed. For patients who came before a Medical Board or Medical Appeal Tribunal for assessment of disability following eye injury at work, opiniorns of ophthalmologists were available. For results of severe injury such as penetrating foreign body or chemical splash, opinions were usually clear-cut, but opinions varied with regard to cause or aggravation of pterygium in a person who had worked in hot or dusty conditions. Mr Stanworth, in his contribution on delayed effects, made the point that traumatic cataract and detachment of retina may occur long after the insult. Dr Bidstrup believed it was customary for Medical Boards to attribute retinal detachment only if it followed relatively soon after the accident. A question had been asked about the use of buffered sodium phosphate as a first-aid treatment for eye-splash, for which water had also been recommended. After some discussion it was agreed that water was usually readily available and valuable time might be lost in seeking a more specific antidote or special solution such as buffered sodium phosphate or normal saline. \\ A speaker had referred to the need to ensure that drops instilled into injured eyes in first-aid or factory medical departments were sterile, and had described a case of pseudomonas infection. In 3 cases where infection followed treatment of eye injury in Dr Bidstrup's medical department, an identical strain of pseudomonas had been found. Pseudomonas organisms might, however, be found in the 'normal' conjunctival sac, and it would not necessarily be correct to attribute pseudomonas following eye injury to contamination during first-aid treatment.

Traumatic injuries: office treatment of eye injury. 1. Injury due to foreign materials.

Abstract: Patients with eye injuries caused by foreign materials are often seen by the primary physician. The causative agents may be foreign objects, noxious liquids or vapors, ultraviolet irradiation, or contact lenses. Injuries caused by foreign bodies that do not penetrate the outer coats of the eye can be treated by the nonspecialist; the intraocular presence of an object requires prompt referral to an ophthalmologist. Ultraviolet light irradiation and contact lenses worn for a prolonged period cause a great deal of pain to the eye but injury is not serious and the eye heals well. Injury from chemicals may be moderate or severe; if pain and functional impairment persist after copious irrigation of the eye with sterile saline solution, the patient should be referred to an ophthalmologist.

I Eye Injuries: Ocular Complications of Industrial Lasers

Abstract: trauma leading to vitreous hemorrhage, adhesions, and bands which may need intravitreous surgery; but it may follow much more subtle changes. Concussion of the eyeball of the type that produces hmmorrhage into the anterior chamber (traumatic hyphtema) may be accompanied by commotio retinxe with dialysis of its anterior insertion, round holes at the macula or elsewhere, vitreoretinal adhesions producing whitish areas or areas which become white when the sclera is indented ('white with pressure') and vitreous condensation and bands. The situation can be assessed one month after the hyphaema has absorbed (Sellors & Mooney 1973) though the risk continues long after this. Prophylactic light coagulation or cryotherapy is occasionally indicated. Glaucoma can also be a late complication of traumatic hyphoema. Examination of the angle of the anterior chamber shows recession of the angle. Unless the patient is predisposed to glaucoma for some other reason glaucoma probably occurs only if the recession affects more than 180 degrees, and usually more than 270 degrees (Kaufman & Tolpin 1974). The recession can be assessed one month after the accident, but the glaucoma may take some years to develop. Provocative tests for glaucoma might be helpful in prognosis. Defects of accommodation and convergence usually follow head injuries, but occasionally a defect of accommodation may be an unexpected persisting complication of concussion injury when the eye has otherwise apparently fully recovered. A conjunctival implantation cyst may arise at a late stage.