Showing papers on "Eye injuries published in 2003"
TL;DR: Most of the accidents reported in this study could have been avoided; the data demonstrate a clear need for primary prevention and control measures.
Abstract: Objective To describe the epidemiology of ocular trauma in children 15 years and younger who underwent evaluation during a 5-year period in the emergency department of a tertiary referral center in northeastern Colombia. Methods We retrospectively reviewed the medical records of children 15 years and younger. Records of 393 children with 415 incidents of eye injury were included in the study, of whom 22 were initially treated for bilateral ocular trauma. Results Most patients (64.9%) were boys. The highest proportion of injuries(44.4%) occurred at home, followed by streets and roads (28.6%). Blunt (35.1%) and sharp (22.6%) objects represented the most frequent causes of trauma. Closed-globe injuries were far more frequent than open-globe injuries for boys (82.4% vs 17.6%) and girls (83.8% vs 16.2%). Of those with closed-globe injuries, 253 injuries (80.0%) registered an initial visual acuity of greater than 20/60, whereas 31 open-globe injuries (52.5%) registered an initial visual acuity of less than 20/400. Most closed-globe injuries (223 [92.1%]) did not cause any final visual impairment in the affected eye, whereas 26 open-globe injuries (55.3%) caused severe visual impairment or blindness. Conclusions Most of the accidents reported in this study could have been avoided; the data demonstrate a clear need for primary prevention and control measures.
132 citations
TL;DR: There is a significant burden of corneal blindness in this population, the majority of which is avoidable, and eye health promotion strategies are warranted to raise awareness about the causes and prevention of corNeal blindness.
Abstract: Aim: To assess the distribution and causes of corneal blindness in a population in southern India.
Methods: A total of 11 786 people of all ages from 94 clusters representative of the population of the Indian state of Andhra Pradesh were sampled using a stratified, random, cluster, systematic sampling strategy. These participants underwent a detailed interview and eye examination including measurement of visual acuity with logMAR charts, refraction, slit lamp biomicroscopy, applanation tonometry, gonioscopy, and stereoscopic dilated fundus evaluation. An eye was considered to have corneal blindness if the visual acuity was <20/200 due to a corneal disease.
Results: Of those sampled, 10 293 (87.3%) people participated in the study. Corneal blindness in at least one eye was present in 86 participants, an age, sex, and urban-rural distribution adjusted prevalence of 0.66% (95% confidence interval 0.49 to 0.86), which included 0.10% prevalence of corneal blindness in both eyes and 0.56% in one eye. The most frequent causes of corneal blindness in at least one eye included keratitis during childhood (36.7%), trauma (28.6%), and keratitis during adulthood (17.7%). Nearly 95% of all corneal blindness was avoidable. Multivariate analysis showed that the prevalence of corneal blindness was significantly higher with decreasing socioeconomic status and with increasing age. Of the 99 eyes with corneal blindness, 51 (51.5%) had visual acuity of inaccurate projection of light or no perception of light.
Conclusions: There is a significant burden of corneal blindness in this population, the majority of which is avoidable. Eye health promotion strategies are warranted to raise awareness about the causes and prevention of corneal blindness.
125 citations
TL;DR: A school eye screening cum intervention programme with periodic evaluation seems to be appropriate for countries like Nepal as most of the eye diseases found are preventable or treatable.
Abstract: Background/aims: Any information on eye diseases in schoolchildren in Nepal is rare and sketchy. A programme to provide basic eye screening to schoolchildren with an aim to provide services as well as gather information on ocular morbidity has been started. Methods: All the children in the schools visited are included in the study. This programme is targeted at poor government schools, which are unable to afford this service. A complete eye examination is given to all the children including slit lamp examination, fundus evaluation and retinoscopy, and subjective refraction. Results: A total of 1100 children from three schools are included in this report. 11% of our schoolchildren have ocular morbidity, 97% (117 out of 121) of which is preventable or treatable. Refractive error is the commonest type of ocular morbidity (8.1%). Myopia is the commonest type of refractive error (4.3%) as opposed to hypermetropia (1.3%). 12.4% of children with refractive error have already developed amblyopia. Strabismus is the second commonest type of ocular disability (1.6%). Alternate divergent squint is the commonest type of strabismus (1.4%). Traumatic eye injuries (0.54%), xerophthalmia (0.36%), and congenital abnormalities (0.36%) are much less common. Conclusion: A school eye screening cum intervention programme with periodic evaluation seems to be appropriate for countries like Nepal as most of the eye diseases found are preventable or treatable.
99 citations
TL;DR: This system for classifying mechanical injuries of the eye appears to be prognostic for visual outcomes in open-globe injuries, and the measurement of visual acuity and testing for a relative afferent pupillary defect at the initial examination should be performed in all injured eyes.
Abstract: Purpose The aim of this study was to determine the prognostic significance of a previously published system for classifying mechanical injuries of the eye (globe) in open-globe injuries.Methods The medical records of 150 patients with open-globe injuries identified from an established institutional
97 citations
Journal Article•
TL;DR: Sports-related eye injuries should be evaluated on site with an adequate examination of the eye and adnexa and the team physician must know which injuries require immediate referral to an ophthalmologist and the guidelines for returning an athlete to competition.
Abstract: Sports have become increasingly popular and account for numerous eye injuries each year. The sports that most commonly cause eye injuries, in order of decreasing frequency, are basketball, water sports, baseball, and racquet sports. Sports are classified as low risk, high risk, and very high risk. Sports-related eye injuries are blunt, penetrating, and radiation injuries. The use of eye protection has helped to reduce the number and severity of eye injuries. The American Society for Testing and Materials has established performance standards for selected eyewear. Consultation with an eye care professional is recommended for fitting protective eyewear. The functionally one-eyed, or monocular, athlete should take extra precautions. A preparticipation eye examination is helpful in identifying persons who may be at increased risk for eye injury. Sports-related eye injuries should be evaluated on site with an adequate examination of the eye and adnexa. Minor eye injuries may be treated on site. The team physician must know which injuries require immediate referral to an ophthalmologist and the guidelines for returning an athlete to competition.
79 citations
Journal Article•
TL;DR: Ten representative cases of laser eye injury that occurred in the U.S. military between 1984 and 2000 are described and human and societal costs from unintentional laser eye injuries can be reduced by improving operator training, safety procedure compliance, and equipment design.
Abstract: Introduction Lasers (light amplification by stimulated emission of radiation) play an important role in our world and their use is increasing. They are powerful tools for good, but can also cause tragedy, especially in an aviation environment. Information about injuries associated with lasers is limited. This study highlights several laser eye injuries in the U.S. military and discusses issues pertaining to them. Methods We gathered data from the U.S. Army Safety Center, the U.S. Army Center for Health Promotion and Preventive Medicine, and the Walter Reed Army Institute of Research. This paper describes ten representative cases of laser eye injury that occurred in the U.S. military between 1984 and 2000. Results Patients suffered retinal damage, though no corneal injury occurred. Most were caused by accidental exposure to a Q-switched, Neodynium:YAG (Nd:YAG) laser at 1064 nm wavelength. The incidents occurred both on and off duty, indoors and outdoors, and from close and long ranges. None of the victims were wearing eye protection. Inadequate training and poor equipment design were major factors in at least six of the nine unintentional cases. The tenth occurred during military operations in the Persian Gulf. All of the victims needed several months medical care and follow up. Two received medical discharges as a result of their injuries. Discussion As illustrated by these cases, human and societal costs from unintentional laser eye injuries can be reduced by improving operator training, safety procedure compliance, and equipment design. In addition, intentional laser eye injuries are a growing concern and further research is needed to design appropriate protection, treatment and countermeasures.
50 citations
TL;DR: Ocular injuries resulting from modern sports are often severe and adequate instruction of the participants in the games, proper use of eye protectors, and a routine complete ophthalmological examination after an eye trauma should be mandatory.
Abstract: Aims: To determine the severity and long term sequelae of eye injuries caused by modern sports that could be responsible for significant ocular trauma in the future.
Methods: Prospective observational study of 24 (25 eyes) athletes with sports related ocular injuries from health clubs, war games, adventure, radical and new types of soccer, presenting to an eye emergency department between 1992 and 2002 (10 years).
Results: Modern sports were responsible for 8.3% of the 288 total sports eye injuries reported. Squash (29.2%) was the most common cause, followed by paintball (20.8%) and motocross (16.6%). The most common diagnosis during the follow up period was retinal breaks (20%). 18 (75%) patients sustained a severe injury. The final visual acuity remained <20/100 in two paintball players.
Conclusions: Ocular injuries resulting from modern sports are often severe. Adequate instruction of the participants in the games, proper use of eye protectors, and a routine complete ophthalmological examination after an eye trauma should be mandatory.
48 citations
TL;DR: A multidisciplinary approach to management is required because facial and cerebral injuries are also common and orbital and ocular injuries are common in association with orbital roof fractures.
Abstract: Purpose: To review the clinical features and management of patients with orbital roof fractures. Methods: Non-comparative, retrospective case review of 21 patients presenting with orbital roof fractures. Results: The orbital roof fractures in our series resulted from motor vehicle accidents, blunt trauma, head injuries, and penetrating orbital injuries. Associated orbital and ocular injuries included other ipsilateral orbital fractures (16 cases), traumatic optic neuropathy (3 cases), ptosis (2 cases), perforating eye injuries (2 cases), intraorbital foreign bodies (2 cases), and oculomotor nerve palsy (1 case). Six patients required surgical intervention for ophthalmic sequelae, which included motility problems (4 cases), lagophthalmos (1 case), and a retained intraorbital foreign body with a cerebrospinal fluid leak (one case). The outcome of surgery was favorable in all cases, with complete resolution of symptoms in five of six patients. Conclusions: Orbital and ocular injuries are common in association with orbital roof fractures. A multidisciplinary approach to management is required because facial and cerebral injuries are also common. Most patients can be managed conservatively. The specific ophthalmic indications for surgical intervention are limited, but the outcome in these cases is gratifying.
46 citations
TL;DR: Implantation of the black-diaphragm IOL type 67 F appeared sufficiently safe and provided satisfactory functional results for correction of post-traumatic aniridia combined with cataract or aphakia, improving BCVA and reducing glare and photophobia in most patients, though clearly more cases and longer follow-up are needed to assess its clinical performance properly.
Abstract: Purpose To retrospectively review the safety and efficacy of black-diaphragm intraocular lenses (IOL) implanted for the treatment of post-traumatic aniridia. Methods Ten patients (mean age 48 years, range 21-75) were implanted with a black-diaphragm posterior chamber IOL (Morcher GmbH, model 67F) for correction of post-traumatic aniridia associated with cataract or aphakia. This IOL, in poly(methylmethacrylate), consists of an opaque diaphragm surrounding the transparent optic, and was inserted through a 10-mm scleral tunnel (seven eyes) or through the corneal trephination in cases of simultaneous penetrating keratoplasty (three eyes), and in-the-sulcus implanted, trans-sclerally sutured (six eyes) or on capsular support (four eyes). Mean follow-up was 33.4 months (range 12-52). Results Best-corrected visual acuity (BCVA) improved in eight eyes and remained unchanged in two. Glare and photophobia decreased in all patients. Intraoperatively, ciliary sulcus bleeding occurred in two cases and haptic rupture during lens insertion in one. Postoperatively, persistent intraocular inflammation was seen in four eyes, secondary glaucoma in four eyes, transient hyphema and/or hemovitreous in four, IOL decentration in two, and post-traumatic haptic detachment in one eye. Conclusions Although in our experience the haptics still seem weak and the diaphragm diameter too large, implantation of the black-diaphragm IOL type 67F appeared sufficiently safe and provided satisfactory functional results for correction of post-traumatic aniridia combined with cataract or aphakia, improving BCVA and reducing glare and photophobia in most patients, though clearly more cases and longer follow-up are needed to assess its clinical performance properly.
42 citations
TL;DR: In this article, the authors evaluated the efficacy and safety of topical anesthesia and IV sedation in surgery for less severe open-globe injury (OGI) using a case series.
35 citations
TL;DR: It is suggested that severe ocular trauma can be caused in post-PRK eyes by airbags at high impact velocities and modification of airbag design and deployment to minimize the risk of ocular injury is important.
Abstract: A simulation model of the human eye which we have developed was applied to simulated airbag ocular injury, to determine the physical and mechanical conditions of the impacting airbag that would cause globe rupture in a post-photorefractive keratectomy (PRK) eye. Simulations were performed with a computer using the finite element analysis program PAM-CRASH (Nihon ESI, Tokyo, Japan). The airbag was set to impact on the surface of post-PRK eyes—D3, D6, D10, and D15—and an intact eye at various impact velocities. Strain on the cornea and sclera exceeding 18.0% and 6.8%, respectively, was assumed to indicate the possibility of rupture of each tissue. In contrast to the intact eye, in post-PRK eyes, at the lowest velocity of 20 m/s, some of the element reached the strain threshold in D15. At the medium velocity of 30 m/s, limited corneal rupture was observed in all situations. At the high velocity, 40 m/s, scleral laceration was found in eyes with all diopters, and apparent corneal rupture was observed in D10 and D15, indicating that globe rupture was very likely to occur. These results suggest that severe ocular trauma can be caused in post-PRK eyes by airbags at high impact velocities. Preoperative discussion with candidates for laser refractive surgery regarding the potential for severe ocular injury if the normal integrity of the eye is compromised by surgery may be appropriate. Research on modification of airbag design and deployment to minimize the risk of ocular injury is important.
TL;DR: The risk of severe eye injury from airbags was very low (0.4%) in fatal or relatively serious accidents and Eyewear did not seem to increase this risk but might interfere with the injury pattern.
TL;DR: The objective is to examine patient outcomes from golf‐related ocular injuries and to establish a baseline level of confidence that golf-related eye injuries are less serious than other types of injuries.
Abstract: Purpose: To examine patient outcomes from golf-related ocular injuries.
Methods: A retrospective case review was undertaken of subjects with golf-related ocular injuries treated at the Auckland and Waikato Hospitals during the 5-year period from 1997 to 2002.
Results: Of 11 injuries treated in the 5-year period, five of the subjects incurred globe rupture with two subjects requiring enucleation. Seven of the injuries were from golf balls and four injuries were from golf clubs. Six of the subjects had a final visual acuity of 6/48 or worse.
Conclusion: Golfing injuries, though uncommon, are frequently associated with severe ocular trauma and poor visual outcome. Although unpredictable and difficult to avoid, proper golf etiquette and safety may diminish the incidence of golf-related ocular injures. Injuries caused by golf clubs occurred only in children.
01 Jan 2003
TL;DR: The computational eye model demonstrated that increased risk was related to the increasing stiffness of the lens, producing up to a 120% larger stress in the ciliary body.
Abstract: The purpose of this paper is to elucidate the incidence of eye injuries with respect to occupant age in frontal automobile crashes as well as to investigate possible injury mechanisms of the elderly eye and the effects of lens stiffness. The National Automotive Sampling System was searched from years 1993-2000 for three separate occupant age groups of 16-35 years old, 36-65 years old, and 66 years old and greater in order to compare the total number of weighted occupants who sustained an eye injury to the number of occupants who sustained an eye injury per age group. Three separate impact scenarios simulating a foam particle (30 m/s), a steering wheel (15 m/s), and an air bag (67 m/s), were applied to a finite element eye model in order to elucidate the effects of aging on the eye when subjected to blunt trauma. The lens stiffness of the model was varied according to human lens stiffness values determined for each age group. Occupants aged 66 years old and greater were two to three times more likely to incur an eye injury than younger occupants. The computational eye model demonstrated that increased risk was related to the increasing stiffness of the lens, producing up to a 120% larger stress in the ciliary body.
01 Jan 2003
TL;DR: Improvements in surgical techniques and rapid evacuation of the wounded allow physicians to repair wounds that at one time would have resulted in the death of a soldier; and improved munitions create more and smaller fragments that can cause severe, even blinding, injuries.
Abstract: : Along with saving the lives and limbs of our soldiers, sailors, and airmen injured in battle, the preservation of their eyes and eyesight is an extremely important goal. Despite comprising as little as 0.1% of the total body surface area and 0.27% of the frontal silhouette, the proportion of eye injuries in nonfatal casualties has been escalating in recent conflicts (Table). Several reasons account for the increasing risk of eye injuries: 1. preferential exposure of the eyes during combat (eg, foxholes, tank turrets); 2. improved body armor protecting the head, thorax, and abdomen, leading to fewer fatal injuries to these regions of the body; 3. improved surgical techniques and rapid evacuation of the wounded, which allow physicians to repair wounds that at one time would have resulted in the death of a soldier; and 4. improved munitions, which create more and smaller fragments that can cause severe, even blinding, injuries.
TL;DR: When evaluating infants who may have suffered child abuse, an ocular fundus examination is essential to rule out shaken infant syndrome.
TL;DR: A prospective, multicenter study of military units in the peacetime Army at selected installations to define the incidence of eye injuries, assess associated variables, and identify targets for intervention is identified.
Abstract: Studies addressing the impact of eye injuries on U.S. Army readiness and the effectiveness of countermeasures are lacking. In 1989, the U.S. Army Environmental Hygiene Agency undertook a prospective, multicenter study of military units in the peacetime Army at selected installations to define the incidence of eye injuries, assess associated variables, and identify targets for intervention. During the first 5 months of 1989 at Fort Bragg, North Carolina, Fort Campbell, Kentucky, and Fort Lewis, Washington, health care providers saw 103 new eye injuries with an overall rate of 14.18 injuries per 1,000 personnel annually. Almost one-half of the injuries (48 cases, 46.60%) occurred during on-duty work and training. Most (93 cases, 90.29%) of the soldiers were not wearing eye protection when injured. This study identifies possible targets for intervention and provides a baseline against which the interventions of the last decade may be assessed for effectiveness.
TL;DR: The major causes of eye injuries in childhood are preventable; thus more adequate adult supervision and educational and legislative measures are necessary and useful in order to reduce prevalence and morbidity of these accidents.
Abstract: PurposeTo assess the frequency, causes, mechanisms, and functional outcomes of eye injuries in childhood.MethodsA retrospective analysis of the hospital files of patients younger than 12 years admi...
TL;DR: In the 10-year period 1986-1996, 85 patients were admitted to the authors' unit with craniofacial injuries, 56 of whom had orbital fractures, and the aesthetic outcome was good, however, the older the patient, the worse the outcome.
Abstract: In the 10-year period 1986-1996, 85 patients were admitted to our unit with craniofacial injuries, 56 of whom had orbital fractures. These were studied with respect to the type of injury, type and location of fracture, presence of ocular and intracranial injury, and associated injuries to the head and body, as well as operative techniques used. Both the patient's and the surgeon's opinion on the aesthetic result were noted. The patients were also given a questionnaire about their quality of life after the injury. Road traffic crashes accounted for 31 (55%) of the injuries, falls for 9 (15%), and horse-riding for 6 (11%). The Injury Severity Score (ISS) ranged from 4 to 41 (mean 18). Twelve also had eye injuries, which resulted in complete blindness in one eye in 4 (7%). Thirty patients had 41 neurological injuries (54%), frontal contusions being the most frequent diagnosis ( n r = r 15). Exact repositioning with rigid fixation included bone grafting to the orbit in 11 patients, and the dominating ...
TL;DR: In this article, the anatomic and functional consequences of wine-cork injury to the eye in relation to the patient's age and the type of cork and wine were analyzed.
Abstract: Purpose To analyze the anatomic and functional consequences of wine-cork injury to the eye in relation to the patient's age and the type of cork and wine. Methods We retrospectively studied 13 patients, six women and seven men, presenting to our department with bottle-cork injury to the eye between January 1999 and June 2001. Results All patients presented with closed-globe injury according to Kuhn et al's classification. All the cases were injured by bottle corks from sparkling wine: white in ten cases and red in three. Mean visual acuity at admission was 20/100 (range, hand motion to 20/20). The most frequent early injury was anterior chamber hyphema (84.6%), followed by corneal injury (62.2%), ocular hypertension (46.1%), lens subluxation (30.8%), traumatic cataract (23.1%), and post-traumatic retinal edema (23.1%). Mean final visual acuity was 20/25; the follow-up ranged from 3 to 29 months, averaging 16.1 months. Late complications were as follows: pupil motility anomalies (38.5%), traumatic cataract (30.8%), iridodialysis (15.4%), traumatic optic neuropathy (7.7%), post-traumatic glaucoma (7.7%), and traumatic maculopathy (15.4%). Surgical treatment was necessary in two cases (15.4%). Conclusions Bottle-cork eye injuries account for 10.8% of post-traumatic hospital admissions to our department. Most of them are due to sparkling white wine served at room temperature. There is no correlation between ocular injury and the eye-bottle distance or the type of cork.
TL;DR: With appropriate threshold for referral, nurses trained in slit lamp examination can offer a successful service to safely diagnose and treat common eye casualty presentations.
TL;DR: Ocular penetration causing cataract occurred in children during unsupervised play with inadequately stored or disposed of hypodermic or sewing needles and eyes with endophthalmitis and/or retinal detachment had a worse visual prognosis.
TL;DR: In this paper, the epidemiological characteristics of severe eye injuries in childhood, in a mixed urban and rural Greek setting, were analyzed with respect to age, sex, type, cause and mode of injury, method of management, duration of hospitalization and final visual deficit.
Abstract: Objective To determine the epidemiological characteristics of severe eye injuries in childhood, in a mixed urban and rural Greek setting Methods Retrospective analysis of 95 cases (103 eyes) of eye injuries in children younger than 17 years of age admitted to the Department of Ophthalmology, University Hospital of Patras, Greece, during a five-year period The data were analyzed with respect to age, sex, type, cause and mode of injury, method of management, duration of hospitalization and final visual deficit Results The average age was 98 years and males were involved 80% of the cases The most common type of eye injury was mechanical closed-globe injury (718%) Mechanical open-globe injuries were found in 213% of the eyes, while burns comprised 67% of the injuries Most injuries were agent-related, with blows and falls being responsible most often Multiple operations were part of the treatment in 116% of the eyes; 145% of the eyes were blinded and 155% had significant final visual acuity loss
Journal Article•
TL;DR: Post-traumatic endophthalmitis with intraocular foreign bodies (IOFBs) deserves great attention because of its high incidence and poor prognosis and it should be performed as soon as possible.
Abstract: Objective: To evaluate the outcome and analyze the methods of surgical treatment of traumatic endophthalmitis following penetrating eye injuries with retained eye foreign bodies. Methods: A total of 62 consecutive cases (58 men, 4 women) from January 1999 to December 2001 with IOFBs following penetrating eye injuries were retrospectively studied. The ages ranged from 8 to 46 years (mean 23 years). Sixty patients (63 eyes) underwent pars plana vitreotomy and 1 patient underwent external magnet extraction. The follow up ranged from 3 to 36 months (mean 12.5 months). Results: Ten eyes developed endophthalmitis, among which 7 ( 10.94 %) were diagnosed preoperatively. The most frequently cultured organism was Staphylococcus epidermis ( 44.44 %, 4/9). Postoperatively, retinal detachment due to vitreoretinal proliferation occurred in 5 patients with endophthalmitis and in 9 patients without endophthalmitis. All the retinal detachments were reattached with additional vitreoretinal surgery. Two eyes with endophthalmitis and two without endophthalmitis were eviscerated. Conclusions: Post traumatic endophthalmitis with intraocular foreign bodies (IOFBs) deserves great attention because of its high incidence and poor prognosis. Vitrectomy is suggested for the treatment of IOFBs and its complications, and it should be performed as soon as possible. Routine intravenous administration of antibiotics combined with periocular injection and topical antibiotics postoperatively are recommended.
TL;DR: The visual outcome of eye injuries due to large FB is poor, but both enucleation and evisceration can be performed with low risk of sympathetic ophthalmia.
Abstract: PURPOSE. Traumatic eye injuries due to large foreign bodies (FB) are rare. The visual prognosis is often poor in these cases because of severe ocular damage. Staged surgical procedures with eventual enucleation or evisceration are often indicated. METHODS. Case series. RESULTS. The authors describe two patients with eye injury due to large FB with visual acuity of no light perception at presentation. Both had initial repair of the ocular injuries and removal of the FB. One patient with an intraocular FB eventually underwent enucleation; the other, with intraorbital FB, had evisceration as a secondary procedure. Orbital implantations were done in both. Neither of the patients had developed sympathetic ophthalmia at the last review. CONCLUSIONS. The visual outcome of eye injuries due to large FB is poor. Both enucleation and evisceration can be performed with low risk of sympathetic ophthalmia. Prevention remains the best approach to such devastating injuries.
TL;DR: It is believed that a jet stream of anesthetic agent may have transiently increased intraocular volume enough to occlude the central retinal artery, and although the retina remained attached, visual acuity failed to improve beyond LP.
Abstract: A patient with a blind fellow eye had cataract surgery in the right eye; anesthesia comprised an intraocular injection of lidocaine and bupivacaine. Forty-eight hours after surgery, visual acuity in the right eye was light perception (LP). Three days later, fundus examination showed inferotemporal hemorrhage, retinal whitening consistent with needle tracking, and a diffusely pale optic disc in the operated eye. Computed tomography showed an intact optic nerve in both eyes and high-density vitreal lesions in the right eye. Laser photocoagulation was applied to the retinal break. We believe that a jet stream of anesthetic agent may have transiently increased intraocular volume enough to occlude the central retinal artery. Although the retina remained attached, visual acuity failed to improve beyond LP.
01 Jan 2003
TL;DR: Children are especially vulnerable to ocular trauma, and perforation of the globe and secondary traumatic retinal detachment following amniocentesis has been reported as a cause of leukocoria at birth.
Abstract: Children are especially vulnerable to ocular trauma. Eye injuries can occur at virtually any age, even in utero. Perforation of the globe and secondary traumatic retinal detachment following amniocentesis has been reported as a cause of leukocoria at birth.1
TL;DR: Two weeks after the injury the conjunctival emphysema, diplopia, lagophthalmos and superficial keratopathy resolved, and visual acuity improved to 1.5.
Abstract: PURPOSE. To describe a patient who developed diplopia, lagophthalmos and exposure keratopathy due to a large subconjunctival emphysema. METHODS. A 24-year-old man sustained an injury in his left eye from a compressed air hose. The patient complained of pain and diplopia. He underwent slit-lamp examination, funduscopy and computed tomography. RESULTS. Ophthalmic examination revealed a decrease in vision in the left eye to 0.5, a conjunctival laceration adjacent to the medial limbus, subconjunctival hemorrhage, a large subconjunctival emphysema, lagophthalmos, hypertropia and superficial punctate keratopathy. The posterior pole was intact as were the orbital bones. Two weeks after the injury the conjunctival emphysema, diplopia, lagophthalmos and superficial keratopathy resolved, and visual acuity improved to 1. CONCLUSIONS. Large subconjunctival emphysema can result in diplopia, lagophthalmos and exposure keratopathy.
Journal Article•
TL;DR: A case of bilateral eye lesions with extended visual sequelae after the inflation of a driver's airbag during a head-on collision, where the visual acuity is 25/20 in both eyes notwithstanding a small paracentral scotoma related to a break in the Bruch membrane.
Abstract: The authors report a case of bilateral eye lesions with extended visual sequelae after the inflation of a driver's airbag during a head-on collision. The superficial facial lesions were accompanied by bilateral eye lesions, reaching both the anterior and posterior segments. Bilateral periorbital palpebral hematomas; voluminous bipalpebral edema combined with severe -conjunctival edema, corneal erosions, and edema; bilateral hyphema; pupillary changes with multiple iris sphincter breaks and weak pupillary light reflex only on the right eye; retrocession of the iridocorneal angle; and on fundus examination both retinas had posterior and peripheral hemorrhages and Berlin retinal edema. Five years after the trauma and 4 years after posttraumatic surgery for cataract that had progressively appeared on the left eye, the visual acuity is 25/20 in both eyes notwithstanding a small paracentral scotoma related to a break in the Bruch membrane. A review of the literature shows several types of ophthalmological lesions related to the airbag mechanism, which after combustion of an alkaline powder inflates at a very high speed, resulting in a risk of corneal-conjunctive-palpebral alkaline burns added to an eye contusion, which may be responsible for severe lesions. The American studies distinguish three factors affecting the seriousness of these airbag accidents: (a) wearing glasses, (b) position and size of the driver, and (c) inflation force of the airbag. Wearing a seatbelt is mandatory to minimize the violence of the oculofacial impact. After facial trauma from an airbag, an ophthalmological examination is necessary to assess of the chemical burns of the tissues exposed to the alkaline powder and possible major ocular lesions.