Showing papers on "Eye injuries published in 2010"
Journal Article•
TL;DR: Recognizing the need for emergent referral to an ophthalmologist is key in the primary care management of red eye when severe pain is not relieved with topical anesthetics; topical steroids are needed; or the patient has vision loss, copious purulent discharge, corneal involvement, traumatic eye injury, recent ocular surgery, distorted pupil, herpes infection, or recurrent infections.
Abstract: Red eye is the cardinal sign of ocular inflammation The condition is usually benign and can be managed by primary care physicians Conjunctivitis is the most common cause of red eye Other common causes include blepharitis, corneal abrasion, foreign body, subconjunctival hemorrhage, keratitis, iritis, glaucoma, chemical burn, and scleritis Signs and symptoms of red eye include eye discharge, redness, pain, photophobia, itching, and visual changes Generally, viral and bacterial conjunctivitis are self-limiting conditions, and serious complications are rare Because there is no specific diagnostic test to differentiate viral from bacterial conjunctivitis, most cases are treated using broad-spectrum antibiotics Allergies or irritants also may cause conjunctivitis The cause of red eye can be diagnosed through a detailed patient history and careful eye examination, and treatment is based on the underlying etiology Recognizing the need for emergent referral to an ophthalmologist is key in the primary care management of red eye Referral is necessary when severe pain is not relieved with topical anesthetics; topical steroids are needed; or the patient has vision loss, copious purulent discharge, corneal involvement, traumatic eye injury, recent ocular surgery, distorted pupil, herpes infection, or recurrent infections
141 citations
TL;DR: Laceration was associatied with a significantly higher risk of endophthalmitis for open globe injuries, and primary repair within 24 h, intraocular tissue prolapse and self-sealing of wounds were independent protective factors against the development of endolympia.
Abstract: Objective: To study the clinical characteristics of post-traumatic endophthalmitis following open-globe injury and identify factors affecting its frequency in order to gain further knowledge about possible risk factors for the development of endophthalmitis. Methods: All consecutive records of open globe injury cases (4968 eyes in 4865 inpatients) in 15 tertiary referral hospitals in China over 5 years (January 2001 to December 2005) were retrospectively reviewed. The information was collected from a standardised database of eye injuries from which a detailed analysis of factors influencing the incidence of endophthalmitis was performed. Results: 173 eyes (one bilateral rupture of a male) removed within 24 h after trauma were excluded. It was observed that 571 eyes (571 patients) out of a total of 4795 eyes (4693 patients) developed endophthalmitis, and the rate of incidence was 11.91%. Laceration was an independent risk factor for open globe injury. Primary repair within 24 h, intraocular tissue prolapse and self-sealing of wounds seemed to impart protective effects against the development of endophthalmitis. However, gender, age, lens breach and posterior zone of wounds were not significant. Intravitreal antibiotic and corticosteroid therapy was administered to 53 eyes (9.28%), and vitrectomy was performed on 305 eyes (53.42%). At discharge or follow-up, the proportion (16.81%) of enucleation/evisceration of eyes with endophthalmitis was higher than that (8.71%) without endophthalmitis. Conclusions: Laceration was associatied with a significantly higher risk of endophthalmitis for open globe injuries. Early primary repair, intraocular tissue prolapse and self-sealing of wounds were independent protective factors against the development of endophthalmitis.
138 citations
TL;DR: The wound closure rate and thickness of the central corneal epithelium in the CMHA-SX treated group was greater than in control eyes for both the abrasion and alkali burn injuries.
Abstract: Objective To evaluate the efficacy of a chemically modified and cross-linked derivative of hyaluronan (CMHA-SX) for treatment of corneal epithelial abrasion and standardized alkali burn injuries.
Animals Twelve female New Zealand white rabbits in two groups were used.
Procedures Bilateral 6-mm diameter corneal epithelial abrasions were made in each of six rabbits in one group and 6-mm standardized alkali burn injuries were made in the second group. A 1% CMHA-SX formulation was applied topically four times per day in right eye of each rabbit for 1 week, and phosphate buffered saline (PBS) was placed in left (control) eye of each rabbit. The wound size was determined by staining with 1% fluorescein and photographed at the slit lamp with a digital camera at 0, 1, 2, 3 days postoperatively in the first group and 0, 1, 2, 3, 7, 12 days in the second group. Rabbit corneas were collected for histological examination on day 7 in the first group and day 12 in the second group.
Results Closure of corneal wound in the abrasion model was complete in the CMHA-SX treated eye by 48 h. The wound closure rate and thickness of the central corneal epithelium in the CMHA-SX treated group was greater than in control eyes for both the abrasion and alkali burn injuries. Moreover, the CMHA-SX treated cornea exhibited better epithelial and stromal organization than the untreated control cornea.
Conclusions Chemically modified and cross-linked derivative of hyaluronan improved corneal wound healing and could be useful for treating noninfectious corneal injuries.
77 citations
TL;DR: In this paper, the authors evaluated the characteristics and outcomes of patients treated for open globe injuries sustained at work and compared these results to patients injured outside of work and found that those injured at work do at least as well as, if not potentially better than, those with open globe injury sustained outside of the workplace.
74 citations
TL;DR: Identification and documentation of inflicted ocular trauma requires a thorough examination by an ophthalmologist, including indirect ophthalmoscopy, most optimally through a dilated pupil, especially for the evaluation of possible RHs.
Abstract: Child abuse can cause injury to any part of the eye. The most common manifestations are retinal hemorrhages (RHs) in infants and young children with abusive head trauma (AHT). Although RHs are an important indicator of possible AHT, they are also found in other conditions. Distinguishing the number, type, location, and pattern of RHs is important in evaluating a differential diagnosis. Eye trauma can be seen in cases of physical abuse or AHT and may prompt referral for ophthalmologic assessment. Physicians have a responsibility to consider abuse in the differential diagnosis of pediatric eye trauma. Identification and documentation of inflicted ocular trauma requires a thorough examination by an ophthalmologist, including indirect ophthalmoscopy, most optimally through a dilated pupil, especially for the evaluation of possible RHs. An eye examination is helpful in detecting abnormalities that can help identify a medical or traumatic etiology for previously well young children who experience unexpected and unexplained mental status changes with no obvious cause, children with head trauma that results in significant intracranial hemorrhage and brain injury, and children with unexplained death.
67 citations
TL;DR: It is concluded that ocular injury is a frequent cause of morbidity in blast victims, occurring in up to 28% of blast survivors, and that health care providers should become familiar with the management of injuries inflicted by blasts and explosions.
Abstract: As the rate of terrorism increases, it is important for health care providers to become familiar with the management of injuries inflicted by blasts and explosions. This article reviews the ocular injuries associated with explosive blasts, providing basic concepts with which to approach the blast-injured patient with eye trauma. We conducted a literature review of relevant articles indexed in PubMed between 1948 and 2007. Two hundred forty-four articles were reviewed. We concluded that ocular injury is a frequent cause of morbidity in blast victims, occurring in up to 28% of blast survivors. Secondary blast injuries, resulting from flying fragments and debris, cause the majority of eye injuries among blast victims. The most common blast eye injuries include corneal abrasions and foreign bodies, eyelid lacerations, open globe injuries, and intraocular foreign bodies. Injuries to the periorbital area can be a source of significant morbidity, and ocular blast injuries have the potential to result in severe vision loss.(Disaster Med Public Health Preparedness. 2010;4:154-160)
58 citations
TL;DR: In addition to head and neck surgery, operations in the lateral or prone position, preoperative anemia and intraoperative deliberate hypotension are also precipitating factors for perioperative eye injuries.
57 citations
TL;DR: It is concluded that initial visual acuity, hyphema, zone and length of injury, retinal detachment and vitreous hemorrhage are statistically significant factors affecting outcome in open globe injuries.
Abstract: A prospective observational study was done to assess ocular survival, visual outcome and prognostic factors of open globe injury. Eighty eyes of penetrating trauma between 2004 and 2006 were categorized according to the ocular trauma classification system. Primary repair was done and outcomes were assessed at one, three and six months. The final vision was categorized as per World Health Organization classification of visual impairment. Factors at presentation were evaluated for prognostic value towards visual outcome. Sixty-nine eyes with minimum one month follow-up were included for analysis. Statistical analysis was done using Univariate and Multivariate analysis. We found Grade IV visual acuity (< 5/200) at presentation (64%) as the most important factor contributing to poor visual outcome. Statistically insignificant factors were time since injury, cataract, and presence of intraocular foreign body. Ocular survival was 97%. We concluded that initial visual acuity, hyphema, zone and length of injury, retinal detachment and vitreous hemorrhage are statistically significant factors affecting outcome in open globe injuries.
50 citations
TL;DR: As ocular firecracker injuries result in significant morbidity, public education regarding proper use of firecrackers may help in reducing the incidence of ocular injuries.
Abstract: We report a large series of ocular injuries caused by fire-crackers. This study was a hospital-based, singlecenter, retrospective case series in which the records of 51 patients with ocular injuries were analyzed. Injuries were classified according to Birmingham eye trauma terminology system (BETTS). Visual outcomes before and after the intervention were recorded. Ten patients were admitted for further management. As ocular firecracker injuries result in significant morbidity, public education regarding proper use of firecrackers may help in reducing the incidence of ocular injuries.
38 citations
TL;DR: Prognosis after repair of an open globe injury is influenced by age, initial visual acuity, mechanism of injury, location and extent of initial damage, and development of endophthalmitis.
Abstract: Background: To identify prognostic factors for visual acuity and anatomic outcomes after repair of open globe injuries. Methods: We retrospectively reviewed the medical records of 443 patients with open globe injuries admitted to King Abdulaziz University Hospital between May 1996 and January 2008. Results: Predictors of good visual outcome (20/200 or better) were age of 18 years or younger, good initial visual acuity of counting fingers or better, sharp mechanism of injury, wound length of 10 mm or less, wounds limited to the cornea, absence of associated ocular injuries at presentation including lens injury, vitreous hemorrhage, vitreous prolapse and retinal detachment, absence of endophthalmitis, vitrectomy not performed, and findings at final evaluation including clear vitreous, attached retina, and absence of hypotony. Predictors of persistent retinal detachment at final evaluation were poor initial visual acuity of hand motions or worse, posterior wound location, and performance of vitrectomy. Predictors of hypotony at final evaluation were poor initial visual acuity of hand motions or worse, dirty wound, presence of vitreous hemorrhage, and vitreous prolapse at presentation, development of culture-positive endophthalmitis, performance of vitrectomy, and persistent retinal detachment at final follow-up. Conclusions: Prognosis after repair of an open globe injury is influenced by age, initial visual acuity, mechanism of injury, location and extent of initial damage, and development of endophthalmitis.
35 citations
TL;DR: After eye trauma, NLP vision and relative afferent pupillary defect of 3 to 4+ alone may not be an indication for enucleation, and performing exploratory surgery within 14 days after the injury may salvage the globe and improve vision.
Abstract: Purpose: To evaluate the anatomical and functional outcomes of surgical intervention in severely traumatized eyes with no light perception (NLP). Methods: In this prospective interventional case series, 18 eyes of 18 patients with severe ocular trauma whose vision was documented as NLP and with relative afferent pupi-llary defect (RAPD) of 3-4+ underwent deep vitrectomy and other necessary procedures once to three times. Results : Vision was NLP in all eyes at the time of surgery which was performed 3-14 days after the initial trauma. During a mean follow up period of 20.5±5.2 (range 11 to 49) months, except for one case of phthisis, other eyes achieved acceptable anatomic and functional outcomes. Postoperative vision was NLP in two eyes (11.1%), light perception in three eyes (16.7%), hand motions in four eyes (22.2%), counting fingers in three eyes (16.7%) and 20/200 or better in six eyes (33.3%). Conclusion: Following eye trauma, NLP vision and RAPD of 3-4+ alone may not be an indication for enucleation. Performing exploratory surgery within 14 days after the injury may salvage the globe and improve vision; this approach may be more acceptable psychologically for patients and relatives.
TL;DR: To review visual acuity outcomes from paediatric traumatic cataract and examine the mechanisms by which they occur, a poster is presented at the annual meeting of the American Academy of Ophthalmic Surgeons.
Abstract: BACKGROUND: To review visual acuity outcomes from paediatric traumatic cataract and examine the mechanisms by which they occur. METHODS: A retrospective review of paediatric patients (aged less than 18 years) who underwent lens surgery following ocular trauma, between 1992 and 2006 at the Royal Children's Hospital and Royal Victorian Eye and Ear Hospital in Melbourne. Data collected included gender, mechanism of injury, wound type, age at injury, age at surgery, refractive rehabilitation, complications and visual acuity outcome. RESULTS: A total of 74 patients (75% male) were identified over the 15-year period, representing an incidence of 4.9 cases per year. The mean age at injury was 7.5 years. Sixty-five cataracts (88%) followed a penetrating eye injury, whereas only nine patients (12%) developed cataract after known blunt trauma. Fourteen patients (19%) underwent lensectomy at the time of primary wound repair and 45 patients (61%) underwent primary intraocular lens (IOL) implantation. Visual acuity outcomes ranged from 6/5 to no perception of light. Twenty-five patients (34%) achieved 6/12 or better in the injured eye, 23 patients (31%) achieved between 6/15 and 6/60, and 14 patients (19%) had visual acuity of less than 6/60. Twelve patients (16%) were lost to follow-up. CONCLUSION: In a paediatric population, cataract formation as a result of trauma requiring lensectomy is not uncommon. Males are more likely to suffer from such injury. A variety of sharp and blunt objects are the primary mechanism by which the injury is sustained with variable visual outcomes. Language: en
TL;DR: Evaluating the epidemiology of eye trauma and the role of occupational injuries at Farabi Eye Hospital in Iran found that work-related eye trauma is the major cause of eye injury in Iran and most often occurs as a result of the lack of proper eye protection.
Abstract: Purpose.Occupational eye injuries are among the major causes of ocular trauma and can cause severe visual impairment, with even minor injuries incurring considerable financial costs due to work abs...
TL;DR: Certain lacerating injuries of the anterior segment are particularly amenable to cataract extraction and IOL implantation at the time of primary laceration repair, which obviates additional operative and anesthetic risks, while affording timelier visual rehabilitation.
Abstract: Purpose To review the changes in the surgical techniques used for cataract removal in the setting of trauma and their postoperative outcome. Recent findings Primary cataract removal with intraocular lens (IOL) implantation is the commonly followed procedure for penetrating injuries with cataract. IOL implantation has evolved through various techniques namely 'in the bag', 'in the sulcus', epilenticular implantation, anterior chamber IOL, scleral fixated IOL and recently glued IOL. Summary Certain lacerating injuries of the anterior segment are particularly amenable to cataract extraction and IOL implantation at the time of primary laceration repair. This approach obviates additional operative and anesthetic risks, while affording timelier visual rehabilitation. Secondary lens removal may also be indicated in cases of severe corneal injury and marked edema, which may interfere with intraocular visualization.
Journal Article•
TL;DR: Delayed arrival of patients in eye hospital with open globe injury may result in endophthalmitis, and this study was conducted on patients less than fifteen years age, presenting with penetrating ocular injuries and associated with endophhalmitis.
Abstract: Objective: To determine the frequency, risk factors, and visual outcome of post traumatic endophthalmitis in children. Methods: The study was conducted on patients less than fifteen years age, presenting with penetrating ocular injuries and associated with endophthalmitis. Anterior segment slit lamp examination and if possible posterior segment slit lamp examination with 90 D fundoscopes was performed. After completing necessary investigations, urgent surgical intervention was carried out. Results: There were 43 registered patients with 29 (67.4%) males and 14 (32.6%) females. Twenty three (53.4%) children presented on the day of injury. Remaining 20 (46.6%) reported after first 24 hours. Twenty seven (62.7%) children presented with corneal wound, 11 (25.6%) had scleral entrance, and 5 (11.7%) patients had corneo scleral extension. Nineteen (44.1%) patients developed clinical evidence of endophthalmitis. Fifteen subjects with endophthalmitis completed six weeks follow up. Two (13.3%) subjects achieved final visual acuity (FVA) of 3/60. Four (26.7%) had only hand movements, 5 (33.4%) subjects were restricted to perception of light, and 2 (13.3%) patients developed phthisis bulbi. Conclusion: Delayed arrival of patients in eye hospital with open globe injury may result in endophthalmitis (JPMA 60:532; 2010).
TL;DR: A new wave of paediatric ocular surface injuries is highlighted in children under the age of 5 at this hospital due to chemical injuries associated with liquid capsules for fabric detergents.
Abstract: We highlight a new wave of paediatric ocular surface injuries1
In 2001 the cleaning products industry produced liquid capsules for fabric detergents Last year chemical injuries associated with these capsules accounted for 40% of ocular chemical injuries in children under the age of 5 at this hospital Guy’s and St Thomas’ Poisons Unit received 192 enquires related …
TL;DR: The finding of IOFB on a DFE for patients with a CMFB without clinical evidence of penetrating injury is very rare and the likelihood of concomitant intraocular foreign body (IOFB) in this clinical setting is low.
TL;DR: Sport is responsible for between 25-40% of all eye injuries severe enough to require hospital admission, and methods of reducing the number and severity of such injuries are of prime importance.
Abstract: Most ocular injuries involve only the external eye. However, in approximately one-third of cases the intraocular structures are damaged with potentially sight threatening consequences. A small number of sports, such as soccer, rugby, hockey and the racquet sports are responsible for most injuries. Sport is responsible for between 25-40% of all eye injuries severe enough to require hospital admission. Most of these are recognised as being largely preventable and methods of reducing the number and severity of such injuries are of prime importance.
TL;DR: Combined anterior and posterior segment injuries in children require optimal surgical treatment management that varies from adult treatment with regard to several essential aspects, and care should be provided by pediatric ophthalmology specialists with orthoptic follow-up as necessary, over many years.
Abstract: Background
Combined anterior and posterior segment injuries in children require special attention to the unique characteristics of children's eyes, including a pronounced tendency to scar formation and proliferation, adherence of the posterior vitreous, as well as the danger of amblyopia.
TL;DR: Personal accidents are the most important cause of open-globe injuries and work-related trauma is more associated with IOFB; imaging is fundamental in emergency department evaluation.
Abstract: Purpose: We aimed to characterize epidemiologically open-globe injuries and patterns of posttraumatic endophthalmitis in northwestern Portugal. Methods: A retrosp
TL;DR: The surgical techniques used in the modern management of devastating ocular trauma are described including selected case examples managed by British military maxillofacial surgeons deployed to Afghanistan.
Abstract: Combat-related eye injuries continue to increase in frequency and are generally secondary to Improvised Explosive Devices. Many ocular injuries are potentially preventable by the wearing of ballistic eye protection. The management of penetrating eye trauma is normally outside the routine practice of maxillofacial surgeons in the UK. The aim of this paper is to describe the surgical techniques used in the modern management of devastating ocular trauma including selected case examples managed by British military maxillofacial surgeons deployed to Afghanistan.
TL;DR: This study further investigates the epidemiology of eye injury in Victoria, specifically hospital‐admitted eye injury, and finds no improvement observed in this public health concern since it was first identified in the 1990s.
Abstract: Background: The public health concern represented by eye injury in Victoria, Australia has been known for a period now approaching twenty years. However, there has been no improvement observed in this public health concern since it was first identified in the 1990's. This study further investigates the epidemiology of eye injury in Victoria, specifically hospital admitted eye injury. Methods: The Victorian Admitted Episodes Dataset was surveyed for eye injury coded by the ICD-10 during the period spanning 2001 - 2005, retrieving all cases of hospital admitted eye injury in Victoria during the surveyed period. Results: During the period surveyed, the average incidence of eye injury requiring hospital admission in Victoria was 53.6 per 100,000 person-years. Sixty-four per cent of patients were male and 36% were female, P Language: en
TL;DR: The most important factors in the prognosis of postoperational visual acuity for wartime open globe eye injuries were: preoperative condition of the eye, localization and extent of the wound, presence, size and nature of foreign bodies, and adequate surgical treatment in specialized institutions.
Abstract: Open globe injuries are the most serious eye injuries in war as in peace time. The purpose of this study is to analyze wartime open globe eye injuries in 72 patients treated at the Department of Ophthalmology, Clinical Hospital of Split from July 1991 to April 1993, during the intensive war in Croatia and Bosnia and Herzegovina, and to evaluate crucial factors responsible for the functional success of the treatment. Wartime open globe eye injuries were retrospectively analyzed in 72 patients (80 eyes) hospitalized at Clinical Hospital of Split, Department of Ophthalmology, between July 1991 and April 1993. The causes and ways of wounding, localization of wounds and presence, nature and localization of the foreign body, as well as admission time, microsurgical management and other factors contributing to poor visual outcome were studied. Standard international classification of ocular traumas (the Birmingham Eye Trauma Terminology and the International Ocular Trauma Classification) was used for the classified and graded injuries. Open globe eye injuries amounted to 52.65% of all war injuries to the eyes. Bilateral injuries were found in eight patients (11.11%). The most frequent cause of the injures were fragments of explosive devices (more than two-thirds). Most of the patients were admitted to the hospital within 24 hours of the injury. Using current microsurgical techniques, the attempt was made to achieve not only anatomical but also functional recovery already in the primary treatment. In 30 eyes (37.50%) final visual acuity amounted to more than 0.1, and in 22 eyes (27.50%) it reached 0.5. There was a statistically significant correlation between admission within the first 12 hours and postoperative improved visual acuity (χ2 = 4.53; p = 0.033). Statistically significantly better visual acuity was found in patients with lesions limited to the anterior segment of the eye. Primary enucleation or evisceration was performed only exceptionally: one enucleation and six eviscerations (8.75%). The most important factors in the prognosis of postoperational visual acuity for wartime open globe eye injuries were: (1) preoperative condition of the eye, (2) localization and extent of the wound, (3) presence, size and nature of foreign bodies, and (4) adequate surgical treatment in specialized institutions.
TL;DR: Eye injuries requiring hospitalisation in Nigeria are not only common, but also severe, and safety measures and health education campaigns should help reduce this public health problem.
Abstract: BACKGROUND : - Eye injuries are becoming relatively important, not only as a cause of presentation but also a cause for admission at health centres in Nigeria. In view of this trend being observed and the fact that most eye injuries requiring hospital admission may give rise to grave ocular consequences. This study set out to highlight the pattern of eye injuries admitted into the eye ward of a Nigerian Teaching Hospital over one year. This is with a view to providing suitable protocols in the management and prevention of such injuries and their attendant ocular complications. MATERIALS AND METHODS : - A retrospective study of all cases of eye injury admitted into the eye ward of the University of Nigeria Teaching Hospital, Enugu, Nigeria in the year 2003 was conducted. All the hospital records of such cases were studied. RESULTS : - Eye trauma constituted 15.95% of 257 admissions. Males comprised 78%, and children comprised 22%. The commonest agents of injury were gunshot pellets, glass, metal and wood pieces. Activities implicated commonly were assault/combat, agricultural/artisan work-related accidents and road traffic accidents. A variety of sight threatening complications were noted in these subjects. Visual acuity on presentation ranged between 6/12 and no light perception (NPL). After treatment, approximately 80% of the injured eyes were blind. CONCLUSION : - Eye injuries requiring hospitalisation in Nigeria are not only common, but also severe. Safety measures and health education campaigns should help reduce this public health problem.
TL;DR: Two doctors felt that a transplant of cultured corneal epithelium, containing the patient’s own limbal stem cells, could give hope to patients with previously untreatable eye injuries, and resolved to start working towards this goal immediately.
Abstract: Dr Geeta K Vemuganti is Head of the Ophthalmic Pathology Laboratory and Head of the Sudhakar and Sreekant Ravi Stem Cell Biology Laboratory at the L V Prasad Eye Institute, India. Virender S Sangwan is an Associate Director of the L V Prasad Eye Institute and a practicing eye surgeon. When the two colleagues discussed Vemuganti’s work on culturing eye tissue tumors in vitro, they identified an opportunity to help patients with previously untreatable eye injuries. Patients whose eyes have been badly damaged through injury or autoimmune disease can lose the ability to produce limbal stem cells, which stimulate the cornea to renew itself, leading to scarring and loss of vision. The two doctors felt that a transplant of cultured corneal epithelium, containing the patient’s own limbal stem cells, could give hope to these patients, and resolved to start working towards this goal immediately. A year after initiating the project they had refined the culture technique and were ready to start human trials. To date,...
TL;DR: In addition to facial burns, the requirement of mechanical ventilation, prolonged sedation, and presence of infection with Pseudomonas or Acinetobacter increase the risk of injury to the eye after burn injury, and these patients may benefit from serial eye examinations for early identification of ocular complications.
Abstract: A retrospective study of patients admitted to MetroHealth Medical Center was performed to identify the risk factors for short- and long-term ophthalmologic complications related to burn injury. From 2000 to 2007, the authors identified 293 patients with the inclusion criteria of facial burns, TBSA ≥20%, or smoke inhalation injury. Seventy (24%) developed ocular complications, and 16 (11%) developed long-term complications. Statistically significant risk factors identified for short-term complications were burn size, chemical burns, depth of facial burns, initial Glasgow Coma Scale, and need for mechanical ventilation/sedation. Risk factors for long-term complications included wound infection with Pseudomonas or Acinetobacter, third-degree burn size, hours to ophthalmology evaluation, LOS, time on mechanical ventilation, and need for STSG. In addition to facial burns, the requirement of mechanical ventilation, prolonged sedation, and presence of infection with Pseudomonas or Acinetobacter increase the risk of injury to the eye after burn injury, and these patients may benefit from serial eye examinations for early identification of ocular complications.
TL;DR: This case report highlights the continuing problem of cyanoacrylate eye injuries and serves as a reminder to healthcare professionals to report such incidents to manufacturers and regulatory bodies, on behalf of their patients, to promote the introduction of universal safety mechanisms on all household chemical containers.
Abstract: A 64-year-old man presented to casualty with blurred vision and pain in his left eye, 2 h after inadvertently instilling clear nail glue into his eye instead of postoperative Timolol eye drops. The glue was removed at the slit lamp revealing a corneal abrasion, which was managed with topical antibiotics. Inadvertent ocular cyanoacrylate, or ‘superglue’, instillation has been reported frequently since 1982 when superglue was repackaged into ophthalmic style dropper bottles. This case report highlights the continuing problem of cyanoacrylate eye injuries and serves as a reminder to healthcare professionals to report such incidents to manufacturers and regulatory bodies, on behalf of their patients, to promote the introduction of universal safety mechanisms on all household chemical containers. Failure of glue manufacturers to introduce safety cap mechanisms has resulted in significant ocular morbidity over the last 27 years, and such incidents are expected to occur until superglue bottles are redesigned.
TL;DR: Early pars plana vitrectomy and intravitreal vancomycin plus ceftazidime injection improved anatomic and functional success in pediatric eyes with exogenous endophthalmitis.
Abstract: Pur P ose . To identify the etiology, culture results, pars plana vitrectomy results, complications, and visual outcome of exogenous endophthalmitis in children. Methods . Seven eyes of 7 consecutive pediatric patients who were treated and followed up for exogenous endophthalmitis between February 2006 and June 2008 were included in this study. The etiology of endophthalmos was penetrating eye injuries in 4 eyes and intraocular surgery in 3 eyes. Combined pars plana vitrectomy and intravitreal vancomycin plus ceftazidime injection were performed on all 7 eyes. Anterior chamber fluid and vitreous cultures were taken from all eyes. The patient files were inspected retrospectively. results . Mean follow-up time was 10.3 months (4–16 months). Mean age of the patients was 8.5 years (3–14 years). At baseline, visual acuity values of the patients were light perception (n=2), hand movements (n=4), and counting fingers from 1 meter (n=1). At final examination, visual acuity improved in 5 eyes, stayed the same in 1 eye, and decreased in 1 eye. Positive culture results were obtained in 3 eyes: alpha hemolytic Streptococcus (n=2) and coagulase-negative Staphylococcus (n=1). Complications seen after vitreoretinal surgery were transient ocular hypertension, emulsification of silicone oil, phthisis bulbi, and secondary retinal detachment. Con C lusions . Early pars plana vitrectomy and intravitreal vancomycin plus ceftazidime injection improved anatomic and functional success in pediatric eyes with exogenous endophthalmitis. (Eur J Ophthalmol 2010; 20: 424-8)
TL;DR: The patient was treated with rituximab, etoposide, doxorubicin, vincristine, cyclophosphamide, and prednisolone and underwent left tarsorrhaphy, and vision improved to counting fingers OS.
Abstract: and engorgement of bilateral ophthalmic arteries. Right medial orbitotomy and biopsy revealed a large-cell T-cell lymphoma (TCL) with immunohistochemical staining positive for CD20, CD3, CD43, CD45RO, and leukocyte common antigen. Specimens stained negative for CD30, CD15, CD79a, S100, AE1/3, epithelial membrane antigen, chromogranin, and synaptophysin. Anti–human T-cell leukemia virus I/II antibody reactivity was present. The patient was treated with rituximab, etoposide, doxorubicin, vincristine, cyclophosphamide, and prednisolone and underwent left tarsorrhaphy. The proptosis and chemosis reduced dramatically, and vision improved to counting fingers OS. Lymphoidneoplasms represent 6%–8%of orbital tumors, and up to 15% of ocular adnexal tumours. Up to 25% of cases present bilaterally. Non-Hodgkin’s lymphomas of all anatomic sites have been increasing at a rate of 3%–4% per year andmay originate from B (90%) or T (10%) cells.Most low-grade B-cell lymphomas express surface CD20 (L26). The pathogenesis of CD20+ TCL is not clearly understood, and has not been described previously with orbital TCL. It may derive from a circulating T-cell subset that has undergone neoplastic transformation. Alternatively, CD20 may be a marker of activation or proliferation. CD20 expression itself is insufficient to assign B lineage. In this case, CD3, CD4, CD5, CD8, and CD45RO identify the tumour as TCL. The CD20 expression represents an aberrant immunophenotype. Despite its broad clinical and pathologic spectrum, CD20+ TCL affects elderly males more commonly and may behave aggressively. Some cases fall into defined TCL subtypes, whereas most are peripheral TCL. To our knowledge, this is the first reported case of CD20+ orbital TCL. Anti-CD20 directed therapy (e.g., rituximab) may be of therapeutic benefit in such cases. More study is needed to further explore the significance of CD20 TCL expression.