Showing papers on "Eye injuries published in 2017"

The epidemiology of Open Globe Injuries presenting to a tertiary referral eye hospital in Australia.

Abstract: Background Open globe injuries (OGIs) account for 44% of the cost of ocular trauma within Australia. It is estimated that 90% of ocular trauma is preventable. However, there have been few epidemiological studies within Australia that have identified groups at risk of OGIs specifically. The aim of our study was to review the epidemiology of OGIs presenting to a tertiary referral eye hospital in Australia. Methods The Birmingham Eye Trauma Terminology (BETT) system was used to classify injuries as globe ruptures, penetrating eye injuries (PEIs), intraocular foreign bodies (IOFBs) or perforating injuries. Demographic data, past ocular history, mechanism of trauma, ocular injuries, and best-corrected visual acuity (BCVA) before and after treatment were recorded. Results The 205 OGIs included 80 globe ruptures, 71 PEIs, 48 IOFBs and six perforating injuries. Falls predominated in older age groups compared to the other mechanisms of injury (p Conclusions The causes of OGI varied in association with age, with older people mostly incurring their OGI through falls and younger adults through assault and working with metal. Globe ruptures occurring after a fall often had a history of intraocular surgery. The initial BCVA is useful for non-ophthalmologists who are unfamiliar with the ocular trauma score to help predict the BCVA following treatment.

Ocular traumas in working age adults in Finland – Helsinki Ocular Trauma Study

Abstract: PURPOSE: To describe epidemiology, causes, treatments and outcomes of ocular injuries in adults aged 17 to 60 in southern Finland. METHODS: All new ocular trauma patients admitted to the Helsinki University Eye Hospital (HUEH), during 1 year in 2011-2012. The data were from hospital records and prospectively from patient questionnaires. The follow-up time was 3 months. RESULTS: The incidence for ocular injury was 88/100 000/year. From 831 trauma patients, 80% were men, 34% were work-related injuries, and 11% were assaults. Most of the injuries were minor traumas (54%). Contusions (22.5%) and chemical injuries and burns (13%) were common. Fractures (5%), lid wounds (3%), open globe injuries (OGI, 2%) and optic nerve injuries (0.5%) were rare. The main causes of ocular injury were superficial foreign bodies (33%), chemicals (13%), body parts (13%) and sports equipment (10%). The most dangerous objects were needles, stones, pellet guns, tools and guns. No patient with OGI used protective eyewear. All OGI and most of contusions needed a lifelong follow-up. Permanent impairment (73 patients, 9%) was caused most often by body parts, sports equipment and work tools. CONCLUSION: A typical ocular trauma patient was a man aged 31-45 with a minor trauma caused by a foreign body at work and a final visual acuity of 20/20. Most common serious injuries were contusion, OGI or fracture at home or at work and were caused by a body part, sport equipment or work tool. Factors causing common and serious eye injuries provide the targets for protective measures.© 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd. Language: en

Epidemiology, clinical profile and factors, predicting final visual outcome of pediatric ocular trauma in a tertiary eye care center of Central India

Abstract: Purpose: Ocular trauma constitutes an important cause of preventable visual morbidity worldwide. This study was done to study the incidence, sociodemographic pattern, and clinical profile of ocular trauma in pediatric age group. Also to evaluate the factors influencing final visual outcome in these patients. Methods: This was a prospective interventional study concerning ocular trauma in pediatric patients up to 16 years of age of either sex. Various variables having an impact on final visual outcome were studied, and results were analyzed using statistical indices – relative risk, Chi-square test, P value, and linear regression analysis. Results: A total of 220 cases of trauma were evaluated with the mean age being 8.74 ± 3.93 years, males were predominantly affected and open globe injuries outnumbered blunt injuries. Penetrating injuries accounted for 67.79% cases of open globe injury, rupture being the least (2.54%). Stepwise multiple linear regression analysis executed, showed the best predictors in the descending order for final visual outcome were presenting visual acuity, size of corneal tear, type of injury, zone of injury, time period between injury and treatment with a variance of 35.9%, 6.3%, 5.3%, 3.7%, and 2.7%, respectively. All above variables were also found to be statistically significant (P < 0.05) on Chi-square test. Conclusion: We report the first study on the epidemiology and clinical outcomes of pediatric ocular trauma in central India. Poor initial Visual Acuity and posterior segment involvement adversely affect the visual outcome. Early medical treatment and globe-salvaging repair should be done in all eyes suffering from trauma.

Systematic analysis of ocular trauma by a new proposed ocular trauma classification

Abstract: Purpose: The current classification of ocular trauma does not incorporate adnexal trauma, injuries that are attributable to a nonmechanical cause and destructive globe injuries. This study proposes a new classification system of ocular trauma which is broader-based to allow for the classification of a wider range of ocular injuries not covered by the current classification. Methods: A clinic-based cross-sectional study to validate the proposed classification. We analyzed 535 cases of ocular injury from January 1, 2012 to February 28, 2012 over a 4-year period in an eye hospital in central India using our proposed classification system and compared it with conventional classification. Results: The new classification system allowed for classification of all 535 cases of ocular injury. The conventional classification was only able to classify 364 of the 535 trauma cases. Injuries involving the adnexa, nonmechanical injuries and destructive globe injuries could not be classified by the conventional classification, thus missing about 33% of cases. Conclusions: Our classification system shows an improvement over existing ocular trauma classification as it allows for the classification of all type of ocular injuries and will allow for better and specific prognostication. This system has the potential to aid communication between physicians and result in better patient care. It can also provide a more authentic, wide spectrum of ocular injuries in correlation with etiology. By including adnexal injuries and nonmechanical injuries, we have been able to classify all 535 cases of trauma. Otherwise, about 30% of cases would have been excluded from the study.

Ocular Effects of Sulfur Mustard and Therapeutic Approaches

Abstract: Sulfur mustard (SM) is a strong blistering, highly reactive, lipophilic chemical war agent that causes injury in different organs including the skin, eyes, and respiratory tract. The Eyes are especially susceptible to the consequences of SM poisoning because of the aqueous and mucosal nature of conjunctiva and cornea. DNA alkylation and depletion of glutathione, are the most important mechanisms of SM action in the eye injuries. Acute clinical symptoms are including decrease in visual acuity, dryness, photophobia, blepharospasm, conjunctivitis, and complaints of foreign body sensation and soreness that gradually progress to severe ocular pain. Corneal abrasions, ulcerations, vesication, and perforations are common corneal consequences in SM injured victims. Appearance of chronic symptoms has been reported as chronic inflammation of the corneal and conjunctival vasculature, ischemia, lipid and cholesterol deposition, scarring in cornea, corneal thinning, opacification and perforation of the cornea, limbal stem cell deficiency (LSCD), and neovascularization. Different medical and surgical protocols have been documented in the management of SM-induced ocular injuries, including preservative-free artificial tears, topical steroids and antibiotic, mydriatic, antiglaucoma drops, therapeutic contact lenses, dark glasses and punctal plugs/cauterization, N-acetylcysteine, tarsorrhaphy, amniotic membrane transplantation, stem cell transplantation, and corneal transplantation. New drugs such as resolvin E1, topical form of essential fatty acids, thymosin β4, 43 amino-acid polypeptides, topical form of curcumin, newly formulated artificial tears, diquafosol, rebamipide, tretinoin, and oral uridineseems to be beneficial in the management of ocular lesion associated with sulfur mustard poisoning. Further studies are needed to approve these drugs in SM victims. J. Cell. Biochem. 118: 3549-3560, 2017. © 2017 Wiley Periodicals, Inc.

Paediatric eye injuries in Finland - Helsinki eye trauma study.

Abstract: PURPOSE: To determine the current population-based epidemiology, treatment, use of resources and outcomes of children's eye injuries in Finland. METHODS: The study included all new patients, 16 years of age or under, with ocular or orbital traumas taken into care to the Helsinki University Eye Hospital (population base 1.5 million people) in 1 year. The follow-up period was 3 months. RESULTS: Two hundred and two children's eye injuries were treated. The eye injury incidence was 5.2-8.3 per 10 000 per year, including all minor and major eye traumas. Eye injury most likely occurred at the junior high school age (13-16 years). Thirty-three percentage of accidents took place at home and 24% at school or in day care. The most common causes were sports equipment (15%), contact with human body (12%) and superficial foreign bodies (11%). Excluding minor injuries, contusion was the most common diagnosis (n = 60, 30%). Eighty-seven percentage of contusion patients were estimated to need lifelong follow-up due to elevated glaucoma risk. Nine percentage of all patients had a permanent disability. Guns, fireworks, tools and pellet guns were relatively the most dangerous objects. Pellet guns caused 6% of eye injuries, 36% of them causing permanent impairment. The number of outpatient visits was altogether 443, inpatient days were 49, and 60 children had major surgeries. CONCLUSIONS: Use of protective eyewear would have prevented or diminished eye traumas caused by pellet gun, floorball, most of the firework and in many superficial foreign body. The use of pellet guns and protective eyewear should be more supervised. Fireworks and tools are not suitable toys for children.© 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd. Language: en

The consequences of avian ocular trauma: histopathological evidence and implications of acute and chronic disease.

Abstract: Objective To present a description and categorization of the histopathological lesions in avian ocular trauma. Animal studied Seventy-five birds diagnosed with ocular trauma at to the Comparative Ocular Pathology Laboratory of Wisconsin. Procedures Histological slides were reviewed, and the type of trauma was classified by cause into either (i) blunt trauma or (ii) penetrating trauma and by duration into (i) acute or (ii) chronic. Results Blunt trauma was the most common source of trauma, and the most frequent lesions were observed in the retina (91%), with 71% of retinas having a tear or detachment and 46% of retinas showing chronic degenerative changes. Damage to the iris/ciliary body was present in 77% of cases. Corneal (17%) and lens (31%) lesions were relatively low. Acute traumatic events had a higher prevalence of readily identifiable discrete retinal tears/detachments (64%). Nearly all cases of chronic trauma exhibited chronic retinal lesions (93.7%), as well as a greater percentage of cartilage/bone lesions (71.4%), irido/cyclodialysis (51.9%), lenticular lesions (72.7%), and corneal damage (83.3%). However, the incidence of iridocyclodialysis was roughly equivalent for acute and chronic blunt trauma. Conclusions Ocular trauma can lead to profound acute and chronic lesions within the eye. Here, we provide insight into understanding ocular damage caused by trauma, which may help future studies suggest new therapeutic options and provide insight regarding the releasability of avian wildlife.

Culture-Positive Endophthalmitis After Open Globe Injuries With and Without Retained Intraocular Foreign Bodies.

Abstract: Background and objective To report the visual and anatomical outcomes and microbiologic spectrum of culture-positive endophthalmitis in open globe injuries (OGIs) with or without intraocular foreign bodies (IOFBs). Patients and methods A retrospective, interventional case series of OGIs (n = 718) treated between 2004 and 2015. Patients underwent a management protocol for OGI, including systemic broad-spectrum antibiotics, on presentation. Results Culture-positive cases of endophthalmitis after open globe repair occurred in 2.1% of eyes (n = 15 of 718 eyes); two eyes had evidence of endophthalmitis on presentation. The most common organism was Staphylococcus species (five of 17 eyes). An IOFB was present in 6.8% of eyes (n = 49 of 718 eyes). All of these eyes received prophylactic intravitreal antimicrobials. In eyes with IOFB, the rate of culture-positive endophthalmitis after initial globe repair was 8.1% (n = 4 of 49 eyes) versus 1.6% (n = 11 of 669 eyes) in eyes without IOFB (P Conclusion Culture-positive endophthalmitis was identified after OGIs more often in eyes with a concurrent IOFB. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:632-637.].

Corneal and Corneoscleral Injury in Combat Ocular Trauma from Operations Iraqi Freedom and Enduring Freedom

Abstract: Objectives: To examine the incidence and the etiology of corneal and corneoscleral injuries in the setting of combat ocular trauma, and to determine what effect these injuries have on overall visual impairment from combat ocular trauma. Methods: Retrospective, noncomparative, interventional case series, analyzing U.S. service members who were evacuated to the former Walter Reed Army Medical Center (WRAMC). Primary outcome measures were types of corneal injuries, length of follow-up at WRAMC, globe survival, and anatomical causes of blindness. Secondary outcome measures included surgical procedures performed, use of eye protection, source of injury, and visual outcomes. Results: Between 2001 and 2011, there were 184 eyes of 134 patients with corneal or corneoscleral injuries. The average age was 26 years (range, 18–50); 99.3% were male, 31.9% had documented use of eye protection. The average follow-up was 428.2 days (3–2,421). There were 98 right-eye and 86 left-eye injuries. There were 169 open-gl...

Demographic Characteristics and Clinical Outcome of Work-related Open Globe Injuries in the Most Industrialised Region of Turkey.

Abstract: Objectives To evaluate demographic characteristics and clinical outcomes of work-related open globe injuries in the most industrialized region of Turkey. Materials and methods The demographic and medical records of patients with work-related open globe injuries who presented to the ophthalmology or emergency departments with an official occupational accident report were retrospectively reviewed. Visual acuity categories were defined according to the World Health Organization. The injury types and zones of the open globes were classified according to Birmingham Eye Trauma Terminology System. Results Among 479 patients with work-related eye injuries in 5 years, there were 102 eyes of 101 patients with open globe injuries (21%). The mean age of the patients was 34.5±8.9 years with a mean follow-up of 12.5±12.6 months. The injuries peaked in June in the hour between 12:00 and 13:00. Eighty-six percent presented to emergency services within 12 hours after the injury. Twenty-two percent of the patients had been wearing protective eyewear at the time of injury. The open globe injuries were penetrating in 51%, intraocular foreign body in 40%, rupture in 7% and perforation in 2% of the eyes. The most frequent finding was traumatic cataract. Final visual acuity of 33.3% of patients was below 3/60. Seventy-eight percent of patients that had visual acuity worse than 6/18 at presentation had visual acuity of 6/18 or better at final visit. Sixty-three percent of eyes which had injuries involving all 3 zones resulted in phthisis bulbi, enucleation or evisceration. Conclusion Work-related open globe injuries may have severe consequences such as visual impairment and blindness among the young male working population in industrialized areas. Nearly half of the occupational open globe injuries resulted in visual impairment and blindness.

Sulfur Mustard-Induced Ocular Injuries: Update on Mechanisms and Management.

Abstract: Sulfur mustard (SM; mustard gas) is a classic chemical warfare agent that has been used in several wars and is still a potential threat especially in the Middle-East region Victims experience acute symptoms in airexposed organs including skin, respiratory tract and the eyes Survivors of the acute stage might develop chronic or delayed-onset complications in the exposed organs The exact mechanism(s) of SM-induced tissue damage is still unknown, however DNA alkylation and oxidative damage are the most relevant mechanisms Eye is the most sensitive organ to the SM vapor and ocular symptoms usually precede other manifestations Ocular findings including blepharitis, dry eye disease, corneal vascularization, persistent epithelial defects, limbal ischemia, limbal stem cell deficiency, corneal thinning, corneal opacity and corneal innervation abnormalities have been reported several years after SM exposure In this review, mechanisms of acute and chronic/delayed ocular manifestations of SM and their current management and potential future therapies have been discussed We have also included recent advances in amniotic membrane transplantation, cultivated stem cell transplantation and anti-angiogenic therapies which might be considered as therapeutic options in SM-induced ocular damage in the future

Floorball-related eye injuries: The impact of protective eyewear.

Abstract: Several previous studies have shown that floorball belongs to a high-risk group of sports in terms of eye injuries. Protective eyewear is available, but the extent of its use and impact on eye injuries are unknown. The purpose of this study was to investigate the current incidence of eye injuries caused by floorball and to compare it with the present use of protective eyewear. Medical records were used to identify all eye injuries suffered while playing floorball in Jonkoping County from 2008 to 2011 (N = 167). All these patients were sent a questionnaire that included inquiries about the use of protective eyewear. The study shows that floorball caused more eye injuries than all other sports combined (56%). Prolonged decreased visual acuity was very unusual (0.5%), but moderate eye injuries with some risk of future problems were seen in 62% of the sample. More than one fifth of the injured patients reported some kind of vision-related problem 2-7 years after the original injury. Only one player had been using protective eyewear at the time of injury. Our results underline the importance of protective eyewear to prevent floorball-related injuries.

Odontogenic orbital cellulitis associated with cavernous sinus thrombosis and pulmonary embolism: a case report.

Abstract: This case illustrates the importance of prompt assessment and treatment of orbital cellulitis. In fact the ocular signs and symptoms may be associated with systemic complications which should be investigated and identified as soon as possible to avoid a poor prognosis. A 46-year-old white woman presented to our emergency room with proptosis, ophthalmoplegia, and conjunctival chemosis of her left eye. An ophthalmologist, having diagnosed orbital cellulitis in her left eye, suspected a cavernous sinus thrombosis. Hematochemical and radiological examinations confirmed the cavernous sinus thrombosis and also showed septic pulmonary embolism. A blood culture indicated Streptococcus constellatus, which is a member of the Peptostreptococcus family, a saprophyte of the oral mucosa that can be pathogenic in immunocompromised persons. The odontogenic origin was then confirmed by dental radiography which showed a maxillary abscess. Her eye signs regressed after antibiotic and anticoagulant therapy. This complex case shows the importance of a multidisciplinary approach for the management of orbital cellulitis, for the prompt diagnosis and treatment of eye injuries and possible complications, so as to avoid serious and permanent sequelae.

The Incidence of Ocular Injuries in Isolated Orbital Fractures.

Abstract: BACKGROUND: Prompt identification of significant ocular injuries in patients who sustain an orbital fracture is important to prevent any potential long-term visual sequelae. The true incidence of these injuries has not been determined, however. As a consequence, most surgeons choose to have all patients evaluated by an ophthalmologist. The objective of this study was to conclusively identify the incidence of significant ocular injuries in patients with isolated orbital fractures and to determine their predictors to guide more efficient patient care. METHODS: A prospective cohort study powered to detect a 15% incidence of ocular injuries was designed. All patients presenting to our center with computed tomography findings of an isolated orbital fracture were included and evaluated by plastic surgery and ophthalmology services. Patients were followed up for a minimum of 1 week to identify any delayed injuries. RESULTS: Eighty patients were enrolled from 2012 to 2014. There were 46 men and 34 women with a mean age of 42.8 years. Assault was the most common mechanism of injury. There were 8 ocular injuries (10%): ruptured globe (1), uveal prolapse (1), retrobulbar hemorrhage (2), hyphema (2), hemorrhagic glaucoma with hyphema (1), and scleral tear (1). Predictors for significant ocular injuries were grossly abnormal visual acuity and abnormal pupillary reactivity of the affected eye. CONCLUSIONS: The incidence of significant ocular injuries in isolated orbital fractures is lower than previously reported. Patients presenting with grossly abnormal visual acuity or abnormal pupillary reactivity are at high risk and should receive prompt ophthalmology service evaluation. Language: en

Ocular Injuries in Patients of Zygomatico-Complex (ZMC) Fractures

Abstract: Mid face injuries commonly destroy the integrity of the orbital skeleton, and are frequently complicated by injury to the eye, ranging between 2.7 and 90.6 % as reported in literature. The eye injuries range from simple subconjunctival haemorrhage to globe rupture. The paper aims to study the types of ocular injuries in patients with ZMC fractures. A study of 67 patients, who had sustained facial trauma sufficient to lead to a facial bone fracture, was undertaken in the department of Oral and Maxillofacial Surgery, Govt Dental College, Srinagar from 2008 to 2014 and the patients received a comprehensive examination by an ophthalmologist within 1 week of injury. All the patients sustaining confirmed ZMC fracture were examined by an ophthalmologist for any associated ocular injury. A thorough ophthalmologic examination included assessment of visual acuity, pupillary reactivity, anterior and posterior segment examination and extraocular motility. The variables reviewed included patient’s gender, mechanism of injury, visual acuity, pupillary reactivity, extra ocular motility, presence or absence of diplopia, ocular and orbital findings, and intraorbital hypoesthesia. The most common etiology of trauma was RTA (64.1 %), followed by falls (14.9 %) in our study. In our study 83.5 % of the patients were males. Minor ocular injuries such as subconjunctival haemorrhage and corneal injury accounted for most of the cases. Subconjunctival haemorrhage was the most common injury, present in 86.5 % of the cases. Hyphema was present 13.4 %, vitreous haemorrhage 2.98 %, retinal haemorrhage 1.49 %, corneal abrasion 4.47 %, mydriasis 1.49 %, choroidal rupture 5.97 %, retinal detachment 2.98 %, decreased visual activity 13.4 %, retinal tear and angle recession was present 7.46 % times. ZMC fractures are associated with higher incidence of ocular injuries. The incidence of traumatic optic neuropathy and other ocular injuries warrants a prompt ophthalmologic examination of all patients with ZMC fractures as quickly as possible to prevent morbidity.

Surgical Management of Traumatic Retinal Detachment with Primary Vitrectomy in Adult Patients

Abstract: Purpose. To evaluate functional and anatomical results of pars plana vitrectomy (PPV) in the retinal detachment (RD) followed by severe eye trauma. Methods. Retrospective analysis of medical records of forty-one consecutive patients treated with 23-gauge PPV due to traumatic RD. Age, gender, timing of PPV, visual acuity, and presence of intraocular foreign body (IOFB) and proliferative vitreoretinopathy (PVR) were included in the analysis. Results. Mean age of patients was 47 years; the majority of patients were men (88%). Closed globe injury was present in 21 eyes and open globe injury in 20 eyes (IOFB in 13 eyes, penetration injury in 4 eyes, and eye rupture in 3 eyes). Mean follow-up period was 14 months; mean timing of PPV was 67 days. Twenty-seven (66%) eyes had a functional success; 32 eyes (78%) had anatomical success. As a tamponade silicone oil was used in 33 cases and SF6 gas in 8 cases. Conclusions. Severe eye injuries are potentially devastating for vision, but vitreoretinal surgery can improve anatomical and functional outcomes. Among analysed pre- and intra- and postoperative factors, absence of PVR, postoperative retinal attachment, and silicone oil as a tamponade were related to significantly improved visual acuity.

Analysis of Ocular Firework-Related Injuries and Common Eye Traumata: a 5-year Clinical Study.

Abstract: Background A comparative study of eye injuries related to fireworks or acts of violence around New Year's Eve and the Swiss National Day on August 1st. The two groups were compared with respect to the overall numbers of eye accidents within the period of review. Patients and Methods Retrospective analysis of emergency consultations at the Department of Ophthalmology, University Hospital Zurich with eye accidents around the Swiss National Day on August 1st and New Year's Eve over the last 5 years. Two subgroups were formed: (1) Firework-related eye traumata, (2) Eye injuries due to acts of violence. The groups were analysed by age, gender, active participant or bystander, eye involved, severity of trauma (from clinical findings), surgical interventions, time of follow-up and visits, visual acuity and outcome. Results The study included 97 patients (100 eyes) with 74 male (76 %) and 23 female (24 %) victims. After filtering out 67 common traumata cases (all unilateral), 17 patients (18 eyes) with firework-related injuries and 13 patients (15 eyes) with damage due to an act of violence remained. Firework injuries accounted for 18 % of cases (65 % men); eye injuries caused by an act of violence accounted for 15 % of cases (92 % men). In the fireworks group, women were significantly older than men (mean age men 32 ± 14 years versus women 38 ± 16 years, p = 0.002). 65 % of cases were bystanders. The two subgroups contained 30 patients (33 eyes) with 22 left eyes (67 %, p < 0.001). The anterior segment was most frequently involved (79 %), significantly more often than the posterior part of the eye (p < 0.001). The posterior segment was injured more often in the fireworks group (28 %), than in the violence group (13 %). 87 % of the victims in the group of common traumata were mild trauma, 10 % moderate and 3 % severe. In the fireworks group the distribution was 53 % mild, 12 % moderate and 35 % severe, in the violence group 46 %, 23 % and 31 % respectively. Severe trauma cases occurred significantly more often around the New Year, with 36 % versus August 1st with 18 % (p = 0.0028). They are more often related to firework injuries than caused by violence (40 % versus 33 %). In summary, 7 victims (23 %) needed 8 interventions, with 3 having additional issues with their intraocular pressure. Full final visual acuity was noted in 88 %, which was alike in the two subgroups. On the contrary common traumata happened significantly more often around August 1st (66 %) than New Year (34 %; p < 0.001). Conclusions The number of injured eyes in the two subgroups of fireworks and violence was twice as high around New Year's Eve than around the Swiss National Day. If the two events were combined, eye injuries were caused by an act of violence in 45 % and by fireworks in 55 % of cases. Injuries from fireworks can be decreased by professional fireworks. Both types of accident can be decreased by public awareness.

Ocular trauma in the Finnish elderly - Helsinki Ocular Trauma Study

Abstract: Purpose To describe epidemiology, causes, treatments and outcomes of all ocular injuries in southern Finland among people aged 61 and older. Methods All new ocular trauma patients, admitted to the Helsinki University Eye Hospital, during 1 year in 2011-2012. The data were from hospital records and prospectively from patient questionnaires. The follow-up time was 3 months. Results The incidence for ocular injuries among the elderly was 38/100 000/year. From 118 patients 69% were men. The mean age was 70.9 years old (median 67). The hospitalization rate was 14%. Injury types were minor traumas (48%), contusions (22%), chemical injuries (10%), eyelid wounds (8%), open globe injuries (OGI; 7%) and orbital fractures (5%). The injuries occurred at home (58%), institutions (12%) and in other public places (12%). The main causes of ocular injury were falls (22%), sticks (19%), superficial foreign bodies (18%) and chemicals (12%). All OGI and 88% of contusions needed a lifelong follow-up. A permanent visual or functional impairment occurred in 15 (13%) patients. Of these 53% were OGI, 40% contusions and 7% chemical injuries. The causes of permanent injuries were falls (seven cases, 47%), work tools, sports equipment, sticks, chemicals and eyeglasses. The incidence for legal blindness was 2.3/100 000. Conclusion Minor trauma was the most frequent type, and home was the location of the most occurred eye injuries. Falls were the most frequent and serious cause, but behavioural causes were not significant. Preventive measures should be directed towards the main identified causes and risk factors of the eye injuries in the elderly.

Early versus late traumatic cataract surgery and intraocular lens implantation.

Abstract: PurposeTo determine the proper time for traumatic cataract surgery after open globe injuries.SettingFarabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.DesignRandomized clinical trial.Patients and methodsIn a randomized clinical trial, 30 eyes with traumatic cataract after open globe injury with IOL implantation underwent early (in the first week after the trauma) and 30 eyes underwent late cataract surgery (from the first to second month after the trauma). We excluded patients who were under 12-year-old. All patients were visited at 1 week, 4 weeks, 12 weeks, and 6 months after surgery. In each visit, patients were examined regarding visual acuity, intraocular pressure (IOP), anterior chamber inflammation, IOL position, and posterior synechiae. In addition, posterior segment evaluation and fundoscopy were performed. Intraoperative complication including posterior capsular rupture, anterior vitrectomy, and zonulysis as well as the site of IOL implantation were documented and post-operative complications including raised IOP, anterior chamber inflammation, visual axis opacity, posterior synechiae, subluxation of IOL, and IOL pigment deposition were listed.ResultsBest-corrected visual acuity 6 months after surgery was not different between the two groups. Also in early cataract surgery group, the rate of posterior capsular rupture was not significantly higher than the late surgery group (P=0.069). On the other hand, zonulysis was significantly higher in the late procedure group (P=0.039). Other complications including anterior vitrectomy, raised IOP, anterior chamber inflammation, visual axis opacity, posterior synechiae, subluxation of IOL, and IOL pigment deposition were not different in the two groups.ConclusionsEarly and late traumatic cataract surgery and IOL implantation after open globe injuries, have no significant difference regarding the post-surgical BCVA and prominent intraoperative and post-operative complications.

Chemical Burns of the Eye.

Abstract: Chemical burns of the eye are one of the most common eye injuries. The extent of the ocular surface damage is influenced by the type, temperature, volume, and pH of the corrosive substance and duration of exposure. Limbal ischemia found on eye assessment is the primary determinant of eventual visual outcome. Eye irrigation must be instituted immediately at the scene of exposure and continued in the emergency department to reduce visual impairment. Traditionally lactated Ringer's and normal saline have been used as irrigation fluids, although one systematic review demonstrates similar outcomes with other irrigation fluids. The Morgan Lens is a device that can be utilized to allow the provider to perform "hands free" eye irrigation. Complications of chemical burns are more common with alkali burns as these substances destroy the corneal epithelium and allow this corrosive base substance to penetrate deeper into the cornea.

Sports-Related Eye Injuries.

Abstract: Hyphema (1,2) Definition: bleeding in the anterior chamber of the eye. Presentation: The mechanism of injury in an athlete is frequently blunt trauma to the eye damaging the microvasculature of the iris. Bleeding can occur spontaneously, usually in association with sickle cell disease. Evaluation: A blood level will be noted in the anterior chamber of the eye. Management: Initial management includes eye shielding, maintaining the head in a relatively upright position, discontinuation of nonsteroidal anti-inflammatory drugs and anticoagulants, and bedrest for 4 d. Consider hospitalization if intraocular pressure is increased, blood fills greater than one third of the chamber, or in athletes with a coagulopathy. Urgent ophthalmology referral is warranted as uncontrolled bleeding can lead to glaucoma and blood staining of the cornea. Monitor for re-bleed which can occur after 3 to 5 d. Timing of return to play is determined in consultation with ophthalmology.

Etiologies and surgical outcomes of pediatric retinal detachment in Hong Kong

Abstract: The purpose of this study was to study the etiologies and operative outcomes of pediatric retinal detachment at a tertiary eye referral center in Hong Kong over a 10-year period. A retrospective study of patients (below 18 years of age) who received primary retinal detachment repair operations at a University Teaching Hospital between 2005 and 2015 was conducted. The study comprised 37 patients with 39 eyes affected who received primary retinal detachment (RD) surgery. Two patients had bilateral RD. 69.2 % were male. The mean follow-up period was 40.6 ± 28.6 months. Their mean age at presentation was 13.4 ± 5.5 years. There were contributing factors for RD identified in 33 eyes (84.6 %), of which congenital/developmental anomalies (23.1 %), high myopia with refractive error greater than -6 diopters (17.9 %), and trauma (15.4 %) ranked the top 3 causes for RD. The retina was reattached after one surgical procedure in 69.2 %. Final anatomical success rate was 82.1 %. Postoperatively, 68.8 % of eyes had improved or stable vision. Functional visual loss with visual acuity less than 5/200 was found to be 30.6 % of eyes which were mostly from younger patients and those with congenital anomalies. Pediatric retinal detachment is often associated with predisposing factors. The presence of congenital/developmental ocular anomalies causing retinal detachment is more frequent in younger children and with worse functional and visual outcomes. Continuing efforts to improve treatment strategies for this group of patients are needed.

Eye-related trauma and infection in dentistry.

Abstract: Despite numerous technological and medical developments achieved in recent years, a significant amount of occupational health problems still exist in modern dentistry. The risk of eye injury is mostly attributed to the use of high-speed hand pieces and ultrasonic devices. A dental clinic may be the source of eye-related infection and injury because of mechanical, chemical, microbiological and electromagnetic irritants. Accidents may cause facial injuries that involve eyes of the clinicians, patients as well as dental assistants. Eye injuries can vary from mild irritation to blindness. The use of eye protection tools, such as protective goggles and visors, reduces the risk of eye damage or complete loss of vision while working with dangerous and floating materials. Therefore, all precautions should be taken, even when performing common procedures for which the risk expectancy is relatively low. Clinicians should be aware that they are also responsible for providing adequate protection for their assistants and patients, as well as themselves.

Suturing repair of subtotal iridodialysis.

Abstract: To report a case of subtotal iridodialysis that was repaired using suturing with the assistance of a guide needle. A 52-year-old man had subtotal iridodialysis of approximately 300° with massive hyphema and vitreous hemorrhage after blunt trauma. The patient was treated with pars plana vitrectomy, and then suturing repair of iridodialysis was performed. After the surgeries, the ratio of pupil area to corneal area is improved from 82.1 to 42.4%. The visual acuity improved to 30/20, and subjective symptoms of glare and monocular diplopia disappeared. There was no remarkable postoperative complication for up to 12 months. Suturing repair is useful for subtotal iridodialysis and may be an alternative for an iris implant.

Sports-Related Eye Injuries.

Abstract: Eye injuries are a common reason for emergency department visits. In the March 2016 issue of JAMA Ophthalmology, Channa et al1 assessed emergency department visits for eye-related conditions from January 2006 to December 2011 using the US Nationwide Emergency Department Sample. Of the estimated approximately 12 million emergency department visits for ocular problems, an estimated 4.3 million occurred because of an eye injury.1 The actual number of eye injuries requiring medical attention is most likely even greater because the Nationwide Emergency Department Sample data include only emergency department data and patients with ocular injuries also may be seen in urgent care centers or directly by an optometrist or ophthalmologist. Many sports and leisure activities can result in serious eye injuries and blindness. The sports most likely to result in eye injury vary based on the age of the participant and the geographic area. Identifying sports with potential for a serious eye injury such as ice hockey, field hockey, and lacrosse was the first step in developing prevention programs. Legislating face and eye protection for youth and professional participation in these sports has resulted in measurable reduction in eye trauma.2-5 States not requiring protective eyewear for high school field hockey had a 5.3-fold higher risk of eye injury compared with states that had these mandates.2,3 Similar benefits were observed with legislation mandating eyewear protection for US women’s lacrosse in 2004. In a study of 25 high schools surveyed in Fairfax County, Virginia, the relative incident ratio was 0.16 for both before and after the mandate of eyewear use in all players.4 In the December 2016 issue of JAMA Ophthalmology, Haring et al6 revisited the epidemiology of sports-related eye injuries in the United States. Data were analyzed from the Nationwide Emergency Department Sample, a survey that is part of the Healthcare Cost and Utilization Project. The Healthcare Cost and Utilization Project is the nation’s most comprehensive source of hospital care data and includes administrative discharge information for in-patient hospital care, ambulatory services, and emergency department visits. The Nationwide Emergency Department Sample collects information about emergency department visits regardless of whether hospital admission occurs. The Nationwide Emergency Department Sample is a population-representative sampling of US hospitals that Related article at jamaophthalmology.com JAMA OPHTHALMOLOGY