Showing papers on "Eye injuries published in 2018"

A five-year retrospective study of the epidemiological characteristics and visual outcomes of pediatric ocular trauma

Abstract: Pediatric trauma can lead to serious visual impairment as a result of the trauma itself or secondary to amblyopia. Precise data on epidemiological characteristics and visual outcomes of pediatric ocular injuries are valuable for the prevention of monocular blindness. A total of 268 cases of pediatric ocular trauma admitted to the Department of Ophthalmology of the Lithuanian University of Health Sciences Hospital from January 2008 to December 2013 were retrospectively reviewed. Data analysed included age, sex, cause, type and treatment of injury, initial and final visual acuity (VA) and tissues involvement. Eye injuries were classified by Birmingham Eye Trauma Terminology (BETT) and Ocular Trauma Classification System (OTCS). The age of children ranged from 6 months to 17.5 years. Boys were more likely to suffer ocular injury than girls. Home was the leading place of eye injury (60.4%), followed by outdoors (31.7%), school (5.2%) and sporting area (2.2%). The highest percentage of eye injuries in children were caused by blunt (40.3%) and sharp objects (29.9%), followed by burns (9.3%), falls (6.7%), explosions (4.5%), fireworks (4.1%), gunshots (1.9%) and traffic accidents (0.7%). Closed globe injury (CGI) was the most common type of eye injury (53.4%). CGI were noted to be higher in children aged 13–18 years, while open globe injury (OGI) were higher in the pre-school age group. Injury of grade 4 and grade 5 were more common in OGI, while grade 1 and grade 2 predominated in cases of CGI. Hypotony, traumatic cataract, iris laceration, vitreous prolapse and uveitis were the most common presentations of OGI, while hyphema, secondary glaucoma and retinal edema were significantly related with CGI. Final diagnoses contributing to poor final visual outcome such as corneal scar corneal opacity, hypotony, aphakia, and retinal detachment were statistically significant related only with OGI. Overall, 65.63% of children regained good visual acuity (VA ≥ 0.5), but for 18.4% of them, the trauma resulted in severe visual impairment (VA ≤ 0.1). Ocular trauma in children still remains an important preventable cause of ocular morbidity. This study provides data indicating that ophthalmological injuries are a significant cause of visual impairment in children.

Trends in US Emergency Department Visits for Pediatric Acute Ocular Injury.

Abstract: Importance There is a lack of literature describing the incidence of pediatric acute ocular injury and associated likelihood of vision loss in the United States. Understanding national pediatric eye injury trends may inform future efforts to prevent ocular trauma. Objective To characterize pediatric acute ocular injury in the United States using data from a stratified, national sample of emergency department (ED) visits. Design, Setting, and Participants A retrospective cohort study was conducted. Study participants received care at EDs included in the 2006 to 2014 Nationwide Emergency Department Sample, comprising 376 040 children aged 0 to 17 years with acute traumatic ocular injuries. Data were analyzed from June 2016 to March 2018. Exposures International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes and external-cause-of-injury codes identified children with acute ocular injuries. Main Outcomes and Measures Demographic and clinical characteristics of children with acute traumatic ocular injuries were collected and temporal trends in the incidence of ocular injuries by age, risk of vision loss, and mechanism of injury were explored. Results In 2014, there were an estimated 163 431 (95% CI, 151 235-175 627) ED visits for pediatric acute ocular injury. Injured children were more often male (63.0%; 95% CI, 62.5-63.5) and in the youngest age category (birth to 4 years, 35.3%; 95% CI, 34.4-36.2; vs 10-14 years, 20.6%; 95% CI, 20.1-21.1). Injuries commonly resulted from a strike to the eye (22.5%; 95% CI, 21.3-23.8) and affected the adnexa (43.7%; 95% CI, 42.7-44.8). Most injuries had a low risk for vision loss (84.2%; 95% CI, 83.5-85.0), with only 1.3% (95% CI, 1.1-1.5) of injuries being high risk. Between 2006 and 2014, pediatric acute ocular injuries decreased by 26.1% (95% CI, −27.0 to −25.0). This decline existed across all patient demographic characteristics, injury patterns, and vision loss categories and for most mechanisms of injury. There were increases during the study in injuries related to sports (12.8%; 95% CI, 5.4-20.2) and household/domestic activities (20.7%; 95% CI, 16.2-25.2). The greatest decrease in high-risk injuries occurred with motor vehicle crashes (−79.8%; 95% CI, −85.8 to −74.9) and guns (−68.5%; 95% CI, −73.5 to −63.6). Conclusions and Relevance This study demonstrated a decline in pediatric acute ocular injuries in the United States between 2006 and 2014. However, pediatric acute ocular injuries continue to be prevalent, and understanding these trends can help establish future prevention strategies.

Traumatic Cataract in Children in Eastern China: Shanghai Pediatric Cataract Study

Abstract: Traumatic cataract is a main cause of visual impairment in pediatric populations and is preventable. Awareness of the causes and consequences of pediatric eye trauma play roles in health education and prevention of blindness. We conducted a retrospective chart review based on 5-year clinical data of pediatric traumatic cataract cases treated at the Eye and Ear, Nose and Throat Hospital of Fudan University, Shanghai, China. Clinical features including demographic data, injury mechanism, and causative agents were analyzed. A total of 321 eyes of 321 children (male, 74.1%) were included. Penetrating injury accounted for 76.6% of all injuries; 65% of children with such injuries underwent their first surgery on the day of injury. The average age at injury was 6.3 ± 3.7 years, while the peak age was from two to eight years. The main causes of ocular injury were sharp metal objects, toys, and wooden sticks. The causative agent changed with increasing age; however, scissors were the leading cause within almost all age groups. Cataract surgery significantly improved visual acuity in children with traumatic cataract. These findings add information regarding the characterization of pediatric traumatic cataract in China and can help guide safety education and preventative measures.

Pediatric Sports- and Recreation-Related Eye Injuries Treated in US Emergency Departments.

Abstract: OBJECTIVES: To investigate the epidemiologic characteristics of sports- and recreation-related eye injuries among children in the United States. METHODS: Data from the National Electronic Injury Surveillance System were analyzed in a retrospective study of children ≤17 years of age treated in US emergency departments for sports- and recreation-related eye injuries from 1990 to 2012. RESULTS: From 1990 through 2012, an estimated 441 800 (95% confidence interval: 378 868–504 733) children were treated in US emergency departments for sports- and recreation-related eye injuries, averaging 26.9 injuries per 100 000 children. Children 10 to 14 and 15 to 17 years old had the highest rate of eye injury. Three-fourths of injuries were sustained by boys. The most common types of injury were corneal abrasion (27.1%), conjunctivitis (10.0%), and foreign body in the eye (8.5%). Most eye injuries were treated and released (94.6%); however, 4.7% were hospitalized. The most common sports and recreation activities and equipment associated with eye injury were basketball (15.9%), baseball and softball (15.2%), and nonpowder guns (10.6%). The overall rate of eye injury decreased slightly during the study period; however, the rate of eye injury associated with nonpowder guns increased by 168.8%, and nonpowder gun-related eye injuries accounted for 48.5% of hospitalizations. CONCLUSIONS: Pediatric sports- and recreation-related eye injuries remain common. Increased prevention efforts are needed, especially for eye injuries associated with nonpowder guns. Increased child, parent, and coach education, as well as adoption of rules that mandate the use of eye protective equipment should be undertaken.

Epidemiological profile of pediatric ocular trauma in a tertiary hospital of northern India

Abstract: Purpose: Ocular trauma is one of the most common causes of acquired blindness in children. It measures about 8%-14% of total childhood injuries. This study aims to determine the epidemiological profile of ocular trauma in the pediatric age group attending a tertiary hospital in northern India. Methods: A retrospective study was conducted in our hospital between June 2014 to July 2015 and all the children aged 0-16 years presenting with ocular trauma in eye outpatient department and emergency were enrolled in the study. Various epidemiological parameters like age, sex distribution, duration of presentation, mode of injury, type of injury and final visual outcome were analyzed. Results: Of total 357 patients, 271 (76%) were below the age of 12 years; 41.1% of children with ocular trauma belonged to age group 2-6 years. The male to female ratio was 2.9:1. Out of total patients, 242 (67.8%) presented with closed globe injury. Among the closed globe injury, the history of fall was present in about 35% of children, followed by trauma while playing with bat/ball (15.7%) and finger nail trauma (13.2%). Among open globe injury, trauma with needle, knife, glass and pen were common causes. Home was the most common place of injury (47.8%), followed by streets (17.9%) and playground (14.9%). Conclusion: Children are vulnerable to ocular trauma and need more supervision. Sharp objects like needles, knives, household chemicals like acids should be out of reach of children. Key words: Ocular trauma; Open globe injuries; Closed globe injuries; Birmingham eye trauma terminology system; Adnexal injuries; Pediatric ocular trauma

The ten-year experience of firework injuries treated at a uk regional burns & plastic surgery unit.

Abstract: Fireworks are used worldwide to celebrate national, religious, cultural festivals and holidays. However the use of fireworks is associated with preventable injuries. We aim to review cases of burns and trauma caused by fireworks presenting to a regional burns and plastic surgery unit in the United Kingdom. We hope our findings will help to guide future firework-related safety practices in the UK. A retrospective review was performed of all patients presenting to our tertiary burns and plastic surgery unit with burns and/or trauma sustained from fireworks over a ten-year period from October 2004 to October 2014. A total of 93 patients were identified. Medical case notes were reviewed, patient demographics, aetiology of injury, management and patient outcomes were recorded. A cohort of 93 patients with burn injuries caused by fireworks were identified from our database. A total of 74% injuries occurred in October and November. Mechanism of injury included contact, flash, flame burns and injury secondary to blast force. Most injuries sustained were to the hands, followed by head and neck, torso, limbs and perineum in descending order of frequency. A total of 38.7% of patients required surgery for their wounds. Fireworks not only result in significant burn injuries, but also eye injuries, soft tissue defects and fractures requiring a spectrum of plastic surgical interventions. The number and severity of accidents can be minimised by raising awareness regarding safety precautions.

Seasonal distribution of ocular conditions treated at the emergency room: a 1-year prospective study.

Abstract: Purpose: To determine the clinical characteristics and seasonal distribution of patients admitted to the ocular emergency department of a tertiary ophthalmology care center. Methods: The study cohort includes 27,120 patients who were admitted to ocular emergency room between November 2013 and November 2014. The age, sex, reason for admission, diagnosis, and complete ocular examination reports were recorded for each patient. X-ray and ultrasonographic examinations were performed if necessary. Results: The mean patient age was 32.83 ± 17.62 years (range, 0-95). The number of males was nearly two times the number of females, with 18,808 (69.4%) males and 8312 (30.6%) females. The diagnoses included viral conjunctivitis (7,859 patients; 29.0%), corneal foreign body (5,286 patients; 19.5%), bacterial conjunctivitis (3,892 patients; 14.4%), corneal abrasions (2,306 patients; 8.5%), and allergic conjunctivitis (1,433 patients; 5.3%) (Table 1). Other frequent diagnoses included subconjunctival hemorrhage, photo keratopathy, chemical eye injury, and penetrating and blunt eye injuries. Allergic conjunctivitis, ocular trauma, and corneal foreign body were more frequent in spring, whereas keratitis and chemical eye injury were more common in winter (chi-square test). The most common reasons for emergency room admission, in order of frequency, were viral conjunctivitis, corneal foreign body, bacterial conjunctivitis, and corneal abrasions. Conclusion: This study is the first long-term prospective study to evaluate the seasonal distribution and diagnosis of all adult and pediatric patients admitted to the emergency room for ocular conditions. The frequency of ophthalmological conditions seen in the emergency room may vary according to the season.

Prophylactic chorioretinectomy for eye injuries with high proliferative-vitreoretinopathy risk.

Abstract: With its incidence exceeding 60%, proliferative vitreoretinopathy (PVR) remains the most important pathology responsible for loss of vision, even the eyeball, after certain types of severe trauma. In this article, we present results obtained using our novel surgical technique, prophylactic chorioretinectomy (PCR), to prevent the development of PVR. Data on severely injured eyes at high risk for PVR [rupture, posterior laceration, deep-impact intraocular foreign body (IOFB) trauma, perforating injury] were collected prospectively. All eyes underwent vitrectomy (PPV) by PCR within 100 hr of the trauma. Eyes were excluded if they presented with endophthalmitis or if the reconstructive surgery was performed outside this time frame. Forty eyes of 40 consecutive patients were analyzed; full follow-up information was obtained for all of them. The injury was rupture in 27%, penetrating in 15%, (deep-impact) IOFB in 35%, and perforating in 23%. PPV-PCR was performed during primary (wound closure) surgery in 59% of cases. All eyes had at least minimal vitreous hemorrhage, and none had a true posterior vitreous detachment. At the time of PPV, 30% of the eyes had a retinal detachment. Sixteen percent developed PVR, but none from the site of the PCR procedure. In 20%, silicone oil remained in the eye at the last follow-up. The visual acuity improved in 93% of eyes and worsened in none; the improvement was mostly due to surgical clearing of the media opacity. In this subgroup of eyes with severe open-globe trauma, over 60% are expected to develop PVR. PPV/PCR performed within 100 hr reduced the PVR risk significantly, so currently it remains the best option for the surgeon. Clin. Anat. 31:28-38, 2018. © 2017 Wiley Periodicals, Inc.

Periocular CO2 laser resurfacing: severe ocular complications from multiple unintentional laser impacts on the protective metal eye shields.

Abstract: Background and objectives A 36-year-old woman underwent CO2 laser resurfacing for periocular rhytides using protective stainless steel Cox II ocular shields. Immediately after the treatment, corneal lesions were seen in both eyes. The left eye subsequent developed corneal ulceration and scarring, a deformed iris, cataract, and lower eye lashes showing signs of acute burns. The right cornea had a small inferior mid-peripheral superficial lesion and concomitant lower mid-peripheral burned eye lashes. Our objective was to determine the most likely cause of these ocular complications. Study We estimated temperature-time combinations that could induce corneal injury and cataract. Heat conduction effects from a heated cornea to the lens and from a heated ring of periocular skin to the cornea were computed. The temperature response of a shield following CO2 laser irradiation was determined. Results We computed that cataract can develop when the corneal temperature reaches, for example, 80 °C for 14 seconds. A periocular ring of heated skin contributes little to the corneal temperature. After 7 pulses of consecutive CO2 laser bursts in 7.5 seconds, the total shield area already reached a homogeneous temperature of 63 °C. Conclusion Despite uncertainties in procedural details and modeling of cataract temperatures, the eye injuries were caused beyond doubt by heating of tear-covered metal eye shields by at least 10 consecutive but unintentional laser impacts. Lasers Surg. Med. 50:980-986, 2018. © 2018 Wiley Periodicals, Inc.

Trends in Eye Injuries and Associated Medical Costs among Children in the United States, 2002-2014.

Abstract: Purpose: To describe the trends in eye injuries and associated medical costs among children in the United States.Methods: Data were from the 2002–2014 Medical Expenditure Panel Survey (MEPS). Eye i...

Eye damage due to cosmetic ultrasound treatment: a case report

Abstract: Rejuvenation of aging eyelids is one of cosmetic changes to the individual to create the appearance of youth. Tightening treatment of eyelid by ultrasonic heat could possibly develop acute eye injury, including acute increase of IOP, cataract and rarely myopia. A case report of rejuvenation tightening treatment caused eye injury with 6 months’ follow-up. All examinations were performed at a university teaching hospital. A healthy 32-year-old Asian woman had pain, photophobia and blurred vision in the right eye after rejuvenation tightening eye brow treatment. Intraocular pressure (IOP) was 31 mmHg in the right eye. Tyndall phenomena were observed. Visual acuity of the right eye dropped to 20/200 (from 20/20), with best-corrected visual acuities (BCVAs) 20/20. An iris pigment detachment was found. Neuro-ophthalmic examination was relative afferent pupillary defect (RAPD) positive with pericentral scotoma in the right eye, indicating optic nerve damage. In the optical quality analysis system (OQAS) exam, the objective scatter index (OSI) was 1.0 in the right eye and 0.7 in the left. Clearing additional plus lens power was difficult for this patient, indicating accommodation spasm in the right eye. Rejuvenation with intense-focused ultrasound (IFUS) could cause heat injury, leads to acute increase of IOP. Heat damage in zonular fibers could cause accommodation spasm and myopia. Eye injuries caused by IFUS has been seldom reported. We recommend that cosmetic treatment in the eye area should be highly aware of side effect.

To study the epidemiological and clinical profile of ocular trauma at a tertiary health-care facility

Abstract: Aim To study the profile of ocular trauma and to find out its risk factors. Settings and design This is a prospective hospital-based study that included patients of ocular trauma presenting to the Department of Ophthalmology and Emergency, Guru Gobind Singh Medical College and Hospital, Faridkot, India during the period from May 2015 to November 2016. Patients and methods The study included patients with recent history of trauma ( Results A total of 200 patients were studied. Men had twofold higher rates of injury than women. The predominant age group was between 21 and 30 years with a mean age of 29.87±12.46 years. Daily laborers were most frequently involved in trauma (n=64; 32%). The workplace trauma was the most common mode accounting for 27.5% of the cases and was most commonly sustained by laborers (50.90%). Metallic objects were responsible in 28.5% followed by vegetative matter (11%). Mechanical trauma was present in 94.5% while 5.5% suffered from chemical trauma. In 94.5% cases with mechanical trauma, 60.5% sustained closed globe injuries and 26% had open globe injuries. Contusions and penetrating injuries were the most common in closed and open globe injuries, respectively. Corneoscleral perforation was the most common clinical presentation in 50 patients. Forty-two percent of patients required only medical management and 58% required surgical management with the most frequent being corneal/scleral perforation repair. Conclusion Workplace-related eye injuries were noted in a significant number of cases. Strict implementation of health education and preventive strategies especially at the workplace will help to decrease the occurrence of ocular injuries.

Work Related Ocular Injury: Nepal.

Abstract: INTRODUCTION Occupational eye injuries comprise a major source of ocular trauma. Knowledge of the epidemiology of occupational eye injuries is essential to formulate viable safety strategies. OBJECTIVES To evaluate the demographics, patterns of protective eye wear use, and patterns of occupational eye injury among workers in Hetauda, Nepal. MATERIALS AND METHODS Community based cross-sectional prospective survey was carried out from September 2010 to July 2011. Survey included all workers irrespective of their age and those who are willing to participate in survey by filling details on structured questioners and comprehensive eye examination at community level. RESULTS 1236 surveys were collected. 38.3% (473) of workers surveyed reported experiencing a work-related eye injury. Over two-thirds [68.3% (844)] of workers surveyed reported never wearing safety eyewear while at work. There was a positive correlation between male sex (P<0.001), reported previous work-related injury (P<0.001), and attending school (P=0.016) and use of personal protective equipment (PPE). CONCLUSIONS The population studied demonstrates a significant level of work related injury. There are potentially modifiable factors that could lead to increased use of eye protection.

Bee sting to the cornea: toxic effects and management.

Abstract: 62-year-old man with a history of bee allergy presented with severe eye pain one day after A being stung in the eye by a bee. Figure A shows corneal oedema due to endothelial toxicity secondary to bee venom. Despite ideal management of intensive topical steroids and antibiotic drops, the cornea did not recover. An endothelial keratoplasty, rather than penetrating keratoplasty, was performed 6 months later. Two weeks after the transplant, his cornea started to clear (Figure, B), and vision improved from 1/60 to 6/18. The entry site of the stinger can be seen as an area of white scarring within the cornea stroma.

Airsoft gun-related ocular injuries: long-term follow-up.

Abstract: Purpose To describe the long-term ocular effects of airsoft gun pellet injuries. Methods The present study extends by 7-10 years the results of a 2010 study on the acute ocular findings related to airsoft gun pellet injuries in 59 patients, wherein we found a variety of anterior and posterior segment injuries, including hyphema (66%), corneal edema (61%), corneal erosions (59%), and traumatic mydriasis (25%), as well as retinal edema in (22%), retinal hemorrhages and mild vitreous hemorrhage in (2.1%), and, in 1 patient, elevated intraocular pressure and traumatic cataract. Results Of the 59 patients in the original study, up-to-date medical records were available for 26 (44%; 20 males). The mean follow-up time was 8 years (range, 7.2-10.3 years); the mean age, 17.1 years. Persistent abnormal findings included traumatic cataract in 3 cases (11.5%) and iris dialysis in 1 case (3.8%). In all traumatic cataract cases, cataract was not present at the time of initial examination after injury. Final mean best-corrected visual acuity was 0.92 (range 0.67-1.0), logMAR 0.03 (range 0.18-0). Conclusions While most acute airsoft gun-related ocular injuries are transient, some patients may develop significant and potentially sight-threatening ocular damage, even in the absence of significant pathologic findings at the time of the injury. Long-term follow-up on these patients is advisable.

Pellet gun injury as a source of ocular trauma; a retrospective review of one hundred and eleven cases.

Abstract: Purpose To report the demographic data, treatment methods, and outcomes among patients with pellet gun eye injuries. Methods This study was a retrospective review of all pellet gun eye injuries coming to Farabi Eye Hospital, a referral ocular trauma center in Iran, from February 2009 to November 2013. Patients' demographics, type of injury, choice of management, complications, and post-treatment visual acuity were recorded. Results One hundred eleven patients with a mean age of 25.7 ± 15.6 years entered the study. The most common age group was younger adults (16–45 years old) (61.3%). The mean uncorrected visual acuity after treatment was 2.05 (20/2240) ±1.5 logMAR. The most prevalent ocular zone was zone III (38.7%), and an intraocular foreign body was present in 97 patients (87.4%). Lid laceration and periocular tissue damage were present in 27 patients (24.3%). Lensectomy and vitrectomy were the most common treatment (31.5%). In most patients (87.4%), the injury was non-deliberate, and the most common time of hospitalization was the same day (45.0%). The only statistically significant indicator of post-treatment visual acuity was ocular trauma score (OTS) at admission ( P Conclusion Pellet gun injuries were more common among young male patients, and the only statistically significant indicator of post-treatment visual acuity was OTS at admission.

A nonlinear dynamic finite-element analyses of the basketball-related eye injuries

Abstract: Eye injuries from blunt forces and penetrating objects can cause morbidity, disability, and blindness. Most of these injuries are preventable not only by understanding the detail of injury, but also by portraying the role of the ball’s characteristics. Basketball can induce severe forms of injuries to the eye. This study was aimed at performing a numerical analysis through the fluid–structure interaction on ocular trauma. Balls with different diameters, elastic moduli, and pressures were shot to the eye. Injury in terms of the stresses and deformations in each component of the eye was computed at ~ 0.72 mm deformation in the apex of the cornea. By increasing the diameter of the ball from 20 to 26 cm the stress in the eye components, excluding the aqueous body, vitreous body, and extraconal fat, increased. Stresses of 2.68 and 3.19 MPa were observed in the cornea under the ball diameters of 20 and 26 cm, respectively. Conversely, the elastic modulus and pressure of the ball in the defined range showed no considerable role on the stress in the eye components. The results revealed the importance of the ball size compared to the elastic modulus and pressure in the stress accumulation as a result of ocular trauma.

A survey of incidental ocular trauma by pencil and pen.

Abstract: Aim To determine characteristic features of ocular trauma resulted from self-trauma by writing instruments among pediatric population. Methods Thirty-six children who suffered from self-inflicted ocular trauma with a writing instrument were included in this prospective cross-sectional study. Results The mean age was 5.6±2.7y with male: female ratio of 1.77. The right eye was involved two times more than the left eye. The superomedial (55.5%) and inferomedial (30.6%) quadrants were the most common sites of injury. The leading culprit was colored pencils (44.4%). During surgical exploration, no foreign body (FB) was found in 25 (69.4%) patients while an FB was found in 11 (30.5%) patients. Brain injury was present in two patients (5.6%) and only in superomedial quadrant injuries. Zone 1 was the most common site for ocular trauma associated with penetrating injury. The mean ocular trauma score (OTS) in penetrating injuries was 3.8±1.2. The best corrected visual acuity (BCVA) was 0.3±0.6 upon admittance and 0.08±0.21 after one year. The final BCVA was significantly correlated with the entrance site, better final BCVA was found in nasal entrance site (P Conclusion The ophthalmologists should keep a high index of suspicion to rule out penetrating eye injuries related to writing instruments in a young uncooperative child. Brain injury is a life-threatening event that should be ruled out by appropriate imaging. Medial canthal area as the most common site needs an especial attention in writing instrument injuries.

[Firework injuries in the south-western region of the Netherlands around the turn of the year 2017-2018].

Abstract: OBJECTIVE To report the number of patients with firework-related injuries treated in December 2017 and January 2018 in a hospital in the south-west Netherlands trauma region, and to provide details about the types of firework used and the specific injuries. DESIGN A prospective multicentre cohort study (NTR6793). METHODS Patients of all ages with firework-related injuries were eligible for inclusion. The injury had to have been sustained between 1 December 2017 and 31 January 2018, and treated at a hospital in the south-west Netherlands trauma region (approximately 2.5 million inhabitants). Data were extracted from patients' medical files and additional information was obtained from patient interviews. RESULTS Fifty-four patients were included. The majority were male (93%) and the median age was 15 years. Twenty-five (46%) patients were bystanders and 12 (22%) were injured by illegal fireworks. Fifty patients were injured by bangers (n=22) or decorative fireworks (n=28). The patients had a total of 79 injuries, of which 29 (37%) were localised to the upper extremity and 19 (24%) to the eyes. Most upper extremity injuries were burns (69%), primarily partial thickness. Of the eye injuries, 14 were caused by blunt trauma, seven by chemical trauma, and one by penetrating trauma. Three patients sustained indirect firework-related injuries. CONCLUSION Between 1 December 2017 and 31 January 2018 in the south-west Netherlands trauma region mainly teenage males and bystanders sustained firework-related injuries. Most injuries were upper extremity burns and eye injuries, mainly due to legal fireworks and bangers or decorative fireworks. The extent of the sample indicates that the study findings can be extrapolated to the rest of the Netherlands.

Anterior Segment Injury by a High-Power Handheld Blue Laser Device.

Abstract: Purpose: To report a case of severe anterior segment inflammation secondary to exposure to a high-power blue laser device.Methods: Case report.Results: A 14-year-old male presented with redness, pain and decreased vision in his left eye after exposure to blue laser. Examination indicated severe conjunctival injection associated with 4+ cells in the anterior chamber with fibrinous reaction. The posterior pole was normal.Conclusion: Blue laser devices are easily available through the Internet. These devices can cause devastating ocular injuries. National safety guidelines are required to regulate use.

Orbital, Periorbital, and Intracranial Emphysema Caused by Compressed Air Injury in a 5-Year-Old Child.

Abstract: A 5-year-old boy was accidentally injured by a compressed air blast to his right eye and developed periorbital and subconjunctival emphysema and proptosis subsequently. CT scan showed periorbital subcutaneous and intraorbital emphysema around the right eye, as well as intracranial and cervical emphysema without frank fractures in orbital bones. He was examined under sedation, and the subconjunctival air was aspirated. He was also prophylactically treated with topical and systemic antibiotics to prevent infection. Emphysema was resorbed entirely within 3 weeks. In conclusion, compressed air injury can occur in a child and manifest with orbital and periorbital emphysema without any detectable fracture and any clear entrance site and may need emergent management to save the vision or upper respiratory airways.

Ophthalmic Injuries Related to Maxillofacial Trauma Due to Urban Warfare.

Abstract: Midfacial trauma commonly causes ocular injuries of varying degrees. Eye injuries account for approximately 10% of all battle injuries. Severity of injuries may range from a subconjunctival haemorrhage to optic nerve injury and globe laceration and rupture. Aim of study Is to evaluate the associated ophthalmic injuries in maxillofacial trauma due to war and to emphasize the need for proper ophthalmic examination to exclude and manage any associated ophthalmic injuries. Materials and methods A total of 66 patients with maxillofacial trauma due to war were considered in this study and underwent classification of the fractures to know patterns of fractures and to specify the ophthalmic injuries which might be associated with each fracture. Referral to ophthalmologist was considered to determine the exact nature of ophthalmic injuries. Results by a maxillofacial surgeon and ophthalmologist were evaluated. Results Midfacial trauma particularly those associated with zygomatic bone fracture was highly significant due to blast and bullets can lead to serious ophthalmic injuries. This was related to 57% of ophthalmic injuries. The related ocular injuries which were subconjunctival hemorrhage and the rupture or lacerated eye globe found to be highly significant war injuries while the preretinal hemorrhage and diplopia were significant. Conclusion A thorough proper ophthalmic examination should be carried out for every patient with these fractures and suspected cases should be placed under close observation so that immediate and active treatment can be taken if necessary.

Major ocular trauma in Taiwan: 2002–2004 versus 2012–2014

Abstract: We investigated the temporal changes in major eye injuries in Taiwan by reviewing the medical records of all patients with ocular trauma hospitalized at the National Cheng Kung University Hospital during 2002–2004 and 2012–2014. A total of 169 eyes (161 patients) during 2002–2004 and 121 eyes (120 patients) during 2012–2014 were enrolled (mean ± SD age: 41.9 ± 20.8 years in 2002–2004, and 51.8 ± 19.3 years in 2012–2014). Males accounted for ~75% of patients. The most frequent injury-causing object was metallic material (~24%), and blunt traumas were most frequently attributable to traffic accidents and falls. The most common locations of injuries for males and females were the workplace and home, respectively. Open-globe injuries occurred in ~70% of eyes, requiring primary repair, cataract extraction, and/or intraocular lens implantation. The frequencies of fall injury, lacrimal system laceration, lens injury, corneal/scleral foreign bodies, and use of intracameral antibiotics increased from 2002–2004 to 2012–2014, while those of closed-globe injury, vitreous haemorrhage, optic nerve injury, and medical treatment decreased. The final visual acuity remained poor (≤20/200) in >1/3 of injured eyes. Despite therapeutic advancements, major eye injuries still pose a high risk for poor visual outcome.

Long-term outcomes with Boston type 1 keratoprosthesis in ocular burns.

Abstract: Purpose: To evaluate the long-term outcomes of Boston type I keratoprosthesis (B-Kpro) in the management of patients with ocular burn injuries. Methods: This prospective study included all patients with ocular burns who underwent B-Kpro implantation at a tertiary eye care center between February 2008 and November 2015. Twelve patients (12 eyes) were enrolled. The procedures performed for managing ocular injury were identified, and information on ocular history, surgical procedures performed, and postoperative outcomes was collected. The main outcome measures were visual acuity, prosthesis retention, postoperative complications, and required surgical procedures. Results: Twelve eyes from 12 patients met the inclusion criteria for B-Kpro implantation, including nine eyes with alkali burns and three eyes with thermal burns. A total of 13 B-Kpro devices were implanted in the 12 eyes. The mean follow-up period was 60.8 months (range, 13-91 months). Preoperative best-corrected visual acuity ranged from counting fingers to light perception. Postoperative best-corrected visual acuity was better than 20/200 in 83.3%, 66.6%, and 57.1% of patients at 12, 48, and 60 months, respectively. The initial keratoprosthesis was retained in 10 (83.3%) eyes and was successfully replaced in one eye. The major cause of worsening of initial visual acuity was advanced glaucoma (four of 12 eyes). Conclusion: The anatomical and functional results support the use of B-Kpro for managing bilateral limbal stem cell deficiency secondary to ocular burns. However, glaucoma should be carefully evaluated, as it is a continuous threat that may result in irreversible visual loss in this population.