Open globe injuries: intraocular foreign body

Firecracker induced open globe injury is a big challenge for ophthalmic surgeons. Its associationwith the intraocular foreign body makes the diagnosis and treatment even more difficult resultingin poor anatomical and visual outcomes. We report a case of a 35-year-old male who presented withbilateral, multiple corneal and intraocular foreign body due to firecracker explosion. His vision waslimited to hand movement in both eyes. Combined penetrating keratoplasty and cataract surgerywere done in both eyes followed by pars plana vitrectomy for intraocular foreign body removal.The final best-corrected visual acuity of the patient stood to be 6/6 and 6/9 in the right and left eyerespectively. The encouraging result in our case prompts ophthalmologists for a timely stepwisemultidisciplinary approach in all open globe injuries with intraocular foreign body cases havingpoor initial acuity.

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Open Globe with Intraocular Foreign Body

Journal of Education and Teaching in Emergency Medicine ◽

10.5070/m541042385 ◽

2019 ◽

Vol 4 (1) ◽

Author(s):

Stephen Weiss ◽

Dustin Williams ◽

Yih Ying (Eva) Yuan ◽

Jo-Ann Nesiama

Keyword(s):

Foreign Body ◽

Intraocular Foreign Body ◽

Open Globe

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Six-year epidemiological analysis of post traumatic endophthalmitis in a Brazilian hospital

International Journal of Retina and Vitreous ◽

10.1186/s40942-019-0193-8 ◽

2019 ◽

Vol 5 (1) ◽

Cited By ~ 1

Author(s):

Luis Filipe Nakayama ◽

Vinicius Campos Bergamo ◽

Nilva Simeren Bueno de Moraes

Keyword(s):

Visual Acuity ◽

Foreign Body ◽

Penetrating Trauma ◽

Onset Time ◽

Intraocular Foreign Body ◽

Time Interval ◽

Light Perception ◽

Initial Visual Acuity ◽

Open Globe ◽

Better Than

Abstract Background To evaluate the epidemiology of endophthalmitis cases related to ocular trauma, including visual acuity during and 1 year after trauma, source of trauma and method of treatment. Methods A retrospective study analyzed the epidemiological data of patients with a clinical presentation of endophthalmitis after ocular penetrating trauma between January 2012 and January 2017 at Escola Paulista de Medicina/UNIFESP, a hospital in São Paulo, SP, Brazil. Results A total of 453 patients with antecedent open globe trauma were evaluated, among these, 30 patients with suspected endophthalmitis. All patients were male. The time interval between trauma and ophthalmological evaluation and collection of vitreous and aqueous material was 1 day in 36.66%, 2–7 days in 43.44%, 7–14 days in 10% and more than 15 days in 10% of patients; 66.66% had positive cultures. 11 patients had intraocular foreign body. One year after trauma, visual acuity was classified as no light perception (NLP) in 33.33%, light perception in 6.66%, hand motion in 13.33%, counting fingers in 13.33%, and better than 20/400 in 20% of patients. Considering presence of intraocular foreign body, initial visual acuity and symptoms onset time, only initial visual acuity showed as better prognostic factor in final visual acuity. Conclusion Endophthalmitis is a severe ocular inflammatory condition that may lead to irreversible vision loss. Initially only one patient had visual acuity of NLP, but after 1 year, 33% showed visual acuity of NLP, and only 20% had visual acuity better than 20/400, what is consistent with a severe infection with a guarded prognosis. The high incidence of endophthalmitis after ocular penetrant trauma justifies distinct treatment and greater attention.

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25-Gauge Vitrectomy in Open Eye Injury with Retained Foreign Body

Journal of Ophthalmology ◽

10.1155/2017/3161680 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

G. Sborgia ◽

N. Recchimurzo ◽

A. Niro ◽

L. Sborgia ◽

A. Sborgia ◽

...

Keyword(s):

Visual Acuity ◽

Foreign Body ◽

Clinical Status ◽

Case Series ◽

Eye Injury ◽

Retained Foreign Body ◽

Open Globe ◽

Open Globe Injuries ◽

25 Gauge Vitrectomy

Purpose. Ocular trauma with retained foreign body is an important cause of visual impairment in working-age population. Clinical status impacts on the timing and planning of surgery. In the last year small gauge vitrectomy has become safer and more efficient, extending the range of pathologies successfully treated.Aims. To evaluate the safety and outcomes in patients with open eye injury with retained foreign body that underwent early 25-gauge vitrectomy.Methods. In this retrospective, noncomparative, interventional case series, we performed 25-gauge vitrectomy on 10 patients affected by open globe injuries with retained foreign body, over 3 years. We analyzed age, wound site, foreign body characteristics, ocular lesions correlated, relative afferent pupillary defect, visual acuity, and intraocular pressure. Follow-up evaluations were performed at 1, 3, and 6 months. According to the clinical status we performed other procedures to manage ocular correlated lesions.Results. The median age of patients was 37 years. The foreign body median size was 3.5 mm (size range, 1 to 10 mm). 25-gauge vitrectomy was performed within 12 hours of trauma. Foreign body removal occurred via a clear corneal or scleral tunnel incision or linear pars plana scleral access. Visual acuity improved in all patients. Endophthalmitis was never reported. Only two cases reported postoperative ocular hypertension resolved within the follow-up. Retinal detachment recurred in one case only.Conclusions. 25-gauge vitrectomy could be considered as early approach to manage open globe injuries with a retained posterior segment foreign body in selected cases with good outcomes and low complication rate.

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Current Concepts and Management of Severely Traumatized Tissues in the Inner Coatings (The Posterior Segment: The Ciliary Body, the Choroid, and the Retina) of the Globe: Mechanical Injuries (Open Globe Without Intraocular Foreign Body and Without Endophthalmitis)

Current Concepts and Management of Eye Injuries ◽

10.1007/978-1-4471-7302-1_6 ◽

2016 ◽

pp. 75-92

Author(s):

Gokhan Gurelik ◽

Sabahattin Sul

Keyword(s):

Foreign Body ◽

Ciliary Body ◽

Posterior Segment ◽

Intraocular Foreign Body ◽

Open Globe

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Perfluorocarbon liquid-assisted intraocular foreign body removal

Malaysian Journal of Ophthalmology ◽

10.35119/myjo.v3i2.190 ◽

2021 ◽

Vol 3 (2) ◽

pp. 120-126

Author(s):

Hui Wen Lim ◽

Suyi Siow ◽

Kiet Phang Ling

Keyword(s):

Foreign Body ◽

Pars Plana Vitrectomy ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Surgical Techniques ◽

Intraocular Foreign Body ◽

Ocular Injury ◽

Perfluorocarbon Liquid ◽

Open Globe ◽

Pars Plana

Traumatic ocular injury is an uncommon yet leading cause of monocular blindness among the working-age group. Retained intraocular foreign body (IOFB) are associated with 41% of open globe injuries. Pars plana vitrectomy is often required for posterior segment IOFB removal. Advances in vitreoretinal surgical techniques and instrumentation have resulted in better treatment outcomes with reduced ocular morbidity. We report a case of modified ILM forceps with perfluorocarbon liquid-assisted non-magnetic IOFB removal in a young man after a motor vehicle accident with zone one open globe injury and a large glass IOFB in the right eye. We describe the use of perfluoro-N-octane to slide the IOFB extramacularly and reorient the IOFB plane for stable and safe retrieval by ILM end-gripping forceps. The modified design of the ILM end-gripping forceps with adjunctive use of perfluorocarbon liquid in pars plana vitrectomy reduces slippage during IOFB extraction and prevents collateral iatrogenic retinal injury.

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Visual outcome in open globe injuries

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v4i2.6542 ◽

2012 ◽

Vol 4 (2) ◽

pp. 263-270 ◽

Cited By ~ 3

Author(s):

T Thevi ◽

Z Mimiwati ◽

S C Reddy

Keyword(s):

Visual Acuity ◽

Foreign Body ◽

Visual Outcome ◽

Detailed Examination ◽

X Rays ◽

Visual Axis ◽

Initial Visual Acuity ◽

Open Globe ◽

Good Visual Outcome ◽

Open Globe Injuries

Objective: To determine the factors affecting the visual outcome in patients with open globe injuries of eye. Materials and methods: In a prospective interventional study of consecutive patients with open globe injuries, the age, gender, place of injury, object causing injury and safety precautions taken were recorded. A detailed examination of the eye was done with a slit-lamp. X-rays of the orbits were taken in order to determine the presence of a foreign body. The injuries were classified as simple or complicated depending on the involvement of the pupil/iris, lens and retina. Finally, post operative best-corrected visual acuity at last follow up was noted. Results: Fifty-two patients (52 eyes) were included in the study. The mean age of patients was 27.25±12.62 years (range 9-73 years). The majority of injuries occurred in the workplace (36.5%); nail (15.4%) and glass (15.4%) were the most common objects causing injury. Of those with good initial visual acuity, 90% maintained good visual outcome. Patients with corneal lacerations of less than 5 mm had significant good visual outcome. The number of corneal lacerations and visual axis involvement did not affect the visual outcome. Those with corneoscleral lacerations had significantly poor visual outcomes compared to those with corneal or scleral lacerations alone.Conclusion: Predictors of good visual outcome are good initial visual acuity, a corneal laceration wound of less than 5mm, a deep anterior chamber, and simple lacerations. Age, gender, place of injury, object causing injury, presence of hyphema or intraocular foreign body, and the use of safety precautions did not affect the visual outcome.DOI: http://dx.doi.org/10.3126/nepjoph.v4i2.6542 Nepal J Ophthalmol 2012; 4 (2): 263-270

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