Frequency of pediatric traumatic cataract and simultaneous retinal detachment

Author(s):  
Howe Qiu ◽  
Nathan A. Fischer ◽  
Jennifer L. Patnaik ◽  
Jennifer L. Jung ◽  
Jasleen K. Singh ◽  
...  
2019 ◽  
Vol 185 (5-6) ◽  
pp. e768-e773 ◽  
Author(s):  
Natalie R Miller ◽  
Grant A Justin ◽  
Won I Kim ◽  
Daniel I Brooks ◽  
Denise S Ryan ◽  
...  

Abstract Introduction The goal of this study is to update the incidence of hyphema in Operation Iraqi (OIF) and Enduring Freedom (OEF). We wanted to assess associated ocular injuries and final visual acuity (VA) in open-globe versus closed-globe injuries with a hyphema. Materials and Methods We performed a retrospective review of the Walter Reed Ocular Trauma Database (WRTOD) to identify U.S. Service members and DoD civilians with hyphema who were evacuated to Walter Reed Army Medical Center between 2001 and 2011. Primary outcome measures were the final VA and differences in concomitant ocular injuries in open-globe hyphema and closed-globe hyphema. Results 168 of 890 eyes (18.9%) in the WROTD had a hyphema. Closed-globe injuries were noted in 64 (38.1%) eyes and open-globe injuries in 104 (61.9%) eyes. A final VA of less than 20/200 was noted in 88 eyes (51.8%). Eyes with hyphema were more likely to have traumatic cataract formation (odds ratio (OR) 6.2, 95% confidence interval (CI) 4.2–9.2, P < 0.001), retinal detachment (OR 4.2, CI 2.8–6.4, P < 0.001), angle recession (OR 8.1, CI 2.9–24.3, P < 0.001), and final VA of less than 20/200 (OR 3.7, CI 2.6–5.4, P < 0.001). Traumatic cataract formation (OR 7.4, CI 2.9–18.7, P < 0.001), retinal detachment (OR 6.1, CI 2.1–17.5, P < 0.001), and a final VA less than 20/200 (OR 6.1, CI 2.4–15.4 P < 0.001) were statistically more likely to occur with an open-globe hyphema than with a closed-globe hyphema. Conclusions Close follow-up in patients with hyphema is important due to the associated development of traumatic cataract and retinal detachment and poor final visual outcome.


2013 ◽  
Vol 141 (7-8) ◽  
pp. 516-518
Author(s):  
Aleksandar Gakovic ◽  
Igor Kovacevic ◽  
Jovana Bisevac ◽  
Bojana Radovic ◽  
Katarina Cubrilo ◽  
...  

Introduction. Penetrated injuries are most difficult injuries of the eye. Intraocular foreign body (IOFB) may lodge in any of the structures it encounters, from anterior chamber to the retina and choroid. Notable effects caused by foreign body injury include traumatic cataract, vitreous liquefaction, retinal and subretinal hemorrhages, retinal detachment and development of endophtalmitis. Case Outline. A 49?year?old man sustained injury of the right eye with a piece of metal wire. On admission visual acuity was VOD: 1.0 and lower intraocular tension TOD=6 mmHg (10?22 mmHg). Corneal entry wound was noticed near limb on 11h with a prominating foreign body of 18 mm in length that passed through the iris, lens and vitreous. X?ray findings confirmed existence of a large foreign body extending along the entire length of the globe. IOFB removal was done with anatomic forceps. On postoperative detailed clinical examination we observed retinal rupture in the upper temporal quadrant fitting in the area of the IOFB damaged retina. Laser photocoagulation of retinal tear (laser retinal barrage) was done. Visual acuity on discharge was the same (1.0) and intraocular tension was within normal limits (10 mmHg). Conclusion. Penetrated injury of eye requires detailed examination of all eye structures, beginning from the anterior to posterior segment. Timely diagnosed ruptures of the posterior segment of eye before the development of traumatic cataract, and adequate therapeutic procedures prevent serious complications of IOFB penetrated eye injury such as retinal detachment and permanent reduction of visual acuity.


2016 ◽  
Vol 9 (1) ◽  
pp. 24-28 ◽  
Author(s):  
Mariya V Kataeva ◽  
Vadim P Nikolaenko

Purpose. To investigate transvitreal intraocular foreign body (IOFB) removal results, and to determine indications for this splinter removal approach. Materials and methods. A chart analysis of 35 cases with splinter eye trauma was carried out. In all patients, a pars plana vitreoretinal surgical procedure was performed to remove the IOFB. Results. The intraocular penetration of foreign body was accompanied by injuries of different eyeball structures, which presented as intravitreal hemorrhage, hyphema, subretinal bleeding, retinal detachment, traumatic cataract, iridocyclitis. Splitter removal was complemented by endolaser coagulation; scleroplastic component and gaz-fluid exchange. In 54.29% patients with trauma, a lensectomy had to be added to the vitrectomy with IOFB removal. As a result of treatment, visual acuity increased in 51.43% injured patients. In the late post-operative period, retinal detachment developed in 14.29% of cases. Conclusions. IOFB removal by transvitreal approach is recommended in intravitreal, pre- or intraretinal splitter position; in retro-equatorial foreign body localization; when intraoperative splitter visualization is possible; in posterior vitreous detachment formation.


2016 ◽  
Vol 235 (4) ◽  
pp. 241-241
Author(s):  
Ahmed Elshewy

Purpose: The aim is to describe tools and techniques that can be used to deal with total retinal detachment (open funnel) and associated proliferative vitreoretinopathy due to a 360-degree giant retinal break following ocular trauma. Setting/Venue: The video (available at www. karger.com/doi/10.1159/000444811) was created at the Ophthalmology Department, Faculty of Medicine Kasr Al Ainy, Cairo University Hospital, Cairo, Egypt. Methods: A 16-year-old female patient presented to the Cairo University Hospital after blunt ocular trauma. She had traumatic cataract, and ultrasound examination showed total retinal detachment. She was scheduled for surgery at the Cairo University Hospital. Phacoemulsification of traumatic cataract was done after insertion of the 3-port 23-gauge trocar system. The 25-gauge chandelier illumination system was used to assist the peeling of adherent posterior hyaloid and epiretinal membranes, allowing bimanual work using an end-gripping forceps and a diamond-dusted retinal scrapper. Removal of the vitreous surrounding the retinal funnel was performed, and a small perfluorocarbon (PFC) bubble was used to support the posterior pole. This was followed by refreshing the rolled edges of the retinal break and shaving the vitreous base and anterior leaflet of the giant break by surgeon-assisted scleral indentation. The eye was completely filled with PFC, and Argon laser retinopexy was performed. Direct PFC-silicone oil exchange was done to avoid retinal slippage (silicone oil 5,000 cSt was used). Results: Retinal attachment was successfully achieved at the end of the surgery. The silicone oil was removed 5 months after the initial surgery. The patient's uncorrected visual acuity 1 month after removal of the silicone was 0.4. Conclusions: The chandelier-assisted bimanual technique is an effective method for dealing with adherent posterior hyaloid and epiretinal membranes in a detached retina, particularly in cases of complex open-funnel retinal detachment. Proper shaving of the anterior leaflet and refreshing the edges of the retinal break helps decrease postoperative PVR formation. Direct PFC-silicone oil exchange in giant retinal breaks helps minimize the risk of retinal slippage occurrence.


PEDIATRICS ◽  
1987 ◽  
Vol 79 (3) ◽  
pp. 473-474
Author(s):  

Both projectile and nonprojectile toys, and nonpowder guns such as air guns and air rifles, are categorized as toy firearms. Although the Academy realizes that the welfare of children and adolescents would be best served by banning these instruments, we are unable to prevent their availability and use. We offer this statement in an attempt to safeguard the young user from possible injury. Between 1980 and 1981, accidents involving projectile toys were responsible for 747 reported injunies to children younger than 15 years of age.1 Most of these injuries involved the face or eyes, 2.9% of these injuries required hospitalization, more than 400 days were lost from school and/or work, and nearly 3,000 days of activities were restricted. In addition, there have been severe or even fatal consequences following the use of substitute projectiles or live ammunition. Children have also died as a result of aspiration of projectiles. Accidents involving air guns and air rifles are an even more frequent cause of injury to children. In 1980, approximately 23,000 injuries associated with nonpowder guns were treated in US hospital emergency rooms.2 In two thirds of the cases the victim was less than 16 years of age. In a 1973 review of 105 air gun-related injuries to the eye, sequelae included traumatic cataract, retinal detachment, and sympathetic ophthalmitis.3 Eighteen of the injuries required enucleation of the eye. More than 70% of those injured were children 6 to 15 years of age. The continuing nature of this problem has been demonstrated by Sternberg et al4 in a 1984 review of 32 children with air gun-related eye injuries.


Author(s):  
Bharat Gurnani ◽  
Kirandeep Kaur ◽  
Subashini Sekaran

A young girl post-stick injury presented with traumatic cataract and lens neovascularization in OS and iris coloboma, key whole pupil, and cataractous changes in OD. Fundoscopy revealed chorioretinal coloboma OD and retinal detachment on B scan OS. In view of guarded visual prognosis, the patient was advised observation in OU


Author(s):  
Dr. Mita V. Joshi ◽  
Dr. Sudhir Mahashabde

All patient coming to Index Medical College Hospital & Research Centre, Indore operated in Department of Ophthalmology for traumatic cataract due to various injuries Result: Of the 37 patients, 19 patients (51%) showed corneal/ corneal sclera injury. 10 cases had injury to iris in the form of spincter tear, traumatic mydriasis, iris incarceration, floppy iris, posterior and anterior synechiae. Subluxation of lens was seen in 2 cases and Dislocation of lens was in 1 cases. 3 cases had corneal opacity. Old retinal detachment was seen in 1 (3%) case. Out of 30 cases who had associated ocular injuries, 3 cases had vision of HM, 07 cases had vision of CF-ctf – CF-3’, 01 cases had vision of 5/60, 07 cases had vision of 6/60-6/36, 03 cases had vision of 6/24-6/18, 09 cases had vision of 6/12-6/6. Out of 7 cases without associated in injury, 2 cases had vision of 6/24-6/18, 05 cases had vision of 6/12-6/6. Conclusion: Corneal scarring obstructing the visual axis as well as by inducing irregular astigmatism formed an important cause of poor visual outcome in significant number of cases. Irreversible posterior segment damage lead to impaired vision case. The final visual outcome showed good result however the final visual outcome depends upon the extent of associated ocular injuries. Effective Intervention and management are the key points in preventing monocular blindness due to traumatic cataract. Keywords: Ocular, Tissues, Traumatic, Cataract & Surgery.


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