Empty Bullet-Related Ocular Injuries During Military Shooting Training: A 20-Year Review

Abstract Introduction Empty bullet-related ocular injuries (EBOI) are rare and may result in unfavorable visual outcomes due to both open globe and closed globe injuries. To our knowledge, no reports of such injuries in terms of outcomes have been previously described in the literature. The aim of this study was to describe the treatment performed and ocular outcomes of such injuries. Materials and Methods EBOI of 23 cases were reviewed who were referred to Gulhane School of Medicine Department of Ophthalmology between January 1998 and January 2018. Patient demographics, ocular signs (initial and final), injury types, type and number of interventions, and ocular trauma scores were recorded. Results In total, 23 eyes of the 23 patients with an average age of 22.3 ± 4.54 years (range, 20–41 years) were included in the study. All of the patients were male, and all injuries were due to empty bullets during shooting training. None had ocular protection at the time of ocular injury. Fourteen patients (60.9%) were open globe injuries, whereas nine (39.1%) of them were closed globe injuries. Mean ocular trauma scores category of the cases was 2.52 ± 1.03. The baseline and final visual acuity was 20/200 or better in 21.7% and 69.5% of eyes, respectively. Nineteen eyes (82.7%) had undergone a total of 31 surgeries with a 1.34 ± 0.88 surgery average. Conclusions The prognosis of EBOI is unpredictable and is dependent on the severity of ocular damage. The best treatment option is prevention of EBOI with protective eyewear.

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A Clinical Study of the Pattern of Ocular Trauma and Its Visual Outcome among Road Traffic Accident Cases in a Tertiary Care Teaching Institute

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/27 ◽

2021 ◽

Vol 8 (03) ◽

pp. 141-145

Author(s):

Vinay Kumar Dawson ◽

Manasvi Dawson

Keyword(s):

Traffic Accidents ◽

Ocular Trauma ◽

Road Traffic ◽

Visual Outcome ◽

Post Treatment ◽

Time Interval ◽

Ocular Injury ◽

Road Traffic Accidents ◽

Open Globe ◽

Ocular Injuries

BACKGROUND Ocular injuries due to road traffic accidents (RTA) is one of the important causes of ophthalmological morbidity and cause of unilateral blindness. Some of the injuries also result in cosmetic disfigurement. Increased usage of vehicles for transport in recent times has increased the incidence of cases. The primary objective of this study was to understand the epidemiology and pattern of ocular trauma in RTA cases and their visual outcome. METHODS A total of 75 cases was included in the study following the inclusion and exclusion criteria. A detailed history was taken which included information regarding time, location, type and mechanism of injury, use of spectacles, car safety belts, and helmets. The time interval between injury and reporting was recorded. Test of visual acuity was done, ophthalmic examination included the examination of all patients with the slit lamp, 90 D examination, and indirect ophthalmoscopy were done. Ultrasound B scan was done in cases where unclear media prevented fundus examination. RESULTS Ecchymosis of the lids was the commonest type of ocular injury. Out of 15 eyelid laceration cases, 10 cases were with mild partial-thickness tears present and 5 had severe lid tears which required suturing. Most of the patients recovered with good vision in 6 months post-treatment and a few fair results. Analysis of variance (ANOVA) comparison between conservative management and surgical management at the end of 4 months post treatment was done. The P-values were > 0.05 hence, not significant. It indicated that the outcomes were independent of the method of management adopted. CONCLUSIONS The incidence of RTAs is increasing due to an increase in the number of vehicles used by the public. Ocular injuries are more often seen in young men especially those driving two-wheelers without safety devices like helmets. Open globe injuries and cases with previous ocular problems have poor outcomes. KEYWORDS Ocular Trauma, Road Traffic Accidents [RTA], Visual Outcome

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Profile of Occupational Ocular Injury in a Tertiary Health Care Centre of Western Odisha - A Prospective Study

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/188 ◽

2021 ◽

Vol 8 (15) ◽

pp. 972-976

Author(s):

Jayashree Dora ◽

Sasmita Sahu ◽

Madhumita Naik ◽

Deepak Jyot Mohanty ◽

Rupasri Sethi

Keyword(s):

Prospective Study ◽

Ocular Trauma ◽

Health Concern ◽

Ocular Injury ◽

Ophthalmological Examination ◽

Protective Devices ◽

Eye Trauma ◽

Open Globe ◽

Ocular Injuries ◽

A Prospective Study

BACKGROUND Occupational ocular injuries are very common in industrial and agricultural workers. These are important and preventable causes of ocular morbidity. Objective of the study was to profile occupational ocular trauma clinicoepidemiologically. METHODS A prospective study was done by collecting data from a standardised questionnaire and complete ophthalmological examination of patients with occupational eye trauma attending VSSIMSAR, Burla, between January 2019 and October 2020. RESULTS Out of 128 cases of work related injuries, males were 85 %. 48 % of the cases were between 21 - 40 years. Out of all cases 66 % injuries were related to industrial work followed by 29 % in agricultural sector and farming. 3 % of cases were due to blast injury. Also there were 3 % cases of chemical conjunctivitis. Most injuries were closed globe (85 %), mostly involving zone 1 (91 %). Open globe injuries were 15 %, majority of them involved zone 2 (47 %). Ocular superficial foreign bodies were the most common clinical entity (60 %), majority of them being metallic in nature (37.5 %). In 4 % cases IOFBs were found. Cornea was the most common ocular structure to get injured (69 %). Out of all cases, 50 % had ocular trauma score (OTS) of 4, and 4 % cases had OTS 2. 48 % of patients presented within 6 hours of injury. 42 % patients were not aware of any eye protective gear at work and 30 % patients were aware but did not use any eye protection. CONCLUSIONS Eye trauma in workplace is an important public health concern in economically productive population. Significant proportion of these injuries is avoidable by using standardised eye protective devices. Attention need to be given for instruction, enforcement of protective eye wear use, and frequent prevention campaigns. KEYWORDS Ocular Trauma, Occupational Ocular Injuries, Eye Protective Devices, Western Odisha

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Pattern of Occurrence of Ocular Injuries and their Forensic Aspects

Birat Journal of Health Sciences ◽

10.3126/bjhs.v4i2.25437 ◽

2019 ◽

Vol 4 (2) ◽

pp. 692-696

Author(s):

Sidarth Timsinha ◽

Suvarna Manjari Kar ◽

Malshree Ranjeetkar

Keyword(s):

Ocular Trauma ◽

Relevant Information ◽

Cross Sectional Study ◽

Ocular Injury ◽

Cross Sectional ◽

Legal Cases ◽

Department Of Ophthalmology ◽

Ocular Injuries ◽

Forensic Implications ◽

Trauma Sequelae

Introduction: All penetrating or non-penetrating intentional ocular trauma causing loss of an organ or part of an organ and which have as a consequence the facial disfigurement or post trauma sequelae formation have forensic implications. Objectives: To study the pattern of ocular injuries its forensic implications and meticulous documentation in ocular medicolegal cases. Methodology: This hospital based cross sectional study was carried out by Forensic medicine personnel in Department of Ophthalmology and Emergency Department of Manipal Teaching Hospital Pokhara, Nepal. A total of 251 cases of ocular injury constituted the sample size. Cases were analyzed according to age, sex, type of trauma, causative agent, and manner of injury and ocular injuries having any medicolegal value. All data was evaluated and relevant information were extracted and entered into a database. Results: Male subjects 174 (69.32%) were more susceptible to ocular injuries and age group 21-30 years 66 (26.3%) were more predisposed to ocular injuries. The commonest cause of ocular trauma was due to fall on blunt objects 42(16.73%). The most common site of injury was cornea 120(47.81%) and corneal abrasion 65(54.16) was the most common ocular finding. Accidental manner of injury was observed in majority of the cases 230 (91.60%). Ocular injuries sustained were all simple in nature 251(100%) as a result no fatality was observed following ocular injury. Conclusion: Proper history taking and methodical documentation of injuries not only assist in diagnosis and management of the patient but also holds an evidentiary value in medico legal cases.

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Profile of pediatric ocular trauma in mid western hilly region of Nepal

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v4i1.5865 ◽

1970 ◽

Vol 4 (1) ◽

pp. 134-137 ◽

Cited By ~ 4

Author(s):

S Dulal ◽

JB Ale ◽

YD Sapkota

Keyword(s):

Medical Records ◽

Ocular Trauma ◽

Ocular Injury ◽

Hilly Region ◽

Open Globe ◽

History Of ◽

Ocular Injuries ◽

The Himalaya ◽

Open Globe Injuries ◽

Conjunctival Hemorrhage

Introduction: Majority of blinding ocular injuries can be prevented. Objective: To describe the epidemiology of ocular trauma in children. Material and methods: A retrospective review of medical records of the patients aged below 16 years who attended the Himalaya Eye Hospital, Pokhara with history of ocular injury. Results: Of 6,829 pediatric patients, 554 (8.1 %) had ocular trauma. The ocular trauma was more prevalent (38.1 %) in the age group of 5 – 10 years followed by 10-15 years (16.6 %). The boys (62 % vs 38 %) were more prone to ocular trauma than girls (RR = 1.7 and 95 % CI = 1.41 - 2.02). Of 554 ocular injuries, 32 (5.8 %) were open globe injuries. Sub-conjunctival hemorrhage was the commonest presenting finding in 96 (17.3 %) subjects. Forty-seven (8.5 %) of them attended the hospital after 15 days of injury. Home was the most common place for trauma (n =204, 36.8%), followed by playground (n = 140, 25.3 %). Conclusion: Children between the ages of 5-10 years are most vulnerable to ocular trauma. Home is the commonest place for ocular injury followed by playground. By adopting some common safety factors or by reducing the ocular injury risks factor, ocular trauma can be greatly reduced. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5865 NEPJOPH 2012; 4(1): 134-137

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The Incidence and Prevention of Ocular Injuries in Orthodontic Practice

British Journal of Orthodontics ◽

10.1179/bjo.20.4.339 ◽

1993 ◽

Vol 20 (4) ◽

pp. 339-343 ◽

Cited By ~ 11

Author(s):

A. P. T. Sims ◽

T. J. Roberts-Harry ◽

D. P. Roberts-Harry

Keyword(s):

Ocular Trauma ◽

Postal Survey ◽

Operative Procedures ◽

Acid Etching ◽

Ocular Injury ◽

Long Term Effects ◽

British Standard ◽

Eye Protection ◽

Ocular Injuries

A postal survey was conducted to determine the use of eye protection and incidence of ocular trauma in orthodontic practice. One-hundred-and-fifty-nine NHS orthodontic consultants and 203 specialist orthodontic practitioners were surveyed. Two-hundred-and-forty-one(66·5 per cent) replies were received. Some form of eye protection was routinely worn by 66·8 per cent of orthodontists, 64·3 per cent of patients, but only 33·6 per cent of DSAs. Eye protection was not offered to DSAs in 31·9 per cent of practices or to patients in 22·1 per cent. Forty-three per cent of orthodontists reported instances of ocular injury in their practices. The majority of these injuries (n = 104) occurred during debonding or trimming acrylic. Other incidents involved ligating materials, intra-oral polishing, and acid etching. Most injuries (83·5 per cent) were treated in the surgery without any long-term effects. The routine use of goggles or spectacles with side-pieces and plastic lenses, which conform to British Standard BS 2092, is recommended for staff and patients during all operative procedures in orthodontic practice.

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Visual Outcome in Open Globe Injury

Medical Journal of Shree Birendra Hospital ◽

10.3126/mjsbh.v11i2.7909 ◽

2013 ◽

Vol 11 (2) ◽

pp. 40-43

Author(s):

Sagar Rajkarnikar ◽

Ramesh Raj Bist ◽

Anu Gurung ◽

Ram Shrestha

Keyword(s):

Ocular Trauma ◽

Visual Outcome ◽

Ocular Injury ◽

Open Globe Injury ◽

Poor Vision ◽

Work Related ◽

Open Globe ◽

History Of ◽

Visually Handicapped ◽

Type Of Injury

Introduction: Ocular trauma is a major cause of monocular blindness and visual impairment throughout the world. It is estimated that more than 2 million people suffer from ocular trauma annually and 40,000 become visually handicapped permanently. The aim of this study was to evaluate the visual outcome in open globe injury patients. Methods: This study was conducted in Nepal Eye Hospital. All the cases of admitted open globe injuries were examined and managed in the hospital were included in this study. The detail history of trauma and visual acuity was recorded. Clinical diagnosis was made after detail examination of anterior and posterior segment. Patient was treated according to the type of injury. Visual recovery and the cause of poor vision at the time of discharge was also noted. Data was analyzed using the SPSS 11 program. Results: Out of the 100 cases enrolled in the study work related injury was the most frequent injury, metal was the most common causative agent. Males of 20-50 years of age are more vulnerable to open globe injury. Vision improved in 48%, same vision in 39% and deteriorated vision in 13% cases was recorded. Conclusions: Present study reveals that open globe injury can present in varying severity and though the overall prognosis is grave, prompt surgical intervention can result in better visual outcome. The visual outcome in mild to moderate ocular injury was satisfactory but poor in severe injuries.Medical Journal of Shree Birendra Hospital; July-December 2012/vol.11/Issue2/40-43 DOI: http://dx.doi.org/10.3126/mjsbh.v11i2.7909

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Optical Coherence Tomography of Bilateral Nanophthalmos with Macular Folds and High Hyperopia

Case Reports in Ophthalmological Medicine ◽

10.1155/2014/173853 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Firat Helvacioglu ◽

Ziya Kapran ◽

Sadik Sencan ◽

Murat Uyar ◽

Ozlem Cam

Keyword(s):

Pigment Epithelium ◽

Retinal Pigment ◽

Anterior Segment ◽

Optic Coherence Tomography ◽

Medicine Department ◽

Surgical Interventions ◽

School Of Medicine ◽

Department Of Ophthalmology ◽

Neurosensory Retina ◽

High Hyperopia

Importance.There is a conflict about the content of the macular folds in nanophthalmic eyes in the literature. Our study clearly demonstrated that papillomacular folds seen in nanophthalmos or posterior microphthalmos were only composed of neurosensory retina without involvement of retinal pigment epithelium and choroid.Observations.This is a report of two consecutive nanophthalmic patients with macular folds at Maltepe University School of Medicine, Department of Ophthalmology, from January to June 2012. Anterior segment dimensions were near normal. The axial lengths of the eyes were short with markedly shortened posterior segment. A macular fold extending from the center of the fovea towards the optic nerve head was present in all eyes. Optic coherence tomography clearly demonstrated that folds were only composed of neurosensory retina. Binocular visual acuities and refractive errors of the cases were 0.3, 0.2 and +16.00, +15.75 diopters, respectively.Conclusions and Relevance.Our study proposes a surgical option to treat these folds like serous retinal detachments by showing the true content of the folds, although there is not any surgical operation accepted for this condition yet. Further studies dealing with the surgical interventions of these folds should be performed to support this option.

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Clinical Review of Ocular Traumas Resulting in Enucleation or Evisceration in a Tertiary Eye Care Center in Hungary

Journal of Ophthalmology ◽

10.1155/2021/5588977 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Gábor Tóth ◽

Milán Tamás Pluzsik ◽

Béla Csákány ◽

Gábor László Sándor ◽

Olga Lukáts ◽

...

Keyword(s):

Ocular Trauma ◽

Care Center ◽

Clinical Indication ◽

Time Interval ◽

Eye Care ◽

Primary Indication ◽

Phthisis Bulbi ◽

Open Globe ◽

Department Of Ophthalmology ◽

The Mean

Purpose. To analyse the demographic and clinical characteristics of ocular traumas resulting in enucleation/evisceration in a large tertiary referral center in a developed country (Hungary) over a period of 15 years. Patients and Methods. A retrospective review of enucleated/eviscerated eyes that underwent surgery between 2006 and 2020 at the Department of Ophthalmology of Semmelweis University, Budapest, Hungary, due to ocular trauma as the primary indication for enucleation/evisceration. For each subject, clinical history, B-scan ultrasound report, and histopathology results were reviewed. Results. There were 124 enucleated/eviscerated eyes from 124 patients (91 males (73.4%)). The mean age at the time of trauma was 37.3 ± 26.0 years while the mean age at the time of enucleation/evisceration was 46.9 ± 20.3 years. The main clinical diagnoses after ocular trauma were open globe injury (n = 96; 77.4%), ocular burns (n = 6; 4.8%), traumatic optic neuropathy (n = 4; 3.2%), bulbar avulsion (n = 3; 2.4%), traumatic cataract (n = 2; 1.6%), retinal ablation (n = 1; 0.8%), and traumatic carotid-cavernous fistula (n = 1; 0.8%). Among the 124 patients, 98 (79.0%) underwent enucleation and 26 (21.0%) evisceration. Patients who underwent primary enucleation/evisceration (n = 24 19.4%) were significantly older at the time of the injury (57.7 ± 22.7 years) than people who underwent secondary eye removal (32.4 ± 24.4 years) ( p < 0.0001 ). The mean time interval between trauma and enucleation/evisceration was 114.9 ± 163.5 months. The main clinical indications for anophthalmic surgery were atrophia/phthisis bulbi (n = 56, 45.2%), acute trauma (n = 25, 20.2%), painful blind eye due to glaucoma (n = 17, 13.7%), endophthalmitis (n = 10, 8.1%), and cosmetic reasons (n = 7, 5.6%). One patient (0.8%) had sympathetic ophthalmia. Conclusions. Primary enucleation/evisceration was performed in one-fifth of all ocular trauma-related anophthalmic surgeries in our tertiary eye care center with enucleation being the most common procedure. Atrophia/phthisis bulbi was the most frequent immediate clinical indication for enucleation/evisceration.

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