Analysis of Ocular Injury Characteristics in Survivors of the 8.12 Tianjin Port Explosion, China

Introduction. On the evening of August 12, 2015, a large chemical explosion occurred at Tianjin Port. We analyzed ocular injury characteristics in the survivors of this accident. Methods. Twenty injured eyes of 17 hospitalized patients were included. Initial best-corrected visual acuity (BCVA), injury type, injury cause, relative afferent pupillary defect (RAPD), zone of injury (ZOI), and ocular trauma score (OTS) were evaluated. Final BCVA and enucleation were the final outcome index. The relationship between risk factors and final outcomes was analyzed. Results. The patients comprised 14 males and 3 females (mean age, 35.24 ± 12.68 years). Eighteen eyes had open-globe and 2 had closed-globe injuries. Fifteen ocular injury types were reported. Initial visual acuity (VA) was 20/50 to 20/200, 20/200 to finger counting (FC), hand motion to light perception (HM-LP), and no light perception (NLP) in 2, 7, 7, and 4 eyes, respectively. RAPD was found in 5 eyes. Most eyes sustained severe injuries with OTSs of 1 (25%) and 2 (40%). Of the injured eyes, 50% had Zone III injuries. In 95% of the injured eyes, glass was the cause of injury. Three of 4 eyes with an initial VA of NLP had a final VA of NLP and an outcome of enucleation. In 5 eyes with RAPD, 3 had a final VA of NLP and a final outcome of enucleation. Eyes with lower OTSs generally had poorer outcomes. All eyes with a final VA of NLP and an enucleation outcome had Zone III injuries. All 3 eyes with an enucleation outcome had retinal injuries, whereas eyes with no retinal injury had a better final BCVA. Conclusions. Explosions can inflict severe ocular trauma, even indoors; 90% of injured eyes had open-globe injuries caused by glass fragments. Initial NLP, RAPD, low OTS, posterior extended wound, and retinal injury indicate a poor final outcome.

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Trauma Okular oleh Serangan Kerbau – Laporan Kasus

e-CliniC ◽

10.35790/ecl.v9i2.33847 ◽

2021 ◽

Vol 9 (2) ◽

pp. 424

Author(s):

Wenny Supit

Keyword(s):

Visual Acuity ◽

Ocular Trauma ◽

Recovery Period ◽

Anterior Segment ◽

Visual Sensitivity ◽

Ocular Motility ◽

Light Perception ◽

Ocular Trauma Score ◽

Hand Motion ◽

Trauma Score

Abstract: Of the many ocular blunt traumas, trauma due to typical buffalo attack thrrough leverage has not been reported. We reported a 65-year-old man attacked by a buffalo on his left eye. The patients complained of pain of his left eye associated with swelling, bleeding, and blurred vision. Eye examination revealed that visual acuity of the left eye was classified as hand motion (HM), limited ocular motility, blepharospasm, and a crescent-shaped anterior lamella laceration with lateral canthal involvement. Anterior segment examination revealed bullous subconjunctival hemorrhage, corneal edema, and rosette-shaped opacification (RSO) of the lens. Head-CT showed traumatic cataract and periorbital haemorrhage; no abnormalities in the right eye. Ovular trauma score (OTS) of the patient was three indicating that the possible visual prognosis was 2% as no light perception (NLP), 11% as light perception (LP) or hand motion (HM), 15% as 1/200-19/200, 31% as 20/200-20/50, and 41% as >20/40. Literature data showed that the visual sensitivity of OTS prediction in NLP, 20/200-20/50, and 20/40 was 100%. The specificity of OTS in predicting vision in LP/HM 1/200-19/200 was 100%. After a recovery period of approximately two months and the sutured wound healed, the patient came to the eye clinic of Prof. Dr. R. D. Kandou Hospital Manado. After a cataract surgery was performed on the left eye of the patient, his visual acuity improved to 20/40.Keywords: ocular trauma, buffalo attack, ocular trauma score (OTS) Abstrak: Dari sekian banyaknya trauma tumpul, trauma akibat rudapaksa tipikal serangan kerbau yang menggunakan gaya ungkit belum pernah dilaporkan. Kami melaorkan seorang laki-laki berusia 65 tahun yang mendapat serangan kerbau pada mata kiri dengan keluhan nyeri disertai pembengkakan, pendarahan, dan penglihatan kabur. Pemeriksaan mata menunjukkan ketajaman visual mata kiri dengan gerakan tangan, motilitas okular terbatas, blefarospasme, dan laserasi lamela anterior berbentuk bulan sabit dengan keterlibatan kantal lateral. Pemeriksaan segmen anterior menunjukkan perdarahan subkonjungtiva bulosa, edema kornea, dan rosette-shaped opacification (RSO) pada lensa. Hasil CT-kepala menunjukkan katarak traumatik dan perdarahan periorbital, tanpa kelainan pada mata kanan. Skor trauma okular pasien (OTS) ialah tiga yang menandakan kemungkinan prognosis pada visual pasien ialah 2% menjadi no light perception (NLP), 11% menjadi light perception (LP) atau hand motion (HM), 15% menjadi 1/200-19/200, 31% menjadi 20/200-20/50, dan 41% menjadi >20/40. Penggunaan OTS pada kasus ini karena data literatur menunjukkan bahwa sensitivitas penglihatan prediksi OTS di NLP, 20/200-20/50, dan 20/40 ialah 100%. Kekhususan OTS dalam memrediksi visi di LP/HM 1/200-19/200 ialah 100%. Setelah masa pemulihan sekitar dua bulan dan luka penjahitan sembuh, pasien datang kontrol ke poliklinik mata RSUP Prof. Dr. R. D. Kandou Manado. Setelah dilakukan operasi katarak pada mata kiri didapatkan tajam penglihatan mata kiri pasien 20/40.Kata kunci: trauma mata, serangan kerbau, ocular trauma score (OTS)

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Firework-inflicted ocular trauma in children and adults in an urban German setting

European Journal of Ophthalmology ◽

10.1177/1120672120902033 ◽

2020 ◽

pp. 112067212090203

Author(s):

Matthias A Lenglinger ◽

Malte Zorn ◽

Daniel Pilger ◽

Christoph von Sonnleithner ◽

Mirjam Rossel ◽

...

Keyword(s):

Visual Acuity ◽

Ocular Trauma ◽

Demographic Data ◽

Retrospective Chart Review ◽

Severe Trauma ◽

Light Perception ◽

Severe Injuries ◽

Younger Patients ◽

Department Of Ophthalmology ◽

New Year’S Eve

Purpose: To assess firework-inflicted ocular trauma in the German capital during the week around New Year’s Eve with regards to patient characteristics and age, severity of injuries, and their management and outcome. Methods: A retrospective chart review of all patients presenting to the department of ophthalmology of Charité—University Medicine Berlin during a 7-day period around New Year’s Eve in the years 2014–2017 was performed. Patients with ocular complaints and injuries caused by fireworks were included. We recorded demographic data, active role, visual acuity at presentation and at last follow-up, the most pertinent clinical findings, management and outcome with regards to visual acuity, and integrity of the eye. Results: A total of 146 patients with 165 injured eyes were included. Median age at presentation was 23 (4–58) years, and 71.2% were male. Fifty-one patients (34.9%) were less than 18 years old. Ninty-seven patients (66.4%) sustained minor, 34 (23.3%) sustained moderate, and 15 (10.3%) sustained severe injuries. Severe trauma was seen in younger patients (median age: 12, range: 4–58 years) than mild and moderate trauma (median age: 23, range: 4–45 years) and resulted in loss of light perception in two eyes and in a visual acuity of only light perception in three eyes. One eye was enucleated. Conclusion: Ocular trauma inflicted by fireworks can have serious consequences for ocular morbidity and visual acuity, especially in severe trauma which affected younger patients. To significantly reduce firework-inflicted trauma, a ban of private fireworks in densely populated areas and in the vicinity of children should be considered.

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Pars Plana Vitrectomy following Traumatic Ocular Injury and Initial Globe Repair: A Retrospective Analysis of Clinical Outcomes

Military Medicine ◽

10.1093/milmed/usaa286 ◽

2021 ◽

Vol 186 (Supplement_1) ◽

pp. 491-495

Author(s):

Hunter H Phillips ◽

Halward J Blegen IV ◽

Christopher Anthony ◽

Brett W Davies ◽

Marissa L Wedel ◽

...

Keyword(s):

Visual Acuity ◽

Retrospective Analysis ◽

Pars Plana Vitrectomy ◽

Ocular Trauma ◽

Ocular Injury ◽

Complication Rates ◽

Vitreoretinal Disease ◽

Open Globe ◽

Initial Injury ◽

Pars Plana

ABSTRACT Introduction Penetrating and perforating ocular trauma are often devastating and may lead to complete visual loss in the traumatized eye and subsequent compromise of the fellow eye. A significant proportion of traumatic injuries are complex, often requiring vitreoretinal intervention to preserve vision. A retrospective analysis at a level 1 trauma center was performed to evaluate the time course, incidence, and outcomes following pars plana vitrectomy (PPV) after traumatic ocular injury and initial globe repair. Materials and Methods Eyes that underwent open globe repair following ocular trauma at Brooke Army Medical Center, between January 1, 2014 and December 30, 2016 were analyzed. Specific factors evaluated include mechanism of injury, defect size and complexity, ocular trauma score, zone of injury, associated orbital trauma, and time from injury to surgical intervention. A subset analysis was conducted specifically on eyes requiring subsequent PPV for vision preservation because of vitreoretinal disease. Surgical outcomes, time to secondary intervention, and complication rates were then assessed. Results In total, 70 eyes requiring open globe repair were examined, with 43 having undergone PPV. Average and median time to vitrectomy were 18.8 and 8 days, respectively. Eyes that underwent PPV were more likely to have an afferent papillary defect, vitreous hemorrhage, intraocular foreign body, and retinal detachment at the time of initial injury (although the latter two factors were not statistically significant), and were more likely to receive penetrating keratoplasty. Proliferative vitreoretinopathy occurred in 37.2% of eyes that underwent PPV, versus 3.7% of those that did not (P = 0.0013). Timing of PPV (i.e., before or after 14 days) had no statistically significant effect on the rate of PVR (Table I). Eyes that underwent PPV showed an improvement of visual acuity from average 2.5 logMAR following initial injury to 1.5 logMAR 6 months after PPV, equivalent to 18.7 Early Treatment Diabetic Retinopathy Study (ETDRS) letters gained, versus 37.7 ETDRS letters gained in eyes without PPV. Among PPV eyes, early repair (<14 days) was associated with greater improvement in visual acuity. Conclusion Overall, patients requiring PPV following open globe repair generally had more severe injuries and worse 6-month postoperative visual acuity. Patients who underwent more expedited vitrectomy showed greater improvement in visual acuity as measured by ETDRS letters gained.

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Visual Outcome of Ocular Trauma Presenting in a Tertiary Care Hospital in Sahiwal

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v36i2.987 ◽

2020 ◽

Vol 36 (2) ◽

Author(s):

Ahmad Zeeshan Jamil ◽

Muhammad Luqman Ali Bahoo

Keyword(s):

Visual Acuity ◽

Ocular Trauma ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Sampling Technique ◽

Visual Outcome ◽

P Value ◽

Care Hospital ◽

Open Globe ◽

Patient Reported

Purpose: To find the visual outcome of ocular trauma presenting in a tertiary care hospital in Sahiwal. Study Design: Descriptive observational study. Place and Duration of Study: This study was conducted at District Headquarter Teaching Hospital affiliated with Sahiwal Medical College, Sahiwal from January 2016 to June 2019. Material and Methods: Four hundred and thirty five patients were included in the study by convenient sampling technique. Patient’s age, gender, occupation, activity at the time of injury, nature of object causing trauma, duration of trauma, visual acuity at the time when patient reported to hospital, the time delay before coming to the hospital were recorded. Ocular injuries were classified according to Birmingham ocular trauma terminology. Detailed ocular examination was performed. Patients were managed and post-management visual acuity at three months was recorded. Results: Mean age of patients was 29.07 ± 12.53 years. There were 219 (50.3%) closed globe and 216 (49.7%) open globe injuries. In 59 (13.6%) cases, cause of injury was metal object. In 146 (33.6%) cases injury was classified as contusion. In 164 (37.7%) cases cornea was involved. Majority of the patients were male. Eighty-seven patients presented within 1 day after trauma. In 154 (35.4%) patients, visual acuity at the time of presentation was 6/12 or better while in 171 (39.3%) cases it was less than 6/60. Chi-square test was used to calculate the difference between pre and post-management visual acuity. This difference was statistically significant with p-value less than 0.05 Conclusion: Ocular trauma cases, if properly and timely managed, have a statistically significant increase in visual acuity.

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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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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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Surgery combined with antibiotics for the treatment of endogenous endophthalmitis caused by liver abscess

10.21203/rs.3.rs-22926/v2 ◽

2020 ◽

Author(s):

Yue Wang ◽

Xue Wang ◽

Yu Di

Keyword(s):

Visual Acuity ◽

Intravitreal Injection ◽

Liver Abscess ◽

Treatment Strategies ◽

Visual Outcome ◽

Drug Susceptibility ◽

Endogenous Endophthalmitis ◽

Light Perception ◽

Hand Motion ◽

Susceptibility Tests

Abstract Backgrounds: Endogenous endophthalmitis is a serious disease caused by intraocular infection that can rapidly progress to cause blindness. This study evaluated the clinical features, surgical and antibiotics treatment strategies, and treatment outcomes in patients with endophthalmitis caused by liver abscess.Methods: Between April 2014 and April 2019, the clinical data of 16 patients (19 eyes) with endophthalmitis associated with liver abscess who underwent surgery at Shengjing Hospital were retrospectively analyzed. Furthermore, we evaluated the final visual outcomes in the patients to determine the efficacy of surgeryResults: Fifteen patients (18 eyes) underwent intravitreal injection followed by vitrectomy after admission. One patient (1 eye) only underwent intravitreal injection. Of the 16 patients, 3 patients (3 eyes) had recurrent intraocular inflammation and eventually underwent evisceration. Systemic antibiotics were administered for all patients based on the results of vitreous humor culture, blood culture, and antibiotic susceptibility tests. Outpatient follow-ups were performed until the patients were stable (6 months). Of the 19 eyes, 1 eye (5%) had visual acuity restored to 20/200, 6 eyes (31%) had visual acuity restored to counting fingers (CF), 2 eyes (11%) had visual acuity restored to hand motion (HM), 4 eyes (22%) showed only light perception (LP), and the remaining 6 eyes (31%) showed no light perception (NLP). Drug susceptibility tests suggested that the carbapenems exhibited significant effects in the inflammatory reaction.Conclusion: Endogenous endophthalmitis caused by liver abscess is a very serious condition, and the final visual outcome is poor. Timely surgical intervention combined with antibiotic treatment is essential, and the primary disease must be treated to control disease progression at the earliest.

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Prognostic Factors and Epidemiology of Open Globe Injuries from Western Sydney: A Twelve-Year Review

10.21203/rs.3.rs-294147/v1 ◽

2021 ◽

Author(s):

Haochi Ho ◽

Jane Foo ◽

Yi-Chiao Li ◽

Samantha Bobba ◽

Christopher Go ◽

...

Keyword(s):

Visual Acuity ◽

Prognostic Factors ◽

Retinal Detachment ◽

Case Series ◽

Final Visual Acuity ◽

Ocular Injury ◽

Visual Outcomes ◽

Globe Rupture ◽

Open Globe ◽

Open Globe Injuries

Abstract BackgroundTo identify prognostic factors determining final visual outcome following open globe injuries.MethodsRetrospective case series of patients presenting to Westmead Hospital, Sydney, Australia with open globe injuries from 1st January 2005 to 31st December 2017. Data collected included demographic information, ocular injury details, management and initial and final visual acuities.ResultsA total of 104 cases were identified. Predictors of poor final visual outcomes included poor presenting visual acuity (p < 0.001), globe rupture (p < 0.001), retinal detachment (p < 0.001), Zone III wounds (p < 0.001), hyphema (p=0.003), lens expulsion (p = 0.003) and vitreous hemorrhage (p < 0.001). Multivariate analysis demonstrated presenting visual acuity (p < 0.001), globe rupture (p = 0.013) and retinal detachment (p = 0.011) as being statistically significant for predicting poor visual outcomes. The presence of lid laceration (p = 0.197) and uveal prolapse (p = 0.667) were not significantly associated with the final visual acuity. ConclusionsPoor presenting visual acuity, globe rupture and retinal detachment are the most important prognostic factors determining final visual acuity following open globe injury.

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Bungee cord related ocular trauma: An avoidable cause of ocular morbidity

Panacea Journal of Medical Sciences ◽

10.18231/j.pjms.2021.060 ◽

2021 ◽

Vol 11 (2) ◽

pp. 297-300

Author(s):

Nazia Imam ◽

Mobashir Sarfraz Ali ◽

Bibhuti Prassan Sinha ◽

Gyan Bhaskar ◽

Rakhi Kusumesh

Keyword(s):

Visual Acuity ◽

Clinical Features ◽

Medical Records ◽

Tertiary Care ◽

Final Visual Acuity ◽

Ocular Injury ◽

Age Group ◽

Mechanism Of Injury ◽

Open Globe Injury ◽

Open Globe

To study the mechanism and clinical features of ocular injury and its outcome associated with bungee cord related eye trauma. A retrospective review of medical records was performed at our tertiary care centre to identify patients presented with bungee cord related eye injury between March 2016 to February 2017. Data collected from medical records were age, sex, mechanism of injury, clinical features, therapeutic intervention, presenting visual acuity, final visual acuity and length of follow up. Total of thirteen patients with bungee cord related trauma were identified. Ten (77%) patients presented with closed globe injury and 3(23%) presented with open globe injury. All patients were male with mean age group of 30.15±7.38 years. Presenting visual acuity ranges from 6/12 to NPL. Only seven (54%) of patients were having final visual acuity of better than or equal to 6/18 in injured eye. Three patients (23.1%) with open globe injury had final visual acuity of counting fingers or worse. Main mechanism of injury being combination of blunt and high speed projectile injury due to slippage of metal or plastic hook while the cord is stretched. Trauma with bungee cord is usually affecting working age group male with injury resulting in loss of workable vision to loss of eye hence there is need of appropriate intervention like use of printed warning on package and modification of hook design to decrease the incidence of bungee cord related trauma.

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

Military Medicine ◽

10.1093/milmed/usz400 ◽

2019 ◽

Vol 185 (5-6) ◽

pp. e799-e803 ◽

Cited By ~ 1

Author(s):

Soner Guven ◽

Ali Hakan Durukan

Keyword(s):

Ocular Trauma ◽

Ocular Injury ◽

Medicine Department ◽

Patient Demographics ◽

School Of Medicine ◽

Open Globe ◽

Department Of Ophthalmology ◽

Protective Eyewear ◽

Ocular Injuries ◽

Trauma Scores

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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