Pediatric open-globe injury in a university-based tertiary hospital

2018 ◽  
Vol 30 (2) ◽  
pp. 269-274 ◽  
Author(s):  
Faisal AlDahash ◽  
Ahmed Mousa ◽  
Priscilla W Gikandi ◽  
Ahmed M Abu El-Asrar
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Visual Outcome ◽  
Tertiary Hospital ◽  
Open Globe Injury ◽  
Female Ratio ◽  
Initial Visual Acuity ◽  
Open Globe ◽  
Type Of Injury

Background: To investigate epidemiology, etiology, and outcomes after repair of pediatric open-globe injury. Methods: We retrospectively reviewed medical records of patients ⩽18 years who underwent primary open-globe repair. Results: A total of 213 patients were identified. Male–female ratio was 1.44:1. Type of injury was penetration in 157 (74.4%) cases, rupture in 52 (24.4%) cases, and perforation in 2 (0.9%) cases. Knife injuries were the most common cause, affecting 38/196 (19.4%), followed by metallic object in 37/196 (18.9%) patients, glass in 26/196 (13.3%) patients, and pen or pencil in 24/196 (12.8%). Predictors of good visual outcome defined as (⩾20/40) were good initial visual acuity (⩾20/40; p < 0.0001), time from injury to arrival at the emergency room >24 h (p = 0.038), size of wound less than 10 mm (p < 0.0001), absence of iris prolapse (p < 0.0001), deep anterior chamber at presentation (p < 0.0001), absence of hyphema (p = 0.043), intact lens (p < 0.0001), and no retinal detachment during follow-up (p < 0.0001). A total of 27 (12.7%) cases were documented to have retinal detachment at any time during follow-up period. Predictors of retinal detachment were perforation and rupture (p < 0.0001), whereas penetration was not associated with development of retinal detachment, size of the wound ⩾10 mm (p < 0.0001), initial visual acuity ⩽20/200 (p < 0.0001), lens injury (p < 0.0001), and development of endophthalmitis (p < 0.027). Eight (3.7%) eyes had the clinical diagnosis of posttraumatic endophthalmitis. Conclusions: The most common type of injury was penetration and the most common tool was knife. Visual outcome was affected by the initial presentation. Retinal detachment was a significant predictor of a worse final visual outcome.

scholarly journals Profile of Open Globe Injury in Children at Lumbini Eye Institute

2015 ◽  
Vol 3 (1) ◽  
pp. 37-40
Author(s):  
Binita Bhattarai ◽  
Santosh Pokhrel ◽  
Bel Thapa ◽  
Prachand Gautam ◽  
Nanda Gurung
Keyword(s):  
Visual Acuity ◽  
Public Health Problem ◽  
Visual Outcome ◽  
Medical Sciences ◽  
Open Globe Injury ◽  
Open Globe ◽  
Male Preponderance ◽  
Time Of Presentation ◽  
Better Than

INTRODUCTION: Ocular trauma is preventable public health problem throughout the world that especially affects the young. During the last several decades the prognosis of open-globe injuries has significantly improved. The aim of this study was to describe the clinical profile of open globe injury in children and visual outcome after surgery.MATERIAL AND METHODS: It is a prospective hospital based study that included children aged 1-15 yrs presenting to Lumbini Eye Institute (LEI), Bhairahawa with open globe injury. Visual acuity and Anterior and Posterior Segment examination findings were recorded at the time of presentation, after surgery and in three subsequent follow up visits.RESULTS: Out of 26,538 pediatric patients, during the study period 0.26% (n=69) had open globe injury. The most common age group was 510 years comprising 43.5%, with a strong male preponderance of 74% and mean age of 8.06±3.6years. Playing was the most common mode of injury comprising 58%, where as stick was the most common agent causing trauma consisting 51%. Fifty two percent were visually impaired and 39% were blind at the time of presentation and only 9% children had visual acuity better than 6/18. Improved vision was found in 52%, same vision in 34% and deteriorated vision in 13% till third follow up visit. Anatomical integrity of the globe was maintained in 88.4% and only 11.6% had Phthisis bulbi.CONCLUSION: The incidence of open globe injury among children at Lumbini Eye Institute was 0.26%. Male children were more vulnerable. Stick was the most common traumatizing agent. There was a favorable outcome with improved vision in most children after surgery.Journal of Universal College of Medical Sciences Vol. 3, No. 1, 2015: 37-40

scholarly journals Visual Outcome in Open Globe Injury

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  

scholarly journals Microbial contamination in open globe injury

1970 ◽  
Vol 4 (1) ◽  
pp. 84-89 ◽  
Author(s):  
S Bhala ◽  
S Narang ◽  
S Sood ◽  
C Mithal ◽  
AK Arya ◽  
...  
Keyword(s):  
Visual Outcome ◽  
Bacillus Species ◽  
Open Globe Injury ◽  
Open Globe ◽  
A Prospective Study ◽  
Culture Positive ◽  
Initial Contamination ◽  
Final Visual Outcome ◽  
Open Globe Injuries

Introduction: Endophthalmitis is the most dreaded complication of ocular trauma and knowledge of the microbial contaminants is essential to start empirical antibiotic therapy. Purpose: To determine incidence of contamination after open globe injuries (OGI) in our setup and to identify the spectrum of microorganisms contaminating open globe injuries. Material and methods: A prospective study including 50 consecutive eyes of open globe injury over a period of two years was conducted. Intra-operatively, 4 - 5 samples were taken from the inferior conjunctival sac and anterior chamber at the beginning and end of the open globe injury repair. Any abscised tissue or foreign body was also sent for culture sensitivity. A vitreous tap was taken from eyes with posterior segment trauma with signs of endophthalmitis. Results: Microbial cultures were positive in13 eyes (26 %). The microbial spectrum included Aspergillus species in 45.6 %, Alternaria in 15.2 %, Curvularia in 15.2 %, Staphylococcus aureus in 7.6 %, Bacillus species in 7.6 %, and Streptococcus pneumoniae in 7.6 %. Of these 13 eyes, nine eyes developed clinically evident frank endophthalmitis during follow-up. Overall, endophthalmitis developed in 20 eyes (40 %). There was a significant association between the initial contamination and development of endophthalmitis (p < 0.05). 53 % of culture positive cases achieved ambulatory vision compared to 73 % of culturenegative cases. Conclusion: Initial contamination was seen in 26 % of OGI cases. Aspergillus (fungus) was the commonest contaminant. There was a strong correlation between the initial contamination and development of endophthalmitis. Culture-negative cases had a trend towards better final visual outcome than culture-positive cases. Close follow up of cases showing contamination following OGI is recommended. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5857 NEPJOPH 2012; 4(1): 84-89

scholarly journals Brief communication (Original). Visual outcome in open globe injuries in Thailand: a prospective study

2011 ◽  
Vol 5 (4) ◽  
pp. 531-536
Author(s):  
Sunisa Sintuwong ◽  
Ruthairat Winitchai
Keyword(s):  
Visual Acuity ◽  
Length Of Stay ◽  
Predictive Factors ◽  
Foreign Bodies ◽  
Visual Outcome ◽  
Time Duration ◽  
Poor Visual Outcome ◽  
Initial Visual Acuity ◽  
Open Globe ◽  
Open Globe Injuries

AbstractBackground: Eye injuries, especially open globe injuries, cause visual morbidities and socioeconomic burden. It is urgent have good database and stakeholder involvement for open globe injuries.Objectives: Investigate the epidemiology and predictive factors of visual outcome in open globe injuries in an industrial area in Thailand.Methods: Consecutive cases of in-patient open globe injuries in Mettapracharak Eye Centre between February 2009 and January 2010 were examined. Patients were interviewed at first visit and followed-up for six months. The Birmingham Eye Trauma Terminology was used to classify types of injuries. Demographic data, cost of treatment, length of stay, and predictive factors (initial visual acuity, presence of relative afferent pupillary defect, hyphema, vitreous hemorrhage, intraocular foreign bodies, retinal detachment, time-duration to surgery, and wound length) were assessed.Results: Fifty-two out of 60 eyes were included. Most (82.7%) of patients were men and average age was 34.1 years (range: 8-68 years). About half (51.9%) graduated from primary school and 65.3% were labourers. Most patients had not used protective devices. The endophthalmitis rate was 13.5%, and panophthalmitis rate was 5.8%. The enucleation rate was 9.6%. The median length of stay was nine days. Poor initial visual acuity and intraocular foreign bodies were significant predictive factors of poor visual outcome (p <0.05).Conclusion: Open globe injuries caused visual morbidity especially in young adult male, laborers with low education. Initial visual acuity and intraocular foreign bodies were significant predictive factors of poor visual outcome.

scholarly journals Novel Suturing Methods for the Management of Traumatic Choroidal Avulsion in Globe Injuries

2022 ◽  
Vol 8 ◽  
Author(s):  
Huijin Chen ◽  
Jiarui Yang ◽  
Changguan Wang ◽  
Xuefeng Feng ◽  
Kang Feng ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Silicone Oil ◽  
Open Globe Injury ◽  
Oil Migration ◽  
Corrected Visual Acuity ◽  
Open Globe ◽  
Baseline Information ◽  
Suturing Methods

PurposeTo explore the long-term efficacy of novel choroidal suturing methods including trans-scleral mattress suturing (TSS) and intraocular suturing (IOS) in the treatment of choroidal avulsion.DesignProspective cohort, hospital-based study.MethodsA total of 24 patients who were diagnosed with choroidal avulsion were enrolled in this study. The demographic characteristics, baseline information of trauma, best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were collected before surgery, and the anatomic abnormities of the globe were recorded before or during surgery. All patients were diagnosed with choroidal avulsion and underwent choroid suturing treatment during vitrectomy, postoperative functional variables including BCVA and IOP, anatomic variables including retinal and choroidal reattachment rate, and silicone oil migration rate, which were recorded at the regular follow-ups at least 1 year after surgery.ResultsAll patients with open globe injury involved zone III, 70.8% of the patients presented with two quadrants of the avulsed choroid, and 29.2% with one quadrant involved; moreover, all patients had complications with retinal detachment (RD), of which 58.3% of patients had closed funnel retinal detachment. TSS was applied in nineteen patients and IOS in five patients. Postoperatively, a significant improvement on LogMAR BCVA was observed at each follow-up from 3.57 ± 0.69 before surgery to 2.82 ± 0.98 at the last follow-up (p &lt; 0.05), and the proportion of no light perception (NLP) was also reduced from 69.6 to 37.5%. IOP was markedly elevated from 6.4 ± 4.1 mmHg preoperatively to 11.3 ± 4.3 mmHg at the last follow-up (p &lt; 0.05). Choroidal reattachment was achieved in 91.7% of patients; two patients were observed with silicone oil migration at 3 months after surgery and underwent drainage of suprachoroidal silicone oil and sclera buckling. Meanwhile, retinal attachment was observed in 95.8% of patients, only one patient developed partial RD due to postoperative proliferative vitreoretinopathy, and secondary vitrectomy was performed; all patients were observed with complete retinal and choroidal attachment at the last follow-up. Eventually, four patients were silicone oil-free, and 20 patients were silicone oil-dependent.ConclusionsChoroidal suturing proved to be an effective method to fix the avulsed choroid, which greatly improved the BCVA and maintained the IOP, and efficiently increased the choroidal and retinal reattachment rate and preservation of the eyeball.

scholarly journals Hyphema in Open-Globe Versus Closed-Globe Injuries in Operation Iraqi Freedom and Enduring Freedom: 2001–2011

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 ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Medical Center ◽  
Visual Outcome ◽  
Walter Reed Army Medical ◽  
Cataract Formation ◽  
Traumatic Cataract ◽  
Open Globe ◽  
Ocular Injuries ◽  
Iraqi Freedom

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 &lt; 0.001), retinal detachment (OR 4.2, CI 2.8–6.4, P &lt; 0.001), angle recession (OR 8.1, CI 2.9–24.3, P &lt; 0.001), and final VA of less than 20/200 (OR 3.7, CI 2.6–5.4, P &lt; 0.001). Traumatic cataract formation (OR 7.4, CI 2.9–18.7, P &lt; 0.001), retinal detachment (OR 6.1, CI 2.1–17.5, P &lt; 0.001), and a final VA less than 20/200 (OR 6.1, CI 2.4–15.4 P &lt; 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.

scholarly journals A Study on Pattern of Retinal Detachment in Patients with Choroidal Coloboma and Its Outcome after Surgery at a Tertiary Eye Hospital in Nepal

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Barsha Suwal ◽  
Govinda Paudyal ◽  
Raba Thapa ◽  
Sanyam Bajimaya ◽  
Sanjita Sharma ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Case Series ◽  
Visual Outcome ◽  
Oil Removal ◽  
Common Complication ◽  
Silicon Oil ◽  
Postsurgical Complications ◽  
Anatomic Success

Background. To review the pattern of retinal detachment (RD) in patients with choroidal coloboma and type of reattachment surgery performed and to study its outcome in terms of retinal reattachment, visual acuity, and postsurgical complications. Methods. Observational case series of a single tertiary eye institution of 13 eyes having choroidal coloboma with RD done from January 2015 to June 2017. Results. Mean age of presentation was 29.3 years (Range 14–60 years). Males were two times more affected than females (2.25 : 1). The overall rate of anatomic success achieved after RD repair and silicon oil removal at 6 months was 92.3% (12/13 eyes). Following surgery, visual acuity improved in 6 out of 11 eyes (54.54%), remained unchanged in 4 eyes (36.36%), and worsened in 1 eye (9.1%). The most common complication following surgery was secondary glaucoma in 30.7% (4/11 eyes). Conclusion. The overall anatomic success rate of retina reattachment surgery in colobomatous eye is good, and the visual outcome following surgery can improve in majority of the cases or may remain same in few cases. Hence, timely surgery is advocated. But careful follow-up is required as the risk of postoperative complications is also high.

scholarly journals Vitreous Hemorrhage in Pediatric Age Group

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Dora H. AlHarkan ◽  
Eman S. Kahtani ◽  
Priscilla W. Gikandi ◽  
Ahmed M. Abu El-Asrar
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Vitreous Hemorrhage ◽  
Visual Outcome ◽  
Age Group ◽  
Pediatric Age ◽  
Pediatric Age Group ◽  
Good Visual Outcome ◽  
Negative Predictor

Purpose.To identify and study causes of vitreous hemorrhage (VH) in pediatric age group and to investigate factors predicting visual and anatomical outcomes.Procedure.A retrospective review of patients aged 16 years or less with the diagnosis of vitreous hemorrhage from January 2005 until December 2010.Results.A total number of 230 patients (240 eyes) were identified. Traumatic vitreous hemorrhage accounted for 82.5%. In cases of accidental trauma, final visual acuity of 20/200 was significantly associated with visual acuity of ≥20/200 at presentation and the absence of retinal detachment at last follow-up. Patients with nontraumatic vitreous hemorrhage were significantly younger with higher rates of enucleation/evisceration/exenteration and retinal detachment at last follow-up compared to traumatic cases.Conclusion.Trauma is the most common cause of VH in pediatric age group. In this group, initial visual acuity was the most important predictor for visual outcome, and the presence of retinal detachment is a negative predictor for final good visual outcome. The outcome is significantly worse in nontraumatic cases compared to traumatic cases.

scholarly journals Open globe injuries in geriatric population in Iran: characteristics and outcomes

2021 ◽  
Vol 14 (8) ◽  
pp. 1237-1240
Author(s):  
Maryam Zamani ◽  
◽  
Akbar Fotouhi ◽  
Morteza Naderan ◽  
Mohammad Soleimani ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Ocular Trauma ◽  
Final Visual Acuity ◽  
Open Globe Injury ◽  
Geriatric Population ◽  
Cross Sectional ◽  
Female Ratio ◽  
Globe Rupture ◽  
Open Globe ◽  
Open Globe Injuries

AIM: To investigate the patterns and outcomes of open globe injuries in the elderly population in Iran. METHODS: In this retrospective cross-sectional chart review, medical records of 248 patients (aged 60y and more) with the diagnosis of open globe injury from 2006 to 2016 were reviewed. Demographic features, type, and mechanism of open globe injury, ocular trauma score (OTS), visual acuity before and after treatment, the zone of injuries, and the associated injuries found at the presentation or thereafter were documented. RESULTS: A total of 248 eyes of 248 patients were included. The mean age was 69.2±5.8y (range: 60-90y). Male/ female ratio was about 3:1 (187 vs 61). The three most common causes of injury were falling (25.2%), sharp objects (18.9%), and tree branches (13.9%). Penetrating injury accounted for most of the geriatric ocular trauma (50.4%), followed by globe rupture (40.3%), intraocular foreign body (IOFB; 7.3%), and perforating injury (2.0%). The median raw OTS for the population was 60.5 and the most common OTS class was 3. The injuries tend to affect zone I more than zone II and zone III. The only predictor of final visual acuity was the class of OTS (P<0.001). CONCLUSION: Geriatric open globe injury should be valued specifically. The most common type of open globe injury in Iran is penetrating injuries but falling remain the main cause. The OTS class must be considered as an important predictor of final visual acuity.

scholarly journals Reliability of the ocular trauma score for the predictability of traumatic and post-traumatic retinal detachment after open globe injury

2021 ◽  
Vol 14 (10) ◽  
pp. 1589-1594
Author(s):  
Simon Dulz ◽  
◽  
Toam Katz ◽  
Robert Kromer ◽  
Eileen Bigdon ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Ocular Trauma ◽  
Vitreous Hemorrhage ◽  
Open Globe Injury ◽  
Ocular Trauma Score ◽  
Open Globe ◽  
Significant Difference ◽  
Post Traumatic ◽  
Trauma Score

AIM: To elucidate the question of whether the ocular trauma score (OTS) and the zones of injury could be used as a predictive model of traumatic and post traumatic retinal detachment (RD) in patients with open globe injury (OGI). METHODS: A retrospective observational chart analysis of OGI patients was performed. The collected variables consisted of age, date, gender, time of injury, time until repair, mechanism of injury, zone of injury, injury associated vitreous hemorrhage, trauma associated RD, post traumatic RD, aphakia at injury, periocular trauma and OTS in cases of OGI. RESULTS: Totally 102 patients with traumatic OGI with a minimum of 12mo follow-up and a median age at of 48.6y (range: 3-104y) were identified. Final best corrected visual acuity (BCVA) was independent from the time of repair, yet a statistically significant difference was present between the final BCVA and the zone of injury. Severe trauma presenting with an OTS score I (P<0.0001) or II (P<0.0001) revealed a significantly worse BCVA at last follow up when compared to the cohort with an OTS score >III. OGI associated RD was observed in 36/102 patients (35.3%), whereas post traumatic RD (defined as RD following 14d after OGI) occurred in 37 patients (36.3%). OGI associated RD did not correlate with the OTS and the zone of injury (P=0.193), yet post traumatic RD correlated significantly with zone III injuries (P=0.013). CONCLUSION: The study shows a significant association between lower OTS score and zone III injury with lower final BCVA and a higher number of surgeries, but only zone III could be significantly associated with a higher rate of RD.

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