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

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

Journal of Ophthalmology ◽

10.1155/2019/1360805 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Hao Jiang ◽

Chao Xue ◽

Yanlin Gao ◽

Yan Wang

Keyword(s):

Visual Acuity ◽

Ocular Trauma ◽

Final Outcome ◽

Ocular Injury ◽

Light Perception ◽

Severe Injuries ◽

Hand Motion ◽

Injury Characteristics ◽

Retinal Injury ◽

Open Globe

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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Characteristics And Outcomes of Perforating Trauma With Intraorbital Foreign Body

10.21203/rs.2.13519/v2 ◽

2020 ◽

Author(s):

Hui Ren ◽

Xiaobing Hu ◽

Min Zhou ◽

Yongheng Huang ◽

Diwen Guo ◽

...

Keyword(s):

Visual Acuity ◽

Foreign Body ◽

Chart Review ◽

Ocular Trauma ◽

Retrospective Chart Review ◽

Light Perception ◽

Orbital Surgery ◽

Ocular Trauma Score ◽

Trauma Score

Abstract Background: To evaluate the characteristics and outcomes of patients with perforating trauma with intraorbital foreign body (IOrbFb). Methods: Retrospective chart review of 31 consecutive patients with perforating trauma and IOrbFb treated in Eye and ENT Hospital of Fudan University from 2014 to 2018. Results: 30 (96.8%) patients were male and 1 (3.2%) was female. The ocular trauma score (OTS) was 1 in 18 (58.1%) patients, 2 in 8 (25.8%) patients and 3 in 5 (16.1%) patients. At the time of the last follow-up, the visual acuity was 20/40 or better in 3 (9.7%) patients, between 20/50-20/200 in 6 (19.4%) patients, between 20/200 or worse in 6 (19.4%) patients, no light perception 16 (51.6%) patients and 14 (45.2%) patients underwent evisceration/enucleation. Conclusions: The visual prognosis of perforating trauma with IOrbFb is closely related to OTS. Removal of IOrbFbs is safe with current orbital surgery techniques.

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Mean difference of visual acuity with auto refraction and subjective refraction.

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v36i1.909 ◽

2020 ◽

Vol 36 (1) ◽

Author(s):

Shakeel Ahmad ◽

Rashida RIaz ◽

Muhammad Haseeb ◽

Hafiza Ammara Rasheed ◽

Samia Iqbal

Keyword(s):

Visual Acuity ◽

Demographic Data ◽

Anterior Segment ◽

Cross Sectional Study ◽

Mean Difference ◽

P Value ◽

Cross Sectional ◽

Department Of Ophthalmology ◽

The Mean ◽

Cylindrical Axis

Purpose: To compare the mean difference of visual acuity as measured by auto refraction and subjective refraction. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Department of ophthalmology, Services hospital Lahore from November 2013 to April 2014. Material and Methods: Using non-probability consecutive sampling 300 eyes of 300 patients fulfilling inclusion criteria were recruited through OPD registration slip. Demographic data including age and gender was recorded. Complete ophthalmic examination was performed. This included measurement of refractive error by auto-refraction as well as subjective refraction. Detailed anterior segment examination with slit lamp and dilated fundus examination with indirect ophthalmoscopy was performed. The collected data was analyzed by using software SPSS version 17. Results: The mean age of patients was 34.71 ± 7.45 years. There were 156 (52%) males and 144 (48%) females. There were 263 (87.69%) patients who had visual acuity of 6/6 and 37 (12.33%) had 6/9. Mean spherical auto-refraction and subjective refraction was 0.0290 ± 2.58 and -0.2842 ± 2.37 D with mean difference of -0.3133 ± 1.27 D. The mean cylindrical auto and subjective refraction in this study was -.9742 ± 0.78 D and -0.7500 ± 0.81 D and mean difference was 0.2242 ± 0.74 D. The mean cylindrical axis of auto and subjective refraction was 114.88 ± 49.75 and 115.60 ± 49.70 with mean difference as 0.72 ± 3.02 D (p-value < 0.05). Conclusion: Difference of spherical, cylindrical and cylindrical axis in auto and subjective refraction was significantly different.

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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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Vitrectomy combined with intravitreal antifungal therapy for posttraumatic fungal endophthalmitis in eastern China

BMC Ophthalmology ◽

10.1186/s12886-020-01703-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Hong Zhuang ◽

Xinyi Ding ◽

Ting Zhang ◽

Qing Chang ◽

Gezhi Xu

Keyword(s):

Visual Acuity ◽

Antifungal Therapy ◽

Medical Records ◽

Ocular Trauma ◽

Eastern China ◽

Antifungal Drugs ◽

Light Perception ◽

Fungal Endophthalmitis ◽

Penetrating Ocular Trauma ◽

Better Than

Abstract Background To evaluate the effect and prognostic factors of vitrectomy combined with intravitreal antifungal therapy for posttraumatic fungal endophthalmitis in Eastern China. Methods We retrospectively reviewed the medical records of patients who developed fungal endophthalmitis after penetrating ocular trauma at an ophthalmic center in Eastern China. All patients underwent vitrectomy and intravitreal injection of antifungal drugs. Results Thirty-five patients (35 eyes) were included. Twelve eyes suffered plant trauma, 17 eyes metal trauma, and 6 eyes other trauma. The culture results for all 35 eyes showed filamentous fungi, including Aspergillus in 26 eyes (74.3%). Twenty-three eyes underwent vitrectomy once and 12 eyes were treated twice. Four eyes were iridectomized because of a fungal lesion behind the iris. Fungal endophthalmitis was effectively controlled in 33 eyes (94.3%), whereas 2 eyes were ultimately enucleated. Visual acuity was significantly better after treatment than before treatment (P = 0.0006). According to the preoperative vision, the affected eyes were divided into two groups: group 1A (light perception) and group 1B (better than light perception). The final visual acuity in group 1B was significantly better than that in group 1A (P = 0.0289). Conclusions Vitrectomy combined with intravitreal antifungal therapy is an effective treatment for posttraumatic fungal endophthalmitis. Preoperative visual acuity is a significant factor affecting the prognosis of visual acuity.

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Profile of pediatric eye trauma at Hospital de Base do Distrito Federal (HBDF), Brasília, Brazil

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.62.04.324 ◽

2016 ◽

Vol 62 (4) ◽

pp. 324-329 ◽

Cited By ~ 4

Author(s):

Juliana Tessari Dias Rohr ◽

Procópio Miguel dos Santos ◽

Regina Candido Ribeiro dos Santos ◽

Camila Viana Vieira ◽

Lylian Moura Fé ◽

...

Keyword(s):

Visual Acuity ◽

Blunt Trauma ◽

Family Income ◽

Ocular Trauma ◽

Primary Repair ◽

P Value ◽

Severe Injuries ◽

Cross Sectional ◽

Adult Supervision ◽

At Home

Summary Objective: To describe the epidemiological profile of ocular trauma in children at the HBDF emergency department. Method: Descriptive, cross-sectional study. We evaluated 103 cases of ocular trauma in children less than 15 years between July 2012 and January 2013. The factors evaluated through semi-structured questionnaire available online were: age, gender, adult supervision, mechanism, type of trauma, time and place, site and nature of injury, visual acuity, need for hospitalization and/or surgery, type of surgery, mother’s level of education, and family income. Results: The average age of patients studied was 7.5 years. Boys (68%) predominate in all age groups. Blunt trauma prevailed (55.3%), followed by open (20%). Most of the cases occurred at home, 14 to 20 hours before seeking hospital care. The most common causes were: wood, stone, bicycle, broken glass, and falls. The cornea was affected in 54%. Visual acuity was ≥20/40 in 68.9%. Primary repair of the eye wall was indicated in 70.37% (p-value=0.022). Open traumas were more severe (p-value=0.005) and had more need for intervention (p-value=0.000). The injuries occurred despite the presence of adult supervision in 54% (p-value=0.002). The most severe injuries predominated in the age range 7-15 years (p=0.001). Conclusion: Ocular trauma was more frequent among boys. The mechanisms of injury are the most diverse, and prevail at home. Blunt trauma prevails, but the visual impact is due to open trauma. Programs of prevention and education on child ocular trauma are needed.

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Open Globe Injuries: Classifications and Prognostic Factors for Functional Outcome

10.21203/rs.3.rs-79471/v1 ◽

2020 ◽

Author(s):

Lukas Reznicek ◽

Christian S. Mayer ◽

Ramin Khoramnia ◽

Jakob Siedlecki ◽

Benedikt Schworm

Keyword(s):

Visual Acuity ◽

Functional Outcome ◽

Ocular Trauma ◽

Visual Outcome ◽

Posterior Segment ◽

Tertiary Referral Center ◽

Open Globe ◽

Department Of Ophthalmology ◽

Trauma Score ◽

Open Globe Injuries

Abstract BACKGROUND: Epidemiology and evaluation of posterior segment involvement as a prognostic factor for functional outcome of patients with open globe injuries in a university eye clinic as a tertiary referral center in Southern Germany. METHODS: A retrospective analysis of 151 consecutive patients with open globe injuries who were referred to the department of Ophthalmology of the Technical University of Munich in Germany from 2004 to 2011 was conducted. Visual acuity, epidemiologic data, classification of the injuries including the ocular trauma score (OTS), performed surgeries, post-operative visual acuity and intraocular pressure (IOP) as well as correlation analyses between OTS and post-operative visual acuity were obtained. RESULTS: On total, 147 eyes were included in the study. The mean age of the patients was 42.9±22.2 years, 78.2% were male, 36.7% of injuries occurred in the workplace. Thirty-eight patients (25.9%) had intraocular foreign bodies (IOFB): 84.2% were metal objects, 5.3% organic material and 10.5% glass. On total, 51.7% of the open globe injuries were located in zone I (cornea, cornealscleral limbus), 15.0% in zone II (up to 5 mm posterior the sclerocorneal limbus) and 32.0% in zone III (posterior of zone 2). Affected structures were eyelids (17.7%), cornea (74.8%), iris (63.9%), lens (56.5%), sclera (48.3%), retina (47.6%) and optic nerve (19.7%). Mean preoperative BCVA was 1.304±0.794 logMAR and 1.289±0.729 logMAR after surgery (p=0.780). Patients with involvement of their posterior segment had significantly worse postoperative BCVA scores than patients without (1.523±0.654 logMAR vs. 0.944±0.708 logMAR, p<0.01). CONCLUSIONS: Predictive factors for good visual outcome of open globe injuries are good initial visual acuity and ocular trauma affecting only zone I and II.

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Characteristics And Outcomes of Perforating Trauma With Intraorbital Foreign Body

10.21203/rs.2.13519/v1 ◽

2019 ◽

Author(s):

Hui Ren ◽

Xiaobing Hu ◽

Min Zhou ◽

Yongheng Huang ◽

Diwen Guo ◽

...

Keyword(s):

Foreign Body ◽

Chart Review ◽

Ocular Trauma ◽

Retrospective Chart Review ◽

Light Perception ◽

Orbital Surgery ◽

Ocular Trauma Score ◽

Protective Eyewear ◽

Trauma Score

Abstract Background To evaluate the characteristics and outcomes of patients with perforating trauma with intraorbital foreign body (IOrbFb). Methods Retrospective chart review of 31 consecutive patients with perforating trauma and IOrbFb treated in Eye and ENT Hospital of Fudan University from 2014 to 2018. Results 30 (96.8%) patients were male and 1 (3.2%) was female. The ocular trauma score (OTS) was 1 in 18 (58.1%) patients, 2 in 8 (25.8%) patients and 3 in 5 (16.1%) patients. At the time of the last follow-up, the visual acuity was 20/40 or better in 3 (9.7%) patients, 6 (19.4%) patients was between 20/50-20/200, 6 (19.4%) was between 20/200 or worse, a total of 16 (51.6%) patients was no light perception and 14 (45.2%) patients underwent evisceration/enucleation. Conclusions The prognosis of perforating trauma with IOrbFb is closely related to OTS. Removal of IOrbFbs is safe with current orbital surgery techniques. An emphasis on education and protective eyewear use would be helpful in reducing these injuries.

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Intraorbital Wooden Foreign Body with Intracranial Extension : A Case Report

Ophthalmologica Indonesiana ◽

10.35749/journal.v44i1.155 ◽

2018 ◽

Vol 44 (1) ◽

pp. 4

Author(s):

Amanda N Shinta ◽

Purjanto Tepo Utomo ◽

Agus Supartoto

Keyword(s):

Visual Acuity ◽

Foreign Body ◽

Frontal Lobe ◽

Vital Sign ◽

Intracranial Extension ◽

Ocular Motility ◽

Light Perception ◽

Bone Segment ◽

Wooden Foreign Body ◽

Wooden Stick

Purpose : The aim of this study is to report a case of intraorbital wooden foreign body with intracranial extension to the frontal lobe and its management. Method : This is a descriptive study: A 53 year-old male referred due to wooden stick stucked in the orbital cavity causing protruding eyeball and vital sign instability. Result : Right eye examination revealed light perception visual acuity, with bad light projection and bad color perception, inwardly folded upper eyelid, proptosis, conjunctival chemosis, corneal erosion and edema, dilated pupil with sluggish pupillary light reflex and limited ocular movement in all direction. Vital sign was unstable with decreasing blood pressure, increasing temperature and heart rate. CT Scan showed complete fracture of the orbital roof due to penetration of the wooden stick, pneumoencephalus, cerebral edema and hematoma. Emergency craniotomy was performed to remove the penetrating wooden stick and bone segment in the frontal lobe and fracture repair. Ophthalmologist pulled the remaining stick, released the superior rectus muscle and repaired the lacerated eyelid. Outcome visual acuity was no light perception with lagophthalmos and limited ocular motility. Patient was admitted to Intensive Care Unit one day post-operatively and treated with systemic and topical antibiotic. Conclusion : Any case presenting with intraorbital foreign body must undergo immediate neuroimaging to exclude any intracranial extension, especially in patients with worsening general condition.

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Influenza With an Infiltrate: Investigating the New Community-Acquired Pneumonia Guidelines

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.884 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s302-s302

Author(s):

Amanda Barner ◽

Lou Ann Bruno-Murtha

Keyword(s):

Demographic Data ◽

Retrospective Chart Review ◽

Vaccination Rate ◽

Community Acquired Pneumonia ◽

Teaching Hospitals ◽

Antibiotic Prescribing ◽

Supporting Evidence ◽

Radiographic Findings ◽

Significant Difference ◽

The Impact

Background: The Infectious Diseases Society of America released updated community-acquired pneumonia (CAP) guidelines in October 2019. One of the recommendations, with a low quality of supporting evidence, is the standard administration of antibiotics in adult patients with influenza and radiographic evidence of pneumonia. Procalcitonin (PCT) is not endorsed as a strategy to withhold antibiotic therapy, but it could be used to de-escalate appropriate patients after 48–72 hours. Radiographic findings are not indicative of the etiology of pneumonia. Prescribing antibiotics for all influenza-positive patients with an infiltrate has significant implications for stewardship. Therefore, we reviewed hospitalized, influenza-positive patients at our institution during the 2018–2019 season, and we sought to assess the impact of an abnormal chest x-ray (CXR) and PCT on antibiotic prescribing and outcomes. Methods: We conducted a retrospective chart review of all influenza-positive admissions at 2 urban, community-based, teaching hospitals. Demographic data, vaccination status, PCT levels, CXR findings, and treatment regimens were reviewed. The primary outcome was the difference in receipt of antibiotics between patients with a negative (<0.25 ng/mL) and positive PCT. Secondary outcomes included the impact of CXR result on antibiotic prescribing, duration, 30-day readmission, and 90-day mortality. Results: We reviewed the medical records of 117 patients; 43 (36.7%) received antibiotics. The vaccination rate was 36.7%. Also, 11% of patients required intensive care unit (ICU) admission and 84% received antibiotics. Moreover, 109 patients had a CXR: 61 (55.9%) were negative, 29 (26.6%) indeterminate, and 19 (17.4%) positive per radiologist interpretation. Patients with a positive PCT (OR, 12.7; 95% CI, 3.43–60.98; P < .0007) and an abnormal CXR (OR, 7.4; 95% CI, 2.9–20.1; P = .000003) were more likely to receive antibiotics. There was no significant difference in 30-day readmission (11.6% vs 13.5%; OR, 0.89; 95% CI, 0.21–3.08; P = 1) and 90-day mortality (11.6% vs 5.4%; OR, 2.37; 95% CI, 0.48–12.75; P = .28) between those that received antibiotics and those that did not, respectively. Furthermore, 30 patients (62.5%) with an abnormal CXR received antibiotics and 21 (43.7%) had negative PCT. There was no difference in 30-day readmission or 90-day mortality between those that did and did not receive antibiotics. Conclusions: Utilization of PCT allowed selective prescribing of antibiotics without impacting readmission or mortality. Antibiotics should be initiated for critically ill patients and based on clinical judgement, rather than for all influenza-positive patients with CXR abnormalities.Funding: NoneDisclosures: None

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