scholarly journals Six-year epidemiological analysis of post traumatic endophthalmitis in a Brazilian hospital

Author(s):  
Luis Filipe Nakayama ◽  
Vinicius Campos Bergamo ◽  
Nilva Simeren Bueno de Moraes

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.

2012 ◽  
Vol 4 (2) ◽  
pp. 263-270 ◽  
Author(s):  
T Thevi ◽  
Z Mimiwati ◽  
S C Reddy

Objective: To determine the factors affecting the visual outcome in patients with open globe injuries of eye. Materials and methods: In a prospective interventional study of consecutive patients with open globe injuries, the age, gender, place of injury, object causing injury and safety precautions taken were recorded. A detailed examination of the eye was done with a slit-lamp. X-rays of the orbits were taken in order to determine the presence of a foreign body. The injuries were classified as simple or complicated depending on the involvement of the pupil/iris, lens and retina. Finally, post operative best-corrected visual acuity at last follow up was noted. Results: Fifty-two patients (52 eyes) were included in the study. The mean age of patients was 27.25±12.62 years (range 9-73 years). The majority of injuries occurred in the workplace (36.5%); nail (15.4%) and glass (15.4%) were the most common objects causing injury. Of those with good initial visual acuity, 90% maintained good visual outcome. Patients with corneal lacerations of less than 5 mm had significant good visual outcome. The number of corneal lacerations and visual axis involvement did not affect the visual outcome. Those with corneoscleral lacerations had significantly poor visual outcomes compared to those with corneal or scleral lacerations alone.Conclusion: Predictors of good visual outcome are good initial visual acuity, a corneal laceration wound of less than 5mm, a deep anterior chamber, and simple lacerations. Age, gender, place of injury, object causing injury, presence of hyphema or intraocular foreign body, and the use of safety precautions did not affect the visual outcome.DOI: http://dx.doi.org/10.3126/nepjoph.v4i2.6542 Nepal J Ophthalmol 2012; 4 (2): 263-270


Trauma ◽  
2020 ◽  
pp. 146040862093576
Author(s):  
SK Aruna ◽  
Pratyusha Ganne ◽  
Prabu Baskaran

Background Removal of an embedded intraocular foreign body remains challenging due to the risks of bleeding and retinal damage. We present a novel technique to deal with this situation. Case report A 32-year man presented with two months of decreased vision in one eye (best corrected visual acuity of 20/200), a year after a workplace injury that necessitated surgery for an open globe injury. Examination revealed the sequalae of his previous surgery, a subtotal retinal detachment and an embedded intraocular foreign body close to inferior ora serrata at the 6 'o clock position confirmed by imaging. The other eye was normal. A pars plana vitrectomy was performed and the embedded intraocular foreign body was released from surrounding dense adhesions using the vitrectomy probe set at 1000 cuts/minute and 100 mm Hg vacuum, followed by fluid air exchange and endolaser with silicon oil injection. The retinal detachment settled well post-operatively, and at the end of one month, the patient had best corrected visual acuity of 20/60. Conclusions The low-cut, low-vacuum vitrectomy technique can be considered as a safe option for releasing the embedded intraocular foreign body in complex ocular trauma scenarios.


2018 ◽  
Vol 44 (1) ◽  
pp. 4
Author(s):  
Amanda N Shinta ◽  
Purjanto Tepo Utomo ◽  
Agus Supartoto

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.


2020 ◽  
Author(s):  
Xin Wen ◽  
Miner Yuan ◽  
Cheng Li ◽  
Chongde Long ◽  
Zhaohui Yuan ◽  
...  

Purpose: To investigate the possible risk factors and prognosis of initial no light perception (NLP) in pediatric open globe injuries (POGI). Procedures: This retrospective, comparative, interventional case-control study included 865 eyes of POGI patients presenting to a tertiary referral ophthalmic center from 1 January 2011 to 31 December 2015. Eyes were divided into two groups: NLP group included eyes with initial NLP, and light perception(LP) group included eyes with initial LP or vision better than LP. Results: The following risk factors were significantly related to initial NLP: severe intraocular hemorrhage (OR=3.287, p=0.015), retinal detachment (RD) (OR=2.527, p=0.007), choroidal damage (OR=2.680, p=0.016) and endophthalmitis (OR=4.221, p<0.001). Choroidal damage is related to remaining NLP after vitreoretinal surgery (OR=12.384, p=0.003). At the last visit, more eyes in the NLP group suffered from silicone oil–sustained status (OR=0.266, p=0.020) or ocular atrophy (OR=0.640, p=0.004), and less eyes benefitted from final LP (OR=41.061, p<0.001) and anatomic success (OR=4.515, p<0.001). Conclusion: Severe intraocular hemorrhage, RD, choroidal damage and endophthalmitis occurred more often in POGI with initial NLP. Choroidal damage was the major factor related to an NLP prognosis. Traumatized eyes with initial NLP could be anatomically and functionally preserved by vitreoretinal surgery.


2022 ◽  
Author(s):  
P. Barrett Paulk ◽  
Dala Eloubeidi ◽  
John O. Mason III ◽  
Christine A. Curcio ◽  
Jason N. Crosson ◽  
...  

Abstract Background Patients presenting with macula-off rhegmatogenous retinal detachment (RRD) with concomitant age-related macular degeneration (AMD) and their treating physicians would benefit from knowledge regarding the visual prognosis after repair. The prognosis for such patients is not well known. The purpose of this study is to compare visual outcomes in macula-off RRD in eyes with AMD versus a group of comparison eyes without AMD. Methods This was a retrospective chart review of 1,149 patients. A total of 191 eyes met study criteria, 162 non-AMD eyes (controls) and 29 AMD eyes. The main outcome measure was postoperative visual acuity in control eyes versus AMD eyes, and this was compared using Fisher’s exact test. Results There was a statistically significant difference in postoperative visual acuity by AMD status, with those without AMD having a higher frequency of Count Fingers (CF), Hand Motion (HM), Light Perception (LP), or No Light Perception (NLP) vision (p = 0.023). More specifically 5.56% of non-AMD eyes and 3.45% of AMD eyes were 20/40 or better, 77.16% of non-AMD and 55.17% of AMD eyes were worse than 20/40 and better than 20/200, 10.49% of non-AMD eyes and 37.93% of AMD eyes were 20/200 or worse, and there were 11 eyes in the non-AMD group with CF, HM, LP, or NLP vision while there was only 1 eye in the AMD group with CF vision. Conclusions Though postoperative visual acuity was worse in the non-AMD group with a higher frequency of patients having final vision of CF, HM, LP, or NLP, this is not likely a clinically significant finding. Rather, it is a function of the difference in sample size and composition between the two groups. Importantly, this study suggests AMD patients can expect similar outcomes to non-AMD patients after RRD repair. Our study suggests that approximately 58% of patients with AMD can expect to maintain functional vision better than 20/200. We conclude that AMD patients can achieve functional vision after RRD surgery, similar to those without AMD. These findings may be helpful in guiding realistic expectations of AMD patients with RRD.


Author(s):  
Stephen Weiss ◽  
Dustin Williams ◽  
Yih Ying (Eva) Yuan ◽  
Jo-Ann Nesiama

1981 ◽  
Vol 75 (2) ◽  
pp. 46-49 ◽  
Author(s):  
Janet F. Fletcher

Theories of spatial representation in blind people have focused on the type of representation of which they, as a group, are capable. This approach overlooks an important issue, namely, the differences among individual blind people and the effects that these differences have on the way spatial information is represented. Data from another article by the author on the same study of spatial representation in blind children were subjected to two step-wise regression analyses to determine the relationships between several subject-related variables and responses to “map” (cognitive map) and “route” (sequential memory) questions about the position of furniture in a recently explored room. The independent variables accounted for 70 percent of the variance on map questions but only 46 percent of the variance on route questions. On map questions, general intellectual ability correlated positively with performance (p < .01), children with visual acuity better than light perception in the first 3 years of life performed better than those with less early vision (p < .05), and children who became blind from retrolental fibroplasia performed more poorly than those whose blindness was due to other causes (p < .05). Fewer independent variables contributed to the variance in performance on route questions. Again children with visual acuity better than light perception in their first 3 years performed better than those with less early vision.


2011 ◽  
Vol 5 (4) ◽  
pp. 531-536
Author(s):  
Sunisa Sintuwong ◽  
Ruthairat Winitchai

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.


2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
G. Sborgia ◽  
N. Recchimurzo ◽  
A. Niro ◽  
L. Sborgia ◽  
A. Sborgia ◽  
...  

Purpose. Ocular trauma with retained foreign body is an important cause of visual impairment in working-age population. Clinical status impacts on the timing and planning of surgery. In the last year small gauge vitrectomy has become safer and more efficient, extending the range of pathologies successfully treated.Aims. To evaluate the safety and outcomes in patients with open eye injury with retained foreign body that underwent early 25-gauge vitrectomy.Methods. In this retrospective, noncomparative, interventional case series, we performed 25-gauge vitrectomy on 10 patients affected by open globe injuries with retained foreign body, over 3 years. We analyzed age, wound site, foreign body characteristics, ocular lesions correlated, relative afferent pupillary defect, visual acuity, and intraocular pressure. Follow-up evaluations were performed at 1, 3, and 6 months. According to the clinical status we performed other procedures to manage ocular correlated lesions.Results. The median age of patients was 37 years. The foreign body median size was 3.5 mm (size range, 1 to 10 mm). 25-gauge vitrectomy was performed within 12 hours of trauma. Foreign body removal occurred via a clear corneal or scleral tunnel incision or linear pars plana scleral access. Visual acuity improved in all patients. Endophthalmitis was never reported. Only two cases reported postoperative ocular hypertension resolved within the follow-up. Retinal detachment recurred in one case only.Conclusions. 25-gauge vitrectomy could be considered as early approach to manage open globe injuries with a retained posterior segment foreign body in selected cases with good outcomes and low complication rate.


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