Consultation with the Specialist

1992 ◽  
Vol 13 (4) ◽  
pp. 127-129
Author(s):  
Betty R. Klein ◽  
Marvin L. Sears

Optimal management of eye trauma requires a careful history, a controlled examination, protective measures to limit the damage and prevent infection, and swift triage to an ophthalmologist. Personnel in the emergency department or office can accomplish these goals and save the patient permanent visual disability. How Does One Evaluate Trauma to the Eye? A systematic approach emphasizing history, visual acuity, and external examination are essential in the evaluation of eye injuries. The history should be detailed and should note the mechanism of injury, the events following the injury, preexisting eye disorders, systemic disorders, drug allergies, contraindications to anesthesia, when the patient last ate, and prior tetanus immunization. If ocular perforation, laceration, or intraocular foreign body is suspected, treat the patient as if preoperatively, allowing nothing by mouth, and consider intravenous antibiotics to protect against exogenous endophthalmitis. Visual acuity examination must be performed in every case. Measure the visual acuity in each eye separately with corrective lenses in place. A near card may be used for examination at bedside. Picture cards and charts are available for measuring acuity in children age 3 to 6 years. Preverbal children can be tested grossly by allowing them to reach for a small toy with one or the other eye covered.

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Katarzyna Nowomiejska ◽  
Tomasz Choragiewicz ◽  
Dorota Borowicz ◽  
Agnieszka Brzozowska ◽  
Joanna Moneta-Wielgos ◽  
...  

Purpose.To evaluate functional and anatomical results of pars plana vitrectomy (PPV) in the retinal detachment (RD) followed by severe eye trauma.Methods.Retrospective analysis of medical records of forty-one consecutive patients treated with 23-gauge PPV due to traumatic RD. Age, gender, timing of PPV, visual acuity, and presence of intraocular foreign body (IOFB) and proliferative vitreoretinopathy (PVR) were included in the analysis.Results.Mean age of patients was 47 years; the majority of patients were men (88%). Closed globe injury was present in 21 eyes and open globe injury in 20 eyes (IOFB in 13 eyes, penetration injury in 4 eyes, and eye rupture in 3 eyes). Mean follow-up period was 14 months; mean timing of PPV was 67 days. Twenty-seven (66%) eyes had a functional success; 32 eyes (78%) had anatomical success. As a tamponade silicone oil was used in 33 cases and SF6 gas in 8 cases.Conclusions.Severe eye injuries are potentially devastating for vision, but vitreoretinal surgery can improve anatomical and functional outcomes. Among analysed pre- and intra- and postoperative factors, absence of PVR, postoperative retinal attachment, and silicone oil as a tamponade were related to significantly improved visual acuity.


2012 ◽  
Vol 59 (1) ◽  
pp. 101-104 ◽  
Author(s):  
Milos Jovanovic ◽  
Anica Bobic-Radovanovic ◽  
Dragan Vukovic ◽  
Vujica Markovic

Purpose: The analysis of ten unusual eye injuries, and the discussion of appropriate preventive measures. Case outline: Ten patients hospitalized at the Clinic of Eye Diseases, Clinical Center of Serbia, Belgrade, in the period from January 2000. to December 2009. were presented. Following data were taken in account: sex and age of the patient, injured eye, the mechanism of injury, type of the injury, applied treatment and final visual acuity. The circumstances of the eye injuring of ten patients were described. The eye injuries in all cases occurred in a bizarre way and they were severe enough to require hospital admission. The surgery was necessary in seven patients. Three injured eyes resulted in blindness, and two additional had subnormal vision. Conclusion: In three quarters of discussed cases injuries can be avoided. It is necessary to implement protective measures constantly and consistently and to think about the possible consequences of certain activities. Particular attention should be paid on safety of children. The iatrogenic injuries require special consideration.


2020 ◽  
Vol 21 (3) ◽  
pp. 106-108
Author(s):  
M. N. Ponomareva ◽  
◽  
S. V. Sakharova ◽  
E. M. Pochinok ◽  
E. V. Fomina ◽  
...  

Aim. To identify current trends in hospital eye trauma based on the materials of the specialized ophthalmology department of a round-the-clock hospital. Materials and methods. The analysis of medical records of patients treated in the round-the-clock specialized ophthalmology department of the state medical establishment OKB No. 2 in the period since January 2017-2019. Results. During the analyzed period, 4948 patients were treated, of which 218 patients (5.6%) were identified for nosologies belonging to the category of eye trauma. Men are most often exposed to eye injuries (84%), in addition, in 62% of cases, these are young patients (18-44 years). The structure of eye trauma is almost unchanged: the leading position is occupied by penetrating wounds of the eyeball and contusions, the third place is occupied by burns, through wounds of the eyeball are rare. Conclusions. Given the poor prognosis of the outcome of a severe eyeball injury, it requires the introduction of modern types of microsurgical intervention using endovitreal surgery at the present stage.


2006 ◽  
Vol 134 (1-2) ◽  
pp. 11-21 ◽  
Author(s):  
Milos Jovanovic

Introduction. Some factors significant for development of mechanical injuries of the eyeball have been analyzed in the study. Objective. Basic objective of such analysis was prevention and reduction of these injuries. Method. Mechanical injuries of the eyeball in patients hospitalized at the Institute of Eye Disease, CCS in Belgrade, in five year period have been analyzed. Only patients with severe eye injuries were hospitalized. The following parameters were analyzed: sex, age, occupation of patients, residence, time of the inflicted injury, i.e. by months in a year, days in a week and hours in a day, place and way of inflicting the injury as well as visual acuity on admission. In addition, the type of injury was analyzed, i.e. contusion or penetrating with all resulting complications. Finally, the timing of primary surgical management of the eye injury was specified, if required. Results. A total number of hospitalized patients with mechanical eye injuries was 1642 during the last five years, meaning that one injury occurred daily. There were 1381 males and 261 females, meaning that males were 5.3 times more the victims of mechanical eye injuries. Out of all the injured, 861 (52.4%) were from rural environment, while 781 (47.6%) were urban population. The proportion of injuries of the right or the left eye was nearly equal, while both eyes were simultaneously injured in 21 (1.3%) cases. The injuries were inflicted in all ages, but most frequently in working population ranging from 16 to 55 years, accounting for 60.8%. Unfortunately, a lot of the injured were children up to 15 years of age - 19.4%. The most commonly injured were workers - 39.8%, followed by students - 17.5%. A piece of wood was the cause of injury in 21.8%, sharp and pointed objects in 17.2%, hammer and metal in 14.2%, glass in 11.6%, and other different causes in varying percentage. There were also rare causes of injuries, such as those caused by zip, dog bite, rooster?s bill, etc. According to months in a year and days in a week, the injuries were almost evenly distributed. Considering the period of a day, even 77.4% of the injuries occurred during daytime, from 10 a.m. to 10 p.m. The highest percentage - 43.5% - of the injuries occurred while working something out of working place, while 24.5% of injuries were inflicted at working places. On admission, the majority of patients - 32.9% had visual acuity L+P+, but this visual acuity ranged from amaurosis to 1.0. There were 746 (45.4%) contusion injuries and 870 (53.0%) penetrating injuries. The rest were the injuries of other ocular adnexa. The majority of primary wound managements were performed in the first 24 hours of the injury - 67.1%. Conclusion. It may be concluded that working population and students are most commonly injured, and that men are five times more frequently injured than women; then, a piece of wood, sharp objects and glass are the most often causes of injury; the number of contusion and penetrating injuries is equal, and that required primary surgical wound management is most often performed in the first 24 hours from the injury. Further analysis of these factors suggests that many of these injuries could have been prevented, and consequently long-term treatment and treatment costs could have been evaded. Most important is that permanent disability due to visual impairment or even blindness of the injured eye could have been avoided.


2013 ◽  
Vol 141 (9-10) ◽  
pp. 586-591 ◽  
Author(s):  
Milos Jovanovic ◽  
Aleksandar Medarevic ◽  
Miroslav Knezevic ◽  
Vera Krstic

Introduction. Eye injuries represent a significant problem in children. Objective. The aim of the study was to determine the incidence and causes of the eye injury and to propose measures of the eye injury prevention in children up to 15 years of age. Methods. This was a retrospective study of 552 children with the eye injuries treated at the Clinic of Eye Diseases in Belgrade during the period March 1999 to February 2010. Gender and age of the children, time of injury, the type and site of injuries, visual acuity upon admission and at discharge, as well as the time of surgery in relation to time of injury were analyzed. Results. The ratio between the injured boys and girls was 3.6:1. The highest percentage of injured children was in the group 6-10 years old (39.7%); the injuries were almost evenly distributed according to months during the year and days during the week. The percentages of severe closed and open injuries of the eyeball were almost equal. Visual acuity upon discharge and subsequent follow-up examinations were significantly improved after the applied treatment in comparison with the visual acuity upon admission. Conclusion. Eye injuries in children still represent a severe health problem. Regarding the youngest age group of children, adults are mainly responsible for these injuries due to their lack of attention, while in older children these injuries are the result of the production and distribution of inappropriate toys and a failure to implement the legal traffic regulations applicable to children. The prevention of eye injuries is essential.


2017 ◽  
Vol 8 (1) ◽  
pp. 13-20 ◽  
Author(s):  
Shih Hao Wang ◽  
Chen Chee Lim ◽  
Yu Ti Teng

A case of choroidal rupture caused by airbag-associated blunt eye trauma and complicated with massive subretinal hemorrhage and vitreous hemorrhage that was successfully treated with intravitreal injection of expansile gas and bevacizumab is presented. A 53-year-old man suffered from loss of vision in his right eye due to blunt eye trauma by a safety airbag after a traffic accident. On initial examination, the patient had no light perception in his right eye. Dilated ophthalmoscopy revealed massive subretinal hemorrhage with macular invasion and faint vitreous hemorrhage. We performed intravitreal injection of pure sulfur hexafluoride twice for displacement, after which visual acuity improved to 0.03. For persistent subretinal hemorrhage and suspicion of choroidal neovascularization (CNV), intravitreal bevacizumab (1.25 mg/0.05 mL) injection was administered. After 3 weeks, the visual acuity of his right eye recovered to 0.4. For early-stage choroidal rupture-induced subretinal hemorrhage and complications of suspected CNV, intravitreal injection of expandable gas and intraocular injection of antiangiogenesis drugs seem to be an effective treatment.


Author(s):  
Jessica J. Otis ◽  
Jill Ann Nerby

A child with aniridia is being placed in your classroom, and you may be wondering whether their needs are different from those of your other students. This information has been written to answer any questions or concerns about this new teaching experience. When a child with a visual disability is enrolled in a regular class, careful consideration is given to assess whether he or she can compete both academically and socially. Although he or she may need to cope with visual and emotional stresses usually not encountered by non-disabled children, he or she will soon become a fully participating member of the class. In order to ensure that the child with aniridia has the opportunity to reach their full academic potential, the child and you will hopefully receive the supportive services of a special teacher of the visually impaired (VI teacher) to discuss classroom situations. A child with aniridia is generally considered eligible for special services of a resource and/or VI teacher if their measured visual acuity is 20/70 or less in the better eye with corrective lenses (in other words, if what he or she can see at twenty feet is no more than what a person with normal vision sees at seventy feet). Children who have a measured visual acuity of 20/200 or less in the better/corrected eye or who have a visual field of no greater than twenty degrees are classified as legally blind. Aniridia is a partial or complete absence of the iris, and it may be associated with other ocular defects such as macular and optic nerve hypoplasia, cataract, corneal surface abnormalities that lead to decreased vision, and nystagmus. The vision may fluctuate, depending on lighting conditions and glare. Glaucoma is a secondary problem causing additional visual loss over time. Because of poor visual acuity and nystagmus, low-vision aids are very helpful. Lifelong regular follow up care is necessary for early detection of any new problem so that timely treatment is given.


2020 ◽  
Author(s):  
Nika Vrabič ◽  
Bor Juroš ◽  
Manca Tekavčič Pompe

Objective. To establish an automated visual acuity test (AVAT) for infants, based on preferential looking technique and controlled with remote eye tracking. To validate the AVAT in a group of healthy children. To compare AVAT visual acuity (VA) values with corresponding VA values, acquired with standard tests (ST). Methods. ST, adapted for age (Keeler acuity cards in preverbal children, LEA symbols in verbal children), was performed to obtain monocular VA in a group of 36 healthy children. During AVAT, nine different stimuli with grating circles that matched spatial frequencies of nine Keeler acuity cards (raging between 0.29–14.5 cycles per degree) were projected on a screen. Three repetitions of each stimulus were showed during nine-second intervals, interchanging with an attention grabber. The remote eye tracker was used to evaluate the proportion of time a child spent looking at each grating circle compared to a homogenous grey background that matched the grating stimuli in average luminance. From this proportion of time child's binocular VA was evaluated. Results. 97 % (35/36) of healthy children successfully completed ST and AVAT. There was an agreement between the results of a ST and AVAT, Lin’s concordance coefficient being 0,53 (95% CI= 0,31–0,72). A tendency was observed towards VA overestimation on AVAT for children with VA> 0.4 logMAR on ST and towards VA underestimation on AVAT for children with VA ≤ 0.4 logMAR on ST. Conclusions. AVAT requires a minimally skilled investigator. The evaluation of better eye monocular VA on ST and binocular VA on AVAT were comparable for healthy children.


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