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

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.

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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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Factors Affecting Final Functional Outcomes in Open-Globe Injuries and Use of Ocular Trauma Score in Nepalese population

10.21203/rs.3.rs-86664/v1 ◽

2020 ◽

Author(s):

Saurav Man Shrestha ◽

Casey Leigh Anthony ◽

Justin A. Grant ◽

Madhu Thapa ◽

Jyoti Baba Shrestha ◽

...

Keyword(s):

Visual Acuity ◽

Ocular Trauma ◽

Final Visual Acuity ◽

Delayed Presentation ◽

Ocular Trauma Score ◽

Visual Outcomes ◽

Open Globe ◽

The Mean ◽

Trauma Score ◽

Open Globe Injuries

Abstract Background: Open globe injury (OGI) is one of the most devastating form of ocular trauma. The aim of the study is to identify the epidemiology and predict visual outcomes in traumatic open globe injuries using ocular trauma score (OTS) and correlate with final visual acuity (VA) at 3 months. Methods: Patients older than 5 years, presenting to B.P. Koirala Lions Centre for Ophthalmic Studies (BPKLCOS) from March 2016- March 2017 with OGI that met inclusion criteria were evaluated. Patient profile, nature and cause of injury, and time to presentation were recorded. Patients were managed accordingly and followed up to 3 months. An OTS score for each patient was calculated and raw scores were categorized accordingly. The VA after 3 months were compared to the predicted OTS values. Results: Seventy-three eyes of 72 patients were examined. 76% were male, and the mean age was 26.17 years (median, 23.5 years). The mean time from injury to presentation was <6 hours (30 patients, 41%). Thirty-seven eyes (51%) had zone I trauma, followed by twenty eyes (27%) with zone II, and sixteen eyes (22%) with zone III trauma. Sixty-five patients (90%) were managed surgically, and fifty (68%) received intravitreal antibiotics with steroid. When compared, the projected VA as per OTS were able to predict actual final visual outcomes in 60% of the eyes with OGI of various zones (p<0.05). Conclusion: OTS can be an accurate predictive tool for final visual acuity even with a short follow up period of 3 months; with poor presenting visual acuity, delayed presentation, posterior zones of injury, need for intravitreal injections, endophthalmitis, and globe rupture associated with poorer prognosis.

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Factors affecting final functional outcomes in open‐globe injuries and use of ocular trauma score as a predictive tool in Nepalese population

BMC Ophthalmology ◽

10.1186/s12886-021-01819-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Saurav M. Shrestha ◽

Casey L. Anthony ◽

Grant A. Justin ◽

Madhu Thapa ◽

Jyoti B. Shrestha ◽

...

Keyword(s):

Visual Acuity ◽

Ocular Trauma ◽

Final Visual Acuity ◽

Predictive Tool ◽

Ocular Trauma Score ◽

Visual Outcomes ◽

Open Globe ◽

The Mean ◽

Trauma Score ◽

Open Globe Injuries

Abstract Background Open globe injury (OGI) is one of the most devastating form of ocular trauma. The aim of the study is to identify the epidemiology and predict visual outcomes in traumatic open globe injuries using ocular trauma score (OTS) and correlate with final visual acuity (VA) at 3 months. Methods Patients older than 5 years, presenting to B.P. Koirala Lions Centre for Ophthalmic Studies (BPKLCOS) from March 2016- March 2017 with OGI that met inclusion criteria were evaluated. Patient profile, nature and cause of injury, and time to presentation were recorded. Patients were managed accordingly and followed up to 3 months. An OTS score for each patient was calculated and raw scores were categorized accordingly. The VA after 3 months were compared to the predicted OTS values. Results Seventy-three eyes of 72 patients were examined. 76 % were male, and the mean age was 26.17 years (median, 23.5 years). The mean time from injury to presentation was < 6 hours (30 patients, 41 %). Thirty-seven eyes (51 %) had zone I trauma, followed by twenty eyes (27 %) with zone II, and sixteen eyes (22 %) with zone III trauma. Sixty-five patients (90 %) were managed surgically, and fifty (68 %) received intravitreal antibiotics with steroid. When compared, the projected VA as per OTS were able to predict actual final visual outcomes in 60 % of the eyes with OGI of various zones. Conclusions OTS can be an accurate predictive tool for final visual acuity even with a short follow up period of 3 months; with poor presenting visual acuity, delayed presentation, posterior zones of injury, need for intravitreal injections, endophthalmitis, and globe rupture associated with poorer prognosis.

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Prognostic factors and epidemiology of adult open globe injuries from Western Sydney: a twelve-year review

BMC Ophthalmology ◽

10.1186/s12886-021-01929-z ◽

2021 ◽

Vol 21 (1) ◽

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 Background To identify prognostic factors determining final visual outcome following open globe injuries. Methods Retrospective 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. Results A 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. Conclusions Poor 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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Comparison of the Ocular Trauma Score and Pediatric Ocular Trauma Score as Two Prognostic Models in Pediatric Open Globe Injuries

Klinische Monatsblätter für Augenheilkunde ◽

10.1055/a-1194-5104 ◽

2020 ◽

Author(s):

Dusica Pahor ◽

Tomaz Gracner

Keyword(s):

Visual Acuity ◽

Ocular Trauma ◽

Final Visual Acuity ◽

Prognostic Models ◽

Ocular Trauma Score ◽

Open Globe ◽

Significant Difference ◽

Trauma Score ◽

Pediatric Ocular Trauma ◽

Open Globe Injuries

Abstract Aim To compare the ocular trauma score (OTS) and the pediatric ocular trauma score (POTS) as prognostic models of visual outcome after open globe injury in children during a period of 19 years. Patients and Methods A retrospective study of 36 open globe injuries in 36 patients younger than 18 years was conducted from January 2000 to January 2019. For each case, OTS and POTS points were calculated. Results Significant differences were observed in our patients using the two models regarding categories 1 to 4. One third of the cases were in categories 1 and 2 using the OTS model, and nearly 60% using the POTS model. Nearly 60% of our patients were in categories 3 and 4 using the OTS model and 30.6% using the POTS model. In category 5, no difference was observed between the two models. The comparison of distribution of the percentage of final visual acuity between OTS and POTS model in each category revealed a significant difference in category 1 in final visual acuity 20/40 or more (25 vs. 50%) as well as in final visual acuity 20/20 (0 vs. 30%). In category 2, final visual acuity was not significantly different in 20/40 or more between the two models; however, there was a significant difference in final visual acuity 20/20 – 12.5% in the OTS model and 45.5% in the POTS model. In category 3, significant differences were revealed between the two models. Using the OTS model, final visual acuity 20/40 or more was observed in more than 60% and using POTS model in 100%; final visual acuity 20/20 was observed in 36.3% using OTS model and in 50% using POTS model. In category 4 and 5, no differences were observed between OTS and POTS models. Conclusion Our study did not confirm the benefit of POTS. The distribution of our cases among OTS categories demonstrated a significant difference between the two models with more cases distributed in lower categories in POTS group. In the POTS group, the prognosis for final visual acuity was significantly better in the first three categories than in the OTS group, probably as a result of a lower calculation for POTS points. In our opinion, the OTS model is easier to use, has a higher prognostic accuracy, and should be further used in counselling of paediatric cases.

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An Uncommon Meridional Globe Rupture due to Blunt Eye Trauma

Case Reports in Emergency Medicine ◽

10.1155/2018/1808509 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Krishan Kumar ◽

Rick Figurasin ◽

Swati Kumar ◽

Muhammad Waseem

Keyword(s):

Ocular Trauma ◽

Severe Form ◽

Open Globe Injury ◽

Unique Case ◽

Pertinent Literature ◽

Eye Trauma ◽

Globe Rupture ◽

Open Globe ◽

Blunt Eye Trauma ◽

Blunt Ocular Trauma

Open globe injury (OGI) is a severe form of eye trauma. It is an important cause of monocular blindness worldwide. Ruptures from blunt trauma are most common at the sites where the sclera is thinnest, at the insertions of the extraocular muscles, and at the limbus. Most often, rupture is equatorial. We present a unique case of open globe injury due to blunt ocular trauma from a thrown rock that resulted in a meridional rupture of the eye. The pertinent literature is reviewed.

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

European Journal of Ophthalmology ◽

10.1177/1120672118818013 ◽

2018 ◽

Vol 30 (2) ◽

pp. 269-274 ◽

Cited By ~ 2

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.

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An Important Cause of Blindness in Children: Open Globe Injuries

Journal of Ophthalmology ◽

10.1155/2016/7173515 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

Meral Yildiz ◽

Sertaç Argun Kıvanç ◽

Berna Akova-Budak ◽

Ahmet Tuncer Ozmen ◽

Sadık Gorkem Çevik

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Visual Impairment ◽

Primary Repair ◽

Final Visual Acuity ◽

Who Criteria ◽

Open Globe ◽

The Mean ◽

And Gender ◽

Open Globe Injuries

Objective. Our aim was to present and evaluate the predictive factors of visual impairment and blindness according to WHO criteria in pediatric open globe injuries.Methods. The medical records of 94 patients younger than 18 years who underwent primary repair surgery were reviewed retrospectively. The initial and final visual acuity, anterior and posterior segment findings, and zone of injury were noted. The patients were classified as blindness in one eye or visual impairment in one eye.Results. Of 412 patients who presented with open globe injury, 94 (23%) were under 18 years old. Fifty-four (16 females, 38 males) children were included. The mean age of the children was 7.1 ± 4.1 years. According to WHO criteria, 19 of 54 patients (35%) had unilateral blindness and 8 had unilateral visual impairment (15%). There was no significant relationship between final visual acuity and gender and injured eye. In visually impaired and blind patients, presence of preoperative hyphema, retinal detachment, and zone 2 and zone 3 injuries was significantly higher.Conclusion. Presence of hyphema and zone 2 and zone 3 injuries and retinal detachment may end up with visual impairment and/or blindness in children.

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Complete Visual Rehabilitation in a Patient with No Light Perception after Surgical Management of a Penetrating Open-Globe Injury: A Case Report

Case Reports in Ophthalmology ◽

10.1159/000434636 ◽

2015 ◽

Vol 6 (2) ◽

pp. 204-209 ◽

Cited By ~ 1

Author(s):

Tania A. Baban ◽

Fady K. Sammouh ◽

Haytham M. El Ballouz ◽

Elias L. Warrak

Keyword(s):

Decision Making ◽

Case Report ◽

Poor Prognosis ◽

Ocular Trauma ◽

Light Perception ◽

Patient Counseling ◽

Open Globe Injury ◽

Visual Rehabilitation ◽

Open Globe ◽

Open Globe Injuries

Open-globe injuries with no light perception (NLP) carry a poor prognosis, and many ophthalmologists select a primary enucleation or evisceration as a result. We present a case of complete visual rehabilitation in a patient who presented with NLP after a zone III penetrating open-globe injury. We recommend patient counseling regarding decision making and management of ocular trauma with NLP, since timely intervention and close follow-ups may restore useful or complete vision even in severely traumatized eyes.

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