scholarly journals Prognostic Factors and Epidemiology of Open Globe Injuries from Western Sydney: A Twelve-Year Review

Author(s):  
Haochi Ho ◽  
Jane Foo ◽  
Yi-Chiao Li ◽  
Samantha Bobba ◽  
Christopher Go ◽  
...  

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.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Haochi Ho ◽  
Jane Foo ◽  
Yi-Chiao Li ◽  
Samantha Bobba ◽  
Christopher Go ◽  
...  

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.


2019 ◽  
Vol 103 (10) ◽  
pp. 1491-1494 ◽  
Author(s):  
Richard J Blanch ◽  
Jonathan Bishop ◽  
Hedayat Javidi ◽  
Philip Ian Murray

Background/AimHistoric data suggest that open globe injuries should be repaired within 12–24 hours to reduce the risk of endophthalmitis. However, endophthalmitis is uncommon when systemic antibiotic prophylaxis is given. It is not clear whether delayed primary repair impacts visual outcomes in other ways or what is the optimum time to repair. We aimed to examine the effect of time to primary repair on visual outcomes.MethodsThis is a retrospective comparative case series including all open globe injuries presenting to the Birmingham Midland Eye Centre between 1 January 2014 and 15 March 2016. Presenting features, mechanism of injury, visual acuity at 6–12 months and demographic data were examined.Results56 open globe injuries were repaired, of which sufficient data for analysis were available on 52 cases. The mean time to primary repair was 1 day after injury (range 5 hours to 7 days). Final visual acuity at 6–12 months was related to the presenting visual acuity and the Ocular Trauma Score and to the time between injury and primary repair, with a reduction in predicted visual acuity of logarithm of the minimum angle of resolution of 0.37 for every 24 hours of delay (95% CI 0.14 to 0.6).DiscussionOpen globe injuries should be repaired promptly. Presenting visual acuity remains the strongest predictor of outcome; however, delay to primary repair also reduced final visual acuity, and any significant delay from injury to repair is likely to negatively impact final visual outcome.


2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Meral Yildiz ◽  
Sertaç Argun Kıvanç ◽  
Berna Akova-Budak ◽  
Ahmet Tuncer Ozmen ◽  
Sadık Gorkem Çevik

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.


2021 ◽  
Vol 14 (8) ◽  
pp. 1237-1240
Author(s):  
Maryam Zamani ◽  
◽  
Akbar Fotouhi ◽  
Morteza Naderan ◽  
Mohammad Soleimani ◽  
...  

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.


2020 ◽  
Author(s):  
Saurav Man Shrestha ◽  
Casey Leigh Anthony ◽  
Justin A. Grant ◽  
Madhu Thapa ◽  
Jyoti Baba Shrestha ◽  
...  

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.


2011 ◽  
Vol 71 (6) ◽  
pp. 1794-1800 ◽  
Author(s):  
Ozlem Yalcin Tök ◽  
Levent Tok ◽  
Elif Eraslan ◽  
Dilek Ozkaya ◽  
Firdevs Ornek ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saurav M. Shrestha ◽  
Casey L. Anthony ◽  
Grant A. Justin ◽  
Madhu Thapa ◽  
Jyoti B. Shrestha ◽  
...  

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.


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.


2021 ◽  
Vol 11 (2) ◽  
pp. 297-300
Author(s):  
Nazia Imam ◽  
Mobashir Sarfraz Ali ◽  
Bibhuti Prassan Sinha ◽  
Gyan Bhaskar ◽  
Rakhi Kusumesh

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.


Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1198
Author(s):  
Edita Puodžiuvienė ◽  
Gabrielė Valeišaitė ◽  
Reda Žemaitienė

Background and Objectives: Open globe injuries (OGI) remain an important cause of visual impairment and loss, impacting all ages. A better understanding of the factors influencing visual outcomes is important in an attempt to improve the results of the treatment of OGI patients. The author aimed to contribute to this knowledge with the analysis of clinical characteristics, prognostic factors, and visual outcomes of their cohort of OGI patients. Materials and Methods: A retrospective medical record review was performed for 160 patients (161 eyes) who sustained an open globe injury between January 2015 and December 2017 and presented to the Hospital of Lithuanian University of Health Sciences. Data analyzed included age, sex, type, cause, place of OGI, initial visual acuity (VA), final best-corrected visual acuity (BCVA), and tissue involvement. Open globe injuries were classified using the Birmingham Eye Trauma Terminology (BETT) and Ocular Trauma Classification System (OTCS). Univariate analysis was conducted to evaluate the prognostic factors. Results: The mean age of the patients was 41.9 years. The male-to-female ratio was found to be 8.4:1. The home was the leading place of eye injury (59.6%), followed by an outdoor environment (14.3%) and workplace (11.8%). Penetrating injury accounted for 43.5%, followed by intraocular foreign body injury (39.1%) and globe rupture (13%). Overall, 19.5% of patients regained a good final vision of ≥0.5, but for 48.1% of them, eye trauma resulted in severe visual impairment (BCVA ≤ 0.02). In the univariate analysis, a bad visual outcome of less than 0.02 was correlated with bad initial VA, iris dialysis, hypotony, vitreous hemorrhage, and vitreous prolapse at presentation. Phthisis bulbi was correlated with eyelid laceration, iris prolapse, iris dialysis, hyphema, vitreous prolapse, vitreous hemorrhage, and choroidal rupture at initial examination. Conclusions: Open globe injury remains an important preventable cause of ocular morbidity. This study provides data indicating that open globe injuries are a significant cause of visual impairment in our research group.


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