scholarly journals Ocular injuries caused by airsoft guns: Ten-year experience

2012 ◽  
Vol 59 (3) ◽  
pp. 73-76 ◽  
Author(s):  
Milos Jovanovic ◽  
Anica Bobic-Radovanovic ◽  
Dragan Vukovic ◽  
Miroslav Knezevic ◽  
Dusica Risovic
Keyword(s):  
Visual Acuity ◽  
Age Groups ◽  
Anterior Segment ◽  
Vitreous Hemorrhage ◽  
Corneal Edema ◽  
Posterior Segment ◽  
Initial Examination ◽  
Globe Rupture ◽  
Duration Of Hospitalization ◽  
Ocular Injuries

INTRODUCTION: The study describes ocular injuries caused by airsoft guns pellets, type of these injuries and their incidence in different age groups. METHODS: This is a retrospective review of medical charts of patients who were hospitalized due to airsoft guns ocular injuries in ten-year period (from 2000 to 2009). Patient?s age, gender, duration of hospitalization, type of treatment and initial and final visual acuity were analyzed. RESULTS: Overall 92 patients with ocular injuries caused by airsoft gun pellets were hospitalized in tenyear period. In all patients only one eye was injured and there were 72 (78.3%) male patients. Injuries involved ocular adnexa, anterior and posterior segment of the eye. On initial examination 41 (44.6%) patients were presented with subconjunctival hemorrhages, 42 (45.6%) with corneal abrasion, 42 (45.6%) patients had corneal edema, 6 (6.5%) had traumatic mydriasis, 90 (97.8%) patients exhibited hyphema, 10 (10.9%) iridodialysis, in 27 (29.3%) patients high intraocular pressure (IOP) was measured, one patient had subluxation of intraocular lens (IOL) and one patient had traumatic cataract. Posterior segment findings included vitreous hemorrhage in 3 (3.3%) patients, retinal hemorrhage in 15 (16.3%) patients, retinal edema in 35 (38.0%) patients and one patient had globe rupture. Average duration of hospitalization was 5.7 days (range from 1 to 18 days). Three patients (3.3%) required eye surgery, eight patients (8.7%) had anterior chamber washout while rest of the patients were conservatively managed. Visual acuity at hospital release was significantly improved comparing to initial visual acuity, ranging from counting fingers at 1 meter to 20/60 in 7 (8.6%) patients, from 20/50 to 20/30 in 13 (16.0%) patients and from 20/25 to 20/20 in 61 (75.3%) patients. In 11 patients testing the visual acuity was not possible because of their young age. CONCLUSION: Injuries attributed to airsoft guns were confined mostly to anterior segment. There was also high percentage of severe posterior segment trauma requiring hospital admission. The most important factors in preventing such injuries are restricting access to airsoft guns, especially to minors, as well as mandatory use of protective equipment such as protective eyeglasses.

scholarly journals Airbag-Associated Severe Blunt Eye Injury Causes Choroidal Rupture and Retinal Hemorrhage: A Case Report

2017 ◽  
Vol 8 (1) ◽  
pp. 13-20 ◽  
Author(s):  
Shih Hao Wang ◽  
Chen Chee Lim ◽  
Yu Ti Teng
Keyword(s):  
Visual Acuity ◽  
Intravitreal Injection ◽  
Sulfur Hexafluoride ◽  
Early Stage ◽  
Vitreous Hemorrhage ◽  
Subretinal Hemorrhage ◽  
Initial Examination ◽  
Eye Trauma ◽  
Choroidal Rupture ◽  
Blunt Eye Trauma

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.

Comparison between Outcomes of Vitrectomy in Granulomatous and Nongranulomatous Uveitis

2015 ◽  
Vol 235 (1) ◽  
pp. 18-25 ◽  
Author(s):  
Kei Takayama ◽  
Atushi Tanaka ◽  
Sho Ishikawa ◽  
Manabu Mochizuki ◽  
Masaru Takeuchi
Keyword(s):  
Visual Acuity ◽  
Immunosuppressive Therapy ◽  
Anterior Segment ◽  
Ocular Inflammation ◽  
Posterior Segment ◽  
Ocular Complications ◽  
Granulomatous Uveitis ◽  
The Mean ◽  
Inflammation Score

Purpose: The aim of this study was to compare the outcomes of vitrectomy in granulomatous uveitis and nongranulomatous uveitis insufficiently managed by immunosuppressive therapy. Methods: Thirty-eight eyes with granulomatous uveitis and 17 eyes with nongranulomatous uveitis that underwent vitrectomy for ocular complications between July 2006 and August 2012 were reviewed retrospectively. Visual acuity and ocular inflammation scores before and 6 months after surgery were compared. Patients treated with vitrectomy alone and those in whom vitrectomy was combined with phacoemulsification were analyzed separately. Results: The mean visual acuity improved significantly both in granulomatous and nongranulomatous uveitis. In granulomatous uveitis, the mean inflammation scores decreased significantly both in the anterior segment and in the posterior segment. In nongranulomatous uveitis, the mean inflammation score in the posterior segment decreased significantly, although it did not change in the anterior segment. Conclusion: Vitrectomy was effective for treating ocular complications both in granulomatous uveitis and nongranulomatous uveitis, with favorable outcomes of improved visual acuity and decreased uveitis activity.

scholarly journals A rare case of cytomegalovirus papillitis in patient with immunodeficiency

2016 ◽  
Vol 25 (3) ◽  
pp. 190-4
Author(s):  
Dinda A. Devona ◽  
Made Susiyanti
Keyword(s):  
Visual Acuity ◽  
Serological Test ◽  
Anterior Segment ◽  
Posterior Segment ◽  
Ocular Infection ◽  
Light Perception ◽  
Blurred Vision ◽  
Cmv Retinitis ◽  
Counting Finger ◽  
Test Result

A 26-year-old male diagnosed with AIDS came with sudden blurred vision and central sco-toma in left eye since 2 weeks before admission. His visual acuity was counting finger at 5 meters with normal IOP and anterior segment. The posterior segment revealed edematous optic nerve covered by exudates and hemorrhages. Due to low CD4+ count and serological test result, we considered a HIV-related opportunistic ocular infection, specifically HSV infection. As visual acuity worsened during treatment with acyclovir, we performed PCR ex-amination from aqueous tap which revealed positive CMV DNA. Unfortunately, the visual acuity had worsened to no light perception before he received any specific anti-CMV agent. CMV papillitis is an unusual presentation of CMV retinitis. PCR examination from aqueous or vitreous tap should be performed while waiting for serological test result, especially in doubtful cases. Therefore, appropriate diagnosis and management can be established early to prevent irreversible visual loss.

Intracameral r-tPA for the management of severe fibrinous reactions in TASS after cataract surgery

2021 ◽  
pp. 112067212110020
Author(s):  
Perach Osaadon ◽  
Nadav Belfair ◽  
Itay Lavy ◽  
Eyal Walter ◽  
Jaime Levy ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Anterior Segment ◽  
Case Series ◽  
Corneal Edema ◽  
Recombinant Tissue Plasminogen Activator ◽  
Maximal Effect ◽  
Corrected Visual Acuity ◽  
Tissue Plasminogen

Background: To describe the use of intracameral recombinant tissue plasminogen activator (r-tPA) in the treatment of severe fibrinous reactions in toxic anterior segment syndrome (TASS) after cataract surgery. Methods: A case series of 59 eyes of 59 patients with severe fibrinous anterior chamber reaction following cataract surgery who received intracameral r-tPA (25 µg/0.1 ml). The main outcome measures after intracameral r-tPA were the incidence of complete fibrinolysis, time of maximal effect, visual acuity, and complications. Results: Severe fibrinous reactions appeared 11.5 ± 5.3 days after cataract surgery. Fibrinolysis was observed 2.33 ± 2.70 days after rtPA use and 36 eyes (61%) exhibited resolution of the fibrin by the end of the first day following injection ( p < 0.001). Transient corneal edema observed at 1-day after injection was the only complication reported during the injection of r-tPA or at follow-up. Eight eyes (13.6%) required a second r-tPA injection. Best-corrected visual acuity improved from 0.88 ± 0.67 logMAR units before rtPA injection to 0.48 ± 0.49 logMAR units at 1-month ( p < 0.001). Conclusions: The application of r-tPA was a quick and efficacious therapeutic approach for the management of severe fibrinous reactions in TASS after cataract surgery. In a clinical setting, intracameral r-tPA may be useful when rapid visual recovery is needed.

scholarly journals PARS PLANA VITRECTOMY FOR VITREOUS HEMORRHAGE IN CIPTOMANGUNKUSUMO HOSPITAL

2021 ◽  
Vol 4 (2) ◽  
pp. 99
Author(s):  
Marsha Alyssa Razief Fitri ◽  
Anggun Rama Yudantha
Keyword(s):  
Visual Acuity ◽  
Pars Plana Vitrectomy ◽  
Diagnostic Procedure ◽  
Vitreous Hemorrhage ◽  
Descriptive Study ◽  
Posterior Segment ◽  
Early Vitrectomy ◽  
Systemic Control ◽  
Pars Plana

Introduction: Vitreous hemorrhage is the presence of blood in the vitreous cavity. This condition could impair the visual function and hindered the clinician’s ability to examine the posterior segment of the eye.  Pars plana vitrectomy (PPV) not only act as a surgical treatment of choice but also diagnostic procedure. Immediate PPV has the advantage to optimalize visual acuity Methods: Retrospective descriptive study of vitreous hemorrhage patients underwent pars plana vitrectomy in Ciptomangunkusumo Hospital, Indonesia from January to December 2018 Result: There were 160 cases of vitreous hemorrhage cases undergoes pars plana vitrectomy in 2018. Most frequent etiology was proliferative diabetic retinopathy (49.4%). Rebleeding was found only in 8 cases within the period of three months follow up. Final visual acuity was improved in majority of the cases and found to be related to timing of the surgery. Conclusion: Early vitrectomy along with systemic control of underlying factors lead to improvement of visual acuity in vitreous hemorrhage.  

scholarly journals THE UNDERGRADUATE MEDICAL STUDENTS’ PITFALLS IN EYE EXAMINATION STATION OF OBJECTIVE STRUCTURED CLINICAL EXAMINATION

2019 ◽  
Vol 8 (3) ◽  
pp. 144
Author(s):  
Widyandana Doni ◽  
Angela Nurini Agni ◽  
Agus Supartoto
Keyword(s):  
Visual Acuity ◽  
Medical Students ◽  
Visual Field ◽  
Clinical Examination ◽  
Anterior Segment ◽  
Posterior Segment ◽  
Objective Structured Clinical Examination ◽  
Undergraduate Medical Students ◽  
Skill Laboratory ◽  
Eye Examination

Background: High prevalence of eye disorders in Indonesia requires medical doctors to be skillful and well trained in ophthalmologic examination. Undergraduate medical students usually start their clinical simulation practice and ophthalmology assessment in a safe learning environment. Skill laboratory as the learning facility should be evaluated and improved regularly. This study aimed to evaluate student’s pitfalls in the eyes OSCE station. Methods: Descriptive analytic study involving Objective Structured Clinical Examination (OSCE) eye examination station score from 1st - 4th year undergraduate medical students batch 2010 in Faculty of Medicine, Universitas Gadjah Mada, Indonesia (n=516). All checklists’ scores were analyzed based on particular sub-scales in every examination topic to explore the most pitfalls made by students in eye examination station during OSCE. Results: The order average value of each subscale in OSCE are: Doctor patient interaction (88.42), History taking skills (82.44), Professionalism (76.43), Physical Examination (74.62), Diagnosis (60.68), Management of Pharmacotherapy (54.70). The percentage of failed-students (scores <70) in 1st-4th year OSCE based on topics skills were Year 1: Visual field (5.08%), Visual acuity (14.21%), Anterior Segment (2.54%). 2nd year: IOP by palpation (24.38%), Visual acuity (9.38%), Anterior Segment (29.38%). Year 3:  visual field (4.94%), IOP by palpation (2.47%), Visual acuity (12.35%), Anterior Segment (7.41%), Posterior Segment (22.22%). Year 4: Comprehensive eye exam (17.95%). Conclusions: Students mostly challenged in the skills of diagnosis establishment and pharmacological management. The highest number of failed students in each year OSCE vary from each year. 1st year failed most at visual acuity examination, 2nd year was anterior segment examination and 3rd year was posterior segment examination. Those three skills need to be enhanced systematically. Keywords: OSCE, pitfall pattern, eye examination, undergraduate students, skill laboratory 

Primary Combined Pars Plana Vitrectomy and Phacoemulsification With Anterior Segment Removal of Posterior Segment Intraocular Foreign Bodies: A 30-Month Longitudinal Study

2018 ◽  
Vol 2 (2) ◽  
pp. 79-86
Author(s):  
Razek Georges Coussa ◽  
Fares Antaki ◽  
Ali Dirani ◽  
Thomas Cordahi ◽  
Radwan Ajlan ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Foreign Bodies ◽  
Anterior Segment ◽  
Posterior Segment ◽  
Long Term Results ◽  
Open Globe ◽  
Pars Plana

Purpose: To describe a surgical technique and report visual and anatomical outcomes after primary combined pars plana vitrectomy (PPV) and phacoemulsification in patients with posterior segment intraocular foreign bodies (IOFBs) removed via the anterior chamber without enlarging preexisting sclerotomies. Posterior IOFBs are generally managed in a stepwise surgery consisting of phacoemulsification/lensectomy for traumatic cataract removal then PPV and removal of IOFB through enlarged sclerotomies. Enlarged sclerotomies may carry a significant risk of hypotony, vitreous hemorrhage, vitreous and retinal incarceration, and rhegmatogenous retinal detachment with proliferative vitreoretinopathy. Limited studies exist on long-term results of primary anterior segment removal of posterior IOFB combined with primary phacoemulsification. Methods: Medical records of consecutive patients who had ocular lacerations and posterior segment IOFB between October 2003 and June 2017 in a university hospital were reviewed. Patients who received a combined primary IOFB removal and phacoemulsification were included in the study. The postoperative evolution including visual acuity and complications were all recorded. Results: Thirteen patients (13 eyes) were included in the study. All patients were men, and the average age at presentation was 38 years. All IOFB were metallic, and their size ranged from 2 to 7 mm. All patients were operated within 24 hours of presentation. Six (46%) of the 13 lacerations were corneal, and 7 (54%) were scleral. Overall, 9 of 13 (69%) had a final postoperative best-corrected visual acuity equal to or better than 20 of 25. There were 3 (23%) postoperative complications of recurrent rhegmatogenous retinal detachment that occurred within the first postoperative year. Conclusion: Primary combined PPV and phacoemulsification with the removal of IOFB via the anterior segment is a safe and promising approach for repairing open globe injuries. Our results demonstrate the favorable prognostic benefit of this technique, which is recommended in cases with small corneal laceration and posterior segment pathology resulting from IOFB.

scholarly journals A modified intrascleral intraocular lens fixation technique with fewer anterior segment manipulations: 27-gauge needle-guided procedure with built-in 8-0 absorbable sutures

2019 ◽  
Author(s):  
Yuan Yang ◽  
Tengteng Yao ◽  
Yali Zhou ◽  
Yixiao Wang ◽  
Zhaoyang Wang
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Anterior Segment ◽  
Vitreous Hemorrhage ◽  
Fixation Technique ◽  
Absorbable Sutures ◽  
Corneal Endothelial Cell Density ◽  
Support Methods ◽  
Iol Fixation

Abstract Background: To report a modified surgical technique for intrascleral intraocular lens (IOL) fixation with fewer anterior segment manipulations in eyes lacking sufficient capsular support. Methods: Eyes from 14 patients who underwent 27-gauge needle-guided intrascleral IOL fixation with built-in 8-0 absorbable sutures were studied. The 8-0 absorbable sutures were inserted into 27-gauge round needles and used to create sclerotomies at the 4 o’clock and 10 o’clock positions under the scleral flap. The sutures were used to tie knots at the end of each haptic and guide haptic externalization through the sclerotomy. After externalization, a sufficient flange was created at the end of each haptic and fixed under the scleral flaps. The best corrected visual acuity (BCVA), corneal endothelial cell density (ECD), IOL tilt and decentration, previous surgery history, and complications were determined. Results: Fourteen cases were analyzed. The majority of eyes exhibited an improvement in the BCVA after surgery. When comparing the last follow-up to preoperative visual acuity, the mean change in BCVA was + 26.32 letters (p=0.011). Postoperative complications included postoperative hypotony in 3 eyes, ocular hypertension in 2 eyes. No cases of postoperative cystoid macular edema (CME), vitreous hemorrhage (VH), IOL dislocation, or endophthalmitis were observed. Conclusions: The 27-gauge needle-guided intrascleral IOL fixation technique with built-in 8-0 absorbable sutures is easy to perform with fewer anterior chamber manipulations and achieves both anatomical and optical stability.

scholarly journals A modified intrascleral intraocular lens fixation technique with fewer anterior segment manipulations: 27-gauge needle-guided procedure with built-in 8-0 absorbable sutures

2019 ◽  
Author(s):  
Yuan Yang ◽  
Tengteng Yao ◽  
Yali Zhou ◽  
Yixiao Wang ◽  
Zhaoyang Wang
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Anterior Segment ◽  
Vitreous Hemorrhage ◽  
Fixation Technique ◽  
Absorbable Sutures ◽  
Support Methods ◽  
Iol Fixation ◽  
Iol Dislocation

Abstract Background To report a modified surgical technique for intrascleral intraocular lens (IOL) fixation with fewer anterior segment manipulations in eyes lacking sufficient capsule support. Methods Eyes from 14 patients who underwent 27-gauge needle-guided intrascleral IOL fixation with built-in 8-0 absorbable sutures were studied. The 8-0 absorbable sutures were inserted into 27-gauge round needles and used to create angled sclerotomies at the 4 o’clock and 10 o’clock positions under the scleral flap. The sutures were used to tie knots at the ends of the haptics and guide haptic externalization through sclerotomy. After externalization, a sufficient flange was created at the end of the haptics and fixed under the scleral flaps. The best corrected visual acuity (BCVA), previous surgery history, and complications were determined. Results Fourteen cases were analyzed. The majority of eyes exhibited an improvement in BCVA after surgery. When comparing the last follow-up to preoperative visual acuity, the mean change in BCVA was + 26.32 letters (p=0.011). Postoperative complications included postoperative hypotony in 3 eyes, ocular hypertension in 2 eyes. No postoperative cystoid macular edema, vitreous hemorrhage, IOL dislocation, or endophthalmitis was observed. Conclusions The 27-gauge needle-guided intrascleral IOL fixation technique with built-in 8-0 absorbable sutures is easy to manipulate with fewer anterior chamber manipulations and achieves both anatomical and optical stability.

A Novel Avastin Injection Technique—“Sunalp Protocol”

2015 ◽  
Vol 08 (02) ◽  
pp. 118
Author(s):  
Murad A Sunalp ◽  
Lindsey B Buchbinder ◽  
Myhidin H Shehu ◽  
◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Adverse Events ◽  
Macular Edema ◽  
Anterior Segment ◽  
Vitreous Hemorrhage ◽  
Vitreous Cavity ◽  
Age Related Macular Degeneration ◽  
Cell Counts ◽  
Endothelial Cell Counts

Purpose: The introduction of vascular endothelial growth factor (VEGF) inhibitors began a new era in the treatment of exudative age-related macular degeneration (ARMD). These drugs are effective at suppressing choroidal neovascularization (CNV) resulting in improvement or stabilization of visual acuity; however, the chronic nature of the disease require these drugs be administered periodically (usually monthly) for the life of the patient. Since intravitreal injections are administered through the sclera, there is the possibility of adverse events, such as vitreous hemorrhage, endophthalmitis, retinal tears, or retinal detachment. To avoid some of the adverse events associated with intravitreal delivery via the scleral route we have developed a technique to deliver bevacizumab (Avastin®) into the vitreous cavity in pseudophakic eyes via a corneal route.Methods: A 27-gauge, 5 mm angled cannula attached to a 1.0 ml syringe is fitted into an 11 o’clock limbal incision and advanced through the anterior and posterior chamber. The cannula is maneuvered through the zonules into the vitreous and 0.1 ml of Avastin is delivered behind the lens into the vitreous cavity. The procedure was performed in 50 eyes (Addendum 1: 499 injections 2014–2015), of five exudative ARMD patients, 21 diabetic macular edema (DME) patients, two cystoid macular edema (CME) patients, and one central retinal vein occlusion (CRVO) patient. Visual acuity (VA), edema, optical coherence tomography (OCT), and endothelial cell counts were performed 1 day following Avastin administration. VA was also determined in 16 eyes at 1 month after Avastin administration.Results: At 1 day post-Avastin administration, vision acuity and edema index improved or remained stable in all eyes, with the exception of one eye from an exudative ARMD patient whose vision deteriorated. At 1 month the average visual acuity in 16 eyes was also significantly improved. The improvement in edema was evident through retinal OCTs. No change in endothelial cell counts was observed.Conclusions: Administration of Avastin via an anterior chamber route in pseudophakic (Addendum 2: Phakic eyes were also treated with no cataract formation) patients is effective for the treatment of exudative ARMD, DME, CME and CRVO, minimizing the possible adverse events related to the administration by the traditional scleral route. In addition, anterior segment administration allows the ophthalmologist to directly observe the delivery of the drug with microscope precision. Pars plana injections are usually performed without magnification and no direct visualization.

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