scholarly journals Approach to: Ocular trauma

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jobanpreet Dhillon
Keyword(s):  
Ocular Trauma ◽  
Vitreous Hemorrhage ◽  
Good Prognosis ◽  
Ocular Injury ◽  
Traumatic Optic Neuropathy ◽  
Chemical Burns ◽  
Open Globe ◽  
Fundamental Understanding ◽  
Pertinent Information

Ocular trauma can be a common presentation in the emergency department. It is therefore important for a physician to be able to quickly recognize vision-threatening conditions and provide necessary medical management prior to consulting ophthalmology. This article describes the pertinent information that should be gathered during a focused ocular history in a patient with ocular injury, and also provides a systematic approach to evaluating ocular trauma. As an example, a case study of open globe injury is used to illustrate the appropriate pre-ophthalmologic management and common medical errors that must be avoided for a good prognosis. Additional ocular conditions such as traumatic hyphema, traumatic optic neuropathy, traumatic vitreous hemorrhage, orbital compartment syndrome, chemical burns, and eyelid lacerations are also described as differential diagnosis. Ultimately, the aim of this work is to provide medical students with a fundamental understanding in approaching ocular trauma in emergency clinics.

VISUAL OUTCOME, CLINICAL FINDINGS AND MANAGEMENT OF BLUNT OCULAR TRAUMA DUE TO SHOTGUN PELLETS.

2021 ◽  
pp. 44-46
Author(s):  
Faisal Qayoom Shah ◽  
Haniyaa Mufti ◽  
Syed Tariq Qureshi
Keyword(s):  
Retinal Detachment ◽  
Ocular Trauma ◽  
Anterior Segment ◽  
Vitreous Hemorrhage ◽  
Visual Outcome ◽  
Retinal Hemorrhage ◽  
Good Prognosis ◽  
Surgical Interventions ◽  
Open Globe ◽  
Blunt Ocular Trauma

Purpose: To analyze the clinical ndings, management and visual prognosis of blunt ocular injuries due to shotgun pellets. Methods: A prospective observational study on 200 eyes with blunt ocular trauma due to shotgun pellets was conducted. Patients with other causes of ocular trauma or with open globe injury were excluded from study. Surgical interventions were employed when indicated for associations like, traumatic cataract, dense persistent vitreous hemorrhage(VH),retinal detachment(RD) etc. Patients were followed up for 6 months from time of injury. Results: The mean age of patients was 22.6+9.52 years. Majority (99.5%) of our patients were males and only 1(0.50%) was female. Subconjunctival hemorrhage (SCH) was the most common clinical manifestation(77.0%) followed hyphaema in 34.0% of patients and vitreous hemorrhage(VH) (27.5%). Cataractous changes were seen in 7.5% of patients, retinal hemorrhage in 11.0% while retinal detachment(RD) in 4.0%. 60.5% of patients were managed conservatively and 39.5% patients needed surgical intervention. Visual Acuity(VA) at presentation was recorded to be <6/60-PL(light perception) in 51.0% of the patients which progressed to range of 6/6 -6/9 in 82.5% of patients. 2 patients reported with no perception of light (NPL) at the time of trauma which persisted till the end of follow-up. Conclusion: We conclude that the blunt ocular trauma due to pellets occurs most commonly in males, and has a good prognosis in terms of anatomical and functional outcome. Anterior segment was more commonly involved than the posterior segment with reparable damage in majority of the cases. Educating the mass for use of any form of eye protection can prevent ocular trauma in most cases

scholarly journals Visual Outcome in Open Globe Injury

2013 ◽  
Vol 11 (2) ◽  
pp. 40-43
Author(s):  
Sagar Rajkarnikar ◽  
Ramesh Raj Bist ◽  
Anu Gurung ◽  
Ram Shrestha
Keyword(s):  
Ocular Trauma ◽  
Visual Outcome ◽  
Ocular Injury ◽  
Open Globe Injury ◽  
Poor Vision ◽  
Work Related ◽  
Open Globe ◽  
History Of ◽  
Visually Handicapped ◽  
Type Of Injury

Introduction: Ocular trauma is a major cause of monocular blindness and visual impairment throughout the world. It is estimated that more than 2 million people suffer from ocular trauma annually and 40,000 become visually handicapped permanently. The aim of this study was to evaluate the visual outcome in open globe injury patients. Methods: This study was conducted in Nepal Eye Hospital. All the cases of admitted open globe injuries were examined and managed in the hospital were included in this study. The detail history of trauma and visual acuity was recorded. Clinical diagnosis was made after detail examination of anterior and posterior segment.  Patient was treated according to the type of injury. Visual recovery and the cause of poor vision at the time of discharge was also noted. Data was analyzed using the SPSS 11 program. Results: Out of the 100 cases enrolled in the study work related injury was the most frequent injury, metal was the most common causative agent. Males of 20-50 years of age are more vulnerable to open globe injury. Vision improved in 48%, same vision in 39% and deteriorated vision in 13% cases was recorded. Conclusions: Present study reveals that open globe injury can present in varying severity and though the overall prognosis is grave, prompt surgical intervention can result in better visual outcome. The visual outcome in mild to moderate ocular injury was satisfactory but poor in severe injuries.Medical Journal of Shree Birendra Hospital; July-December 2012/vol.11/Issue2/40-43 DOI: http://dx.doi.org/10.3126/mjsbh.v11i2.7909  

scholarly journals Party Poppers and Balloons: Fun and Games or Lives and Limbs?

2020 ◽  
Vol 36 (2) ◽  
Author(s):  
Fiza Shaheen ◽  
Rehan Naqaish ◽  
Muhammad Amer Awan
Keyword(s):  
Ocular Trauma ◽  
Vitreous Hemorrhage ◽  
Open Globe Injury ◽  
Lens Extraction ◽  
Safety Awareness ◽  
Full Thickness Macular Hole ◽  
Open Globe ◽  
Awareness Programs ◽  
Pars Plana ◽  
Popular Party

Abstract We report two cases of ocular trauma caused by recently popular party poppers and LED balloons, commonly used in parties nowadays. One case depicted a closed globe injury as a result of a party popper spray over the eye. The pressure of the spray resulted in a blunt trauma causing full thickness macular hole which was later treated with Pars Plana Vitrectomy (PPV) surgery. The second case is an example of an open globe injury caused by the bursting of LED balloon over the eye of a young child resulting in corneal perforation, traumatic cataract, vitreous hemorrhage with an intraocular foreign body (IOFB). It was successfully treated with corneal suturing, lens extraction, PPV surgery and removal of IOFB followed by a secondary lens implantation. Both of the sustained injuries were completely avoidable hence emphasizing the requirement of eye safety awareness programs and diligence in the use of these gadgets in everyday lives.

scholarly journals Empty Bullet-Related Ocular Injuries During Military Shooting Training: A 20-Year Review

2019 ◽  
Vol 185 (5-6) ◽  
pp. e799-e803 ◽  
Author(s):  
Soner Guven ◽  
Ali Hakan Durukan
Keyword(s):  
Ocular Trauma ◽  
Ocular Injury ◽  
Medicine Department ◽  
Patient Demographics ◽  
School Of Medicine ◽  
Open Globe ◽  
Department Of Ophthalmology ◽  
Protective Eyewear ◽  
Ocular Injuries ◽  
Trauma Scores

Abstract Introduction Empty bullet-related ocular injuries (EBOI) are rare and may result in unfavorable visual outcomes due to both open globe and closed globe injuries. To our knowledge, no reports of such injuries in terms of outcomes have been previously described in the literature. The aim of this study was to describe the treatment performed and ocular outcomes of such injuries. Materials and Methods EBOI of 23 cases were reviewed who were referred to Gulhane School of Medicine Department of Ophthalmology between January 1998 and January 2018. Patient demographics, ocular signs (initial and final), injury types, type and number of interventions, and ocular trauma scores were recorded. Results In total, 23 eyes of the 23 patients with an average age of 22.3 ± 4.54 years (range, 20–41 years) were included in the study. All of the patients were male, and all injuries were due to empty bullets during shooting training. None had ocular protection at the time of ocular injury. Fourteen patients (60.9%) were open globe injuries, whereas nine (39.1%) of them were closed globe injuries. Mean ocular trauma scores category of the cases was 2.52 ± 1.03. The baseline and final visual acuity was 20/200 or better in 21.7% and 69.5% of eyes, respectively. Nineteen eyes (82.7%) had undergone a total of 31 surgeries with a 1.34 ± 0.88 surgery average. Conclusions The prognosis of EBOI is unpredictable and is dependent on the severity of ocular damage. The best treatment option is prevention of EBOI with protective eyewear.

A Clinical Study of the Pattern of Ocular Trauma and Its Visual Outcome among Road Traffic Accident Cases in a Tertiary Care Teaching Institute

2021 ◽  
Vol 8 (03) ◽  
pp. 141-145
Author(s):  
Vinay Kumar Dawson ◽  
Manasvi Dawson
Keyword(s):  
Traffic Accidents ◽  
Ocular Trauma ◽  
Road Traffic ◽  
Visual Outcome ◽  
Post Treatment ◽  
Time Interval ◽  
Ocular Injury ◽  
Road Traffic Accidents ◽  
Open Globe ◽  
Ocular Injuries

BACKGROUND Ocular injuries due to road traffic accidents (RTA) is one of the important causes of ophthalmological morbidity and cause of unilateral blindness. Some of the injuries also result in cosmetic disfigurement. Increased usage of vehicles for transport in recent times has increased the incidence of cases. The primary objective of this study was to understand the epidemiology and pattern of ocular trauma in RTA cases and their visual outcome. METHODS A total of 75 cases was included in the study following the inclusion and exclusion criteria. A detailed history was taken which included information regarding time, location, type and mechanism of injury, use of spectacles, car safety belts, and helmets. The time interval between injury and reporting was recorded. Test of visual acuity was done, ophthalmic examination included the examination of all patients with the slit lamp, 90 D examination, and indirect ophthalmoscopy were done. Ultrasound B scan was done in cases where unclear media prevented fundus examination. RESULTS Ecchymosis of the lids was the commonest type of ocular injury. Out of 15 eyelid laceration cases, 10 cases were with mild partial-thickness tears present and 5 had severe lid tears which required suturing. Most of the patients recovered with good vision in 6 months post-treatment and a few fair results. Analysis of variance (ANOVA) comparison between conservative management and surgical management at the end of 4 months post treatment was done. The P-values were > 0.05 hence, not significant. It indicated that the outcomes were independent of the method of management adopted. CONCLUSIONS The incidence of RTAs is increasing due to an increase in the number of vehicles used by the public. Ocular injuries are more often seen in young men especially those driving two-wheelers without safety devices like helmets. Open globe injuries and cases with previous ocular problems have poor outcomes. KEYWORDS Ocular Trauma, Road Traffic Accidents [RTA], Visual Outcome

Profile of Occupational Ocular Injury in a Tertiary Health Care Centre of Western Odisha - A Prospective Study

2021 ◽  
Vol 8 (15) ◽  
pp. 972-976
Author(s):  
Jayashree Dora ◽  
Sasmita Sahu ◽  
Madhumita Naik ◽  
Deepak Jyot Mohanty ◽  
Rupasri Sethi
Keyword(s):  
Prospective Study ◽  
Ocular Trauma ◽  
Health Concern ◽  
Ocular Injury ◽  
Ophthalmological Examination ◽  
Protective Devices ◽  
Eye Trauma ◽  
Open Globe ◽  
Ocular Injuries ◽  
A Prospective Study

BACKGROUND Occupational ocular injuries are very common in industrial and agricultural workers. These are important and preventable causes of ocular morbidity. Objective of the study was to profile occupational ocular trauma clinicoepidemiologically. METHODS A prospective study was done by collecting data from a standardised questionnaire and complete ophthalmological examination of patients with occupational eye trauma attending VSSIMSAR, Burla, between January 2019 and October 2020. RESULTS Out of 128 cases of work related injuries, males were 85 %. 48 % of the cases were between 21 - 40 years. Out of all cases 66 % injuries were related to industrial work followed by 29 % in agricultural sector and farming. 3 % of cases were due to blast injury. Also there were 3 % cases of chemical conjunctivitis. Most injuries were closed globe (85 %), mostly involving zone 1 (91 %). Open globe injuries were 15 %, majority of them involved zone 2 (47 %). Ocular superficial foreign bodies were the most common clinical entity (60 %), majority of them being metallic in nature (37.5 %). In 4 % cases IOFBs were found. Cornea was the most common ocular structure to get injured (69 %). Out of all cases, 50 % had ocular trauma score (OTS) of 4, and 4 % cases had OTS 2. 48 % of patients presented within 6 hours of injury. 42 % patients were not aware of any eye protective gear at work and 30 % patients were aware but did not use any eye protection. CONCLUSIONS Eye trauma in workplace is an important public health concern in economically productive population. Significant proportion of these injuries is avoidable by using standardised eye protective devices. Attention need to be given for instruction, enforcement of protective eye wear use, and frequent prevention campaigns. KEYWORDS Ocular Trauma, Occupational Ocular Injuries, Eye Protective Devices, Western Odisha

scholarly journals Pars Plana Vitrectomy following Traumatic Ocular Injury and Initial Globe Repair: A Retrospective Analysis of Clinical Outcomes

2021 ◽  
Vol 186 (Supplement_1) ◽  
pp. 491-495
Author(s):  
Hunter H Phillips ◽  
Halward J Blegen IV ◽  
Christopher Anthony ◽  
Brett W Davies ◽  
Marissa L Wedel ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retrospective Analysis ◽  
Pars Plana Vitrectomy ◽  
Ocular Trauma ◽  
Ocular Injury ◽  
Complication Rates ◽  
Vitreoretinal Disease ◽  
Open Globe ◽  
Initial Injury ◽  
Pars Plana

ABSTRACT Introduction Penetrating and perforating ocular trauma are often devastating and may lead to complete visual loss in the traumatized eye and subsequent compromise of the fellow eye. A significant proportion of traumatic injuries are complex, often requiring vitreoretinal intervention to preserve vision. A retrospective analysis at a level 1 trauma center was performed to evaluate the time course, incidence, and outcomes following pars plana vitrectomy (PPV) after traumatic ocular injury and initial globe repair. Materials and Methods Eyes that underwent open globe repair following ocular trauma at Brooke Army Medical Center, between January 1, 2014 and December 30, 2016 were analyzed. Specific factors evaluated include mechanism of injury, defect size and complexity, ocular trauma score, zone of injury, associated orbital trauma, and time from injury to surgical intervention. A subset analysis was conducted specifically on eyes requiring subsequent PPV for vision preservation because of vitreoretinal disease. Surgical outcomes, time to secondary intervention, and complication rates were then assessed. Results In total, 70 eyes requiring open globe repair were examined, with 43 having undergone PPV. Average and median time to vitrectomy were 18.8 and 8 days, respectively. Eyes that underwent PPV were more likely to have an afferent papillary defect, vitreous hemorrhage, intraocular foreign body, and retinal detachment at the time of initial injury (although the latter two factors were not statistically significant), and were more likely to receive penetrating keratoplasty. Proliferative vitreoretinopathy occurred in 37.2% of eyes that underwent PPV, versus 3.7% of those that did not (P = 0.0013). Timing of PPV (i.e., before or after 14 days) had no statistically significant effect on the rate of PVR (Table I). Eyes that underwent PPV showed an improvement of visual acuity from average 2.5 logMAR following initial injury to 1.5 logMAR 6 months after PPV, equivalent to 18.7 Early Treatment Diabetic Retinopathy Study (ETDRS) letters gained, versus 37.7 ETDRS letters gained in eyes without PPV. Among PPV eyes, early repair (&lt;14 days) was associated with greater improvement in visual acuity. Conclusion Overall, patients requiring PPV following open globe repair generally had more severe injuries and worse 6-month postoperative visual acuity. Patients who underwent more expedited vitrectomy showed greater improvement in visual acuity as measured by ETDRS letters gained.

scholarly journals Reliability of the ocular trauma score for the predictability of traumatic and post-traumatic retinal detachment after open globe injury

2021 ◽  
Vol 14 (10) ◽  
pp. 1589-1594
Author(s):  
Simon Dulz ◽  
◽  
Toam Katz ◽  
Robert Kromer ◽  
Eileen Bigdon ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Ocular Trauma ◽  
Vitreous Hemorrhage ◽  
Open Globe Injury ◽  
Ocular Trauma Score ◽  
Open Globe ◽  
Significant Difference ◽  
Post Traumatic ◽  
Trauma Score

AIM: To elucidate the question of whether the ocular trauma score (OTS) and the zones of injury could be used as a predictive model of traumatic and post traumatic retinal detachment (RD) in patients with open globe injury (OGI). METHODS: A retrospective observational chart analysis of OGI patients was performed. The collected variables consisted of age, date, gender, time of injury, time until repair, mechanism of injury, zone of injury, injury associated vitreous hemorrhage, trauma associated RD, post traumatic RD, aphakia at injury, periocular trauma and OTS in cases of OGI. RESULTS: Totally 102 patients with traumatic OGI with a minimum of 12mo follow-up and a median age at of 48.6y (range: 3-104y) were identified. Final best corrected visual acuity (BCVA) was independent from the time of repair, yet a statistically significant difference was present between the final BCVA and the zone of injury. Severe trauma presenting with an OTS score I (P<0.0001) or II (P<0.0001) revealed a significantly worse BCVA at last follow up when compared to the cohort with an OTS score >III. OGI associated RD was observed in 36/102 patients (35.3%), whereas post traumatic RD (defined as RD following 14d after OGI) occurred in 37 patients (36.3%). OGI associated RD did not correlate with the OTS and the zone of injury (P=0.193), yet post traumatic RD correlated significantly with zone III injuries (P=0.013). CONCLUSION: The study shows a significant association between lower OTS score and zone III injury with lower final BCVA and a higher number of surgeries, but only zone III could be significantly associated with a higher rate of RD.

Posterior Segment Pathologies in Patients with Ocular Trauma Using B-Scan Ultrasonography

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Fatima Sidra Tanweer ◽  
Afia Matloob Rana ◽  
Waseem Akhter
Keyword(s):  
Retinal Detachment ◽  
Foreign Bodies ◽  
Ocular Trauma ◽  
Vitreous Hemorrhage ◽  
Posterior Segment ◽  
Categorical Variables ◽  
Ocular Injury ◽  
Continuous Variables ◽  
Cross Sectional ◽  
Female Ratio

Purpose:  To determine the frequency of posterior segment pathologies caused by ocular trauma using B scan USG. Study Design:  Descriptive, cross-sectional study. Place and Duration of Study:  Holy family hospital, Rawalpindi, from September 2015 to March 2016. Methods:  One hundred patients of ocular trauma, 12 to 45 years of age were included in the study. Patients who had any posterior segment pathology prior to the ocular trauma were excluded. B scan was performed in all patients. The data was collected and analyzed using SPSS version 17. For all the categorical variables like gender, type and site of ocular injury, the side of eye involved, type of posterior segment pathology as detected on B Scan, frequencies and percentages were calculated. For the continuous variables like age and time since injury, mean and standard deviation were calculated. Results:  Mean age was30.43 ± 9.58 years. Majority of the patients (35.0%) were between 26 to 35 years of age. Out of these 100 patients, 73 were males and 27 were females with male to female ratio of 2.7:1. Vitreous hemorrhage was the most common and ocular pathology (38 patients). Retinal detachment was seen in 21 patients. Intra-ocular foreign bodies were seen in 12 patients. Conclusion:  Vitreous hemorrhage was the most common posterior segment pathology in ocular trauma followed by retinal detachment and intra-ocular foreign bodies. Key Words:  Trauma, B-scan, Vitreous hemorrhage, Retinal detachment.

scholarly journals Profile of pediatric ocular trauma in mid western hilly region of Nepal

1970 ◽  
Vol 4 (1) ◽  
pp. 134-137 ◽  
Author(s):  
S Dulal ◽  
JB Ale ◽  
YD Sapkota
Keyword(s):  
Medical Records ◽  
Ocular Trauma ◽  
Ocular Injury ◽  
Hilly Region ◽  
Open Globe ◽  
History Of ◽  
Ocular Injuries ◽  
The Himalaya ◽  
Open Globe Injuries ◽  
Conjunctival Hemorrhage

Introduction: Majority of blinding ocular injuries can be prevented. Objective: To describe the epidemiology of ocular trauma in children. Material and methods: A retrospective review of medical records of the patients aged below 16 years who attended the Himalaya Eye Hospital, Pokhara with history of ocular injury. Results: Of 6,829 pediatric patients, 554 (8.1 %) had ocular trauma. The ocular trauma was more prevalent (38.1 %) in the age group of 5 – 10 years followed by 10-15 years (16.6 %). The boys (62 % vs 38 %) were more prone to ocular trauma than girls (RR = 1.7 and 95 % CI = 1.41 - 2.02). Of 554 ocular injuries, 32 (5.8 %) were open globe injuries. Sub-conjunctival hemorrhage was the commonest presenting finding in 96 (17.3 %) subjects. Forty-seven (8.5 %) of them attended the hospital after 15 days of injury. Home was the most common place for trauma (n =204, 36.8%), followed by playground (n = 140, 25.3 %). Conclusion: Children between the ages of 5-10 years are most vulnerable to ocular trauma. Home is the commonest place for ocular injury followed by playground. By adopting some common safety factors or by reducing the ocular injury risks factor, ocular trauma can be greatly reduced. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5865 NEPJOPH 2012; 4(1): 134-137

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