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 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.

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.

Surgical management and outcomes of pediatric open globe injuries requiring vitrectomy

2021 ◽  
pp. 112067212110006
Author(s):  
Xin Liu ◽  
Lufei Wang ◽  
Fengjuan Yang ◽  
Jia’nan Xie ◽  
Jinsong Zhao ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Management ◽  
Pediatric Patients ◽  
Vitreous Hemorrhage ◽  
Visual Outcome ◽  
Poor Visual Outcome ◽  
Early Vitrectomy ◽  
Open Globe ◽  
Time From Injury ◽  
Ocular Sign

Purpose: To describe surgical management and establish visual outcomes of open globe injury (OGI) in pediatric patients requiring vitrectomy. Methods: Forty-eight eyes of 48 pediatric patients underwent vitrectomy for OGI with secondary vitreoretinal complications in the eye center of Jilin University were included. Characteristics of patients, details of ocular examination and operation, presenting and final visual acuity were recorded. Results: Presenting visual acuity less than 20/400 was found in 44 eyes (91.7%), which included no light perception (NLP) in four eyes. At last visit, there was no eyes with visual acuity of NLP, and 19 eyes (39.6%) had a vision recovery to 20/400 or better. Mechanisms of injury, intraocular contents prolapse, presence of hyphema, intraocular foreign body, vitreous hemorrhage, retinal detachment, and total time from injury to PPV > 2 weeks were significant predictors of visual prognosis. Logistic regression analysis showed that hyphema was a significant predictive factor for poor visual outcome. Conclusion: Visual acuity was improved in most of the patients with OGI in this study. Hyphema is an important presenting ocular sign in estimating the post-vitrectomy visual outcome for OGI in children. Proper timing of vitrectomy is suggested, and in this study patients may benefit more with early vitrectomy as less proliferative vitreoretinopathy (PVR) was found together with a better visual acuity.

Limitation of computed tomography scan in ocular trauma in diagnosing posterior globe rupture and retinal detachment

Trauma ◽  
2016 ◽  
Vol 20 (1) ◽  
pp. 72-76
Author(s):  
AR Munirah ◽  
MK Safinaz ◽  
ZMZ Aida ◽  
A Malisa ◽  
MI Hazlita
Keyword(s):  
Computed Tomography ◽  
Retinal Detachment ◽  
Ocular Trauma ◽  
Silicone Oil ◽  
Primary Repair ◽  
Computed Tomography Scan ◽  
Penetrating Eye Injury ◽  
Globe Rupture ◽  
Open Globe ◽  
Tomography Scan

Ocular trauma with penetrating eye injury or globe rupture is an ophthalmic emergency. Immediate but gentle ocular assessment is mandatory to diagnose the extent of the injury. Imaging modalities are valuable in aiding diagnosis and management in open globe injury due to the difficulty of full eye assessment in the presence of multiple head and facial injuries. This report presents a case of an elderly man with ocular trauma of the left only seeing eye where computed tomography scan showed anterior globe rupture and the possibility of posterior globe rupture due to discontinuity of the posterior sclera. Primary repair and exploration of the left eye revealed no posterior globe rupture. Post-operative B-scan revealed a total retinal detachment with intact posterior globe. Vision of the left eye after pars planar vitrectomy and tamponade of the retina detachment with heavy silicone oil improved to 1/60. Computed tomography scan in ocular trauma has limitations especially in diagnosing retinal detachment and posterior globe rupture.

scholarly journals An Uncommon Meridional Globe Rupture due to Blunt Eye Trauma

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
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.

scholarly journals Visual Outcome of Ocular Trauma Presenting in a Tertiary Care Hospital in Sahiwal

2020 ◽  
Vol 36 (2) ◽  
Author(s):  
Ahmad Zeeshan Jamil ◽  
Muhammad Luqman Ali Bahoo
Keyword(s):  
Visual Acuity ◽  
Ocular Trauma ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Visual Outcome ◽  
P Value ◽  
Care Hospital ◽  
Open Globe ◽  
Patient Reported

Purpose: To find the visual outcome of ocular trauma presenting in a tertiary care hospital in Sahiwal. Study Design: Descriptive observational study. Place and Duration of Study: This study was conducted at District Headquarter Teaching Hospital affiliated with Sahiwal Medical College, Sahiwal from January 2016 to June 2019. Material and Methods:  Four hundred and thirty five patients were included in the study by convenient sampling technique. Patient’s age, gender, occupation, activity at the time of injury, nature of object causing trauma, duration of trauma, visual acuity at the time when patient reported to hospital, the time delay before coming to the hospital were recorded. Ocular injuries were classified according to Birmingham ocular trauma terminology. Detailed ocular examination was performed. Patients were managed and post-management visual acuity at three months was recorded. Results: Mean age of patients was 29.07 ± 12.53 years. There were 219 (50.3%) closed globe and 216 (49.7%) open globe injuries. In 59 (13.6%) cases, cause of injury was metal object. In 146 (33.6%) cases injury was classified as contusion. In 164 (37.7%) cases cornea was involved. Majority of the patients were male. Eighty-seven patients presented within 1 day after trauma. In 154 (35.4%) patients, visual acuity at the time of presentation was 6/12 or better while in 171 (39.3%) cases it was less than 6/60. Chi-square test was used to calculate the difference between pre and post-management visual acuity. This difference was statistically significant with p-value less than 0.05 Conclusion:  Ocular trauma cases, if properly and timely managed, have a statistically significant increase in visual acuity.

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 Open-Globe Injury With Intraocular Foreign Body

2020 ◽  
pp. 247412642096503
Author(s):  
Filippos Vingopoulos ◽  
Yvonne Wang ◽  
Seanna Grob ◽  
Chloe Yang Ling Li ◽  
Dean Eliott ◽  
...  
Keyword(s):  
Foreign Body ◽  
Primary Repair ◽  
Anterior Segment ◽  
Case Series ◽  
Visual Outcome ◽  
Posterior Segment ◽  
Open Globe ◽  
Time From Injury

Purpose: To investigate characteristics of Open Globe Injuries (OGI) that presented with Intra-Ocular Foreign Body (IOFB), along with their long-term visual outcomes and complications. Methods: Retrospective interventional consecutive case series of OGIs with IOFBs that presented at Massachusetts Eye and Ear from 2010 to 2015. Data collected included time from injury to OGI repair, location of IOFB, retinal detachment (RD) rate, presenting and final visual acuity and subsequent surgeries. Results: Fifty-seven consecutive cases of OGIs with IOFBs were included. Mean follow-up was 28 months and median time from injury to OGI repair was 0 days. Overall, 38/57 (66.7%) eyes achieved final vision of 20/40 or better and 43/57 (75.4%) 20/150 or better. Thirty-three cases had IOFBs in the anterior segment only, 24 cases had posterior segment involvement. Thirty percent of cases (17/57) were complicated by an RD, 58.3% (14/24) in the posterior versus 9.1% (3/33) in the anterior IOFB group ( P = .01). There were no cases of endophthalmitis. Posterior IOFB and higher zone of injury were risk factors for RD both at presentation (both P < .001) and post-primary repair (both P < .001). Posterior IOFB was associated with higher vitrectomy rates both at presentation ( P < .001) and post-primary repair ( P = .002) and worse long-term visual outcome ( P = .01). Conclusions: OGIs with IOFB involving the posterior segment are associated with higher complication and re-operation rates and worse visual prognosis compared to those involving the anterior segment only.

scholarly journals Asteroid Hyalosis Seen on Ocular Point-of-Care Ultrasound

2019 ◽  
Vol 3 (3) ◽  
pp. 318-320
Author(s):  
Blake Arthurs ◽  
Randi Connor-Schuler ◽  
Wendelin Kreifels ◽  
Julian Suszanski ◽  
Sudhir Baliga ◽  
...  
Keyword(s):  
Ocular Trauma ◽  
Point Of Care ◽  
Vitreous Hemorrhage ◽  
Point Of Care Ultrasound ◽  
Benign Condition ◽  
Lens Dislocation ◽  
Ultrasound Evaluation ◽  
Ocular Ultrasound ◽  
Asteroid Hyalosis ◽  
Blunt Ocular Trauma

We present a case of a patient who underwent ultrasound evaluation for potential blunt ocular trauma. She was found to have multiple, freely mobile, scintillating hyperechoic opacities within the vitreous that was diagnosed as asteroid hyalosis, a rare but benign condition easily confused with vitreous hemorrhage, retinal detachment, lens dislocation, or foreign body on ocular ultrasound.

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