Culture-Positive Endophthalmitis After Open Globe Injuries With and Without Retained Intraocular Foreign Bodies

Introduction: Endophthalmitis is the most dreaded complication of ocular trauma and knowledge of the microbial contaminants is essential to start empirical antibiotic therapy. Purpose: To determine incidence of contamination after open globe injuries (OGI) in our setup and to identify the spectrum of microorganisms contaminating open globe injuries. Material and methods: A prospective study including 50 consecutive eyes of open globe injury over a period of two years was conducted. Intra-operatively, 4 - 5 samples were taken from the inferior conjunctival sac and anterior chamber at the beginning and end of the open globe injury repair. Any abscised tissue or foreign body was also sent for culture sensitivity. A vitreous tap was taken from eyes with posterior segment trauma with signs of endophthalmitis. Results: Microbial cultures were positive in13 eyes (26 %). The microbial spectrum included Aspergillus species in 45.6 %, Alternaria in 15.2 %, Curvularia in 15.2 %, Staphylococcus aureus in 7.6 %, Bacillus species in 7.6 %, and Streptococcus pneumoniae in 7.6 %. Of these 13 eyes, nine eyes developed clinically evident frank endophthalmitis during follow-up. Overall, endophthalmitis developed in 20 eyes (40 %). There was a significant association between the initial contamination and development of endophthalmitis (p < 0.05). 53 % of culture positive cases achieved ambulatory vision compared to 73 % of culturenegative cases. Conclusion: Initial contamination was seen in 26 % of OGI cases. Aspergillus (fungus) was the commonest contaminant. There was a strong correlation between the initial contamination and development of endophthalmitis. Culture-negative cases had a trend towards better final visual outcome than culture-positive cases. Close follow up of cases showing contamination following OGI is recommended. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5857 NEPJOPH 2012; 4(1): 84-89

Download Full-text

Brief communication (Original). Visual outcome in open globe injuries in Thailand: a prospective study

Asian Biomedicine ◽

10.5372/1905-7415.0504.070 ◽

2011 ◽

Vol 5 (4) ◽

pp. 531-536

Author(s):

Sunisa Sintuwong ◽

Ruthairat Winitchai

Keyword(s):

Visual Acuity ◽

Length Of Stay ◽

Predictive Factors ◽

Foreign Bodies ◽

Visual Outcome ◽

Time Duration ◽

Poor Visual Outcome ◽

Initial Visual Acuity ◽

Open Globe ◽

Open Globe Injuries

AbstractBackground: Eye injuries, especially open globe injuries, cause visual morbidities and socioeconomic burden. It is urgent have good database and stakeholder involvement for open globe injuries.Objectives: Investigate the epidemiology and predictive factors of visual outcome in open globe injuries in an industrial area in Thailand.Methods: Consecutive cases of in-patient open globe injuries in Mettapracharak Eye Centre between February 2009 and January 2010 were examined. Patients were interviewed at first visit and followed-up for six months. The Birmingham Eye Trauma Terminology was used to classify types of injuries. Demographic data, cost of treatment, length of stay, and predictive factors (initial visual acuity, presence of relative afferent pupillary defect, hyphema, vitreous hemorrhage, intraocular foreign bodies, retinal detachment, time-duration to surgery, and wound length) were assessed.Results: Fifty-two out of 60 eyes were included. Most (82.7%) of patients were men and average age was 34.1 years (range: 8-68 years). About half (51.9%) graduated from primary school and 65.3% were labourers. Most patients had not used protective devices. The endophthalmitis rate was 13.5%, and panophthalmitis rate was 5.8%. The enucleation rate was 9.6%. The median length of stay was nine days. Poor initial visual acuity and intraocular foreign bodies were significant predictive factors of poor visual outcome (p <0.05).Conclusion: Open globe injuries caused visual morbidity especially in young adult male, laborers with low education. Initial visual acuity and intraocular foreign bodies were significant predictive factors of poor visual outcome.

Download Full-text

Validation of the Ocular Trauma Score for Intraocular Foreign Bodies in Deadly Weapon-Related Open-Globe Injuries

Ophthalmic Surgery Lasers and Imaging ◽

10.3928/15428877-20080301-15 ◽

2008 ◽

Vol 39 (2) ◽

pp. 121-124 ◽

Cited By ~ 14

Author(s):

Melih H. Unal ◽

Ali Aydin ◽

Murat Sonmez ◽

Ali Ayata ◽

Dilaver Ersanli

Keyword(s):

Foreign Bodies ◽

Ocular Trauma ◽

Ocular Trauma Score ◽

Deadly Weapon ◽

Open Globe ◽

Trauma Score ◽

Open Globe Injuries

Download Full-text

Tips and tricks in open globe injuries (management of intraocular foreign bodies)

Acta Ophthalmologica ◽

10.1111/j.1755-3768.2017.03111 ◽

2017 ◽

Vol 95 ◽

Author(s):

H. Durukan

Keyword(s):

Foreign Bodies ◽

Tips And Tricks ◽

Open Globe ◽

Open Globe Injuries

Download Full-text

Prognostic value of ocular trauma score for open globe injuries associated with metallic intraocular foreign bodies

BMC Ophthalmology ◽

10.1186/s12886-018-0874-3 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 5

Author(s):

Dilek Yaşa ◽

Zeynep Gizem Erdem ◽

Ali Demircan ◽

Gökhan Demir ◽

Zeynep Alkın

Keyword(s):

Prognostic Value ◽

Foreign Bodies ◽

Ocular Trauma ◽

Ocular Trauma Score ◽

Open Globe ◽

Trauma Score ◽

Open Globe Injuries

Download Full-text

Predictive factors of visual outcome in open globe injuries in Thailand: a prospective study

Asian Biomedicine ◽

10.5372/1905-7415.0502.040 ◽

2011 ◽

Vol 5 (2) ◽

pp. 289-294

Author(s):

Sunisa Sintuwong ◽

Ruthairat Winitchai

Keyword(s):

Visual Acuity ◽

Length Of Stay ◽

Predictive Factors ◽

Foreign Bodies ◽

Vitreous Hemorrhage ◽

Visual Outcome ◽

Time Duration ◽

Initial Visual Acuity ◽

Open Globe ◽

Open Globe Injuries

AbstractBackground: Eye injuries, especially open globe injuries, cause visual morbidities and socioeconomic burden. It is an urgent task to require good database and stakeholder involvement for open globe injuries.Objectives: Investigate the epidemiology and predictive factors of visual outcome in open globe injuries in an industrial area in Thailand.Methods: Consecutive cases of in-patient open globe injuries in Mettapracharak Eye Centre between February 2009 and January 2010 were examined. Patients were interviewed at first visit and followed-up for six months. The Birmingham Eye Trauma Terminology was used to classify types of injuries. Demographic data, cost of treatment, length of stay, and predictive factors (initial visual acuity, presence of relative afferent pupillary defect, hyphema, vitreous hemorrhage, intraocular foreign bodies, retinal detachment, time-duration to surgery, and wound length) were assessed.Results: Fifty-two out of 60 eyes were included. Most (82.7%) of patients were men and average age was 34.1 years (range: 8-68 years). About half (51.9%) were graduated from primary school and 65.3% were laborers. Most patients had not used protective devices. The endophthalmitis rate was 13.5%, and panophthalmitis rate was 5.8%. The enucleation rate was 9.6%. The median length of stay was nine days. Poor initial visual acuity and intraocular foreign bodies were significant predictive factors (p <0.05).Conclusion: Open globe injuries caused visual morbidity especially in young adult male, laborers with low education. Initial visual acuity and intraocular foreign bodies were significant predictive factors.

Download Full-text

Risk factors and prognosis of pediatric open globe injuries without initial light perception

Ophthalmologica ◽

10.1159/000513337 ◽

2020 ◽

Author(s):

Xin Wen ◽

Miner Yuan ◽

Cheng Li ◽

Chongde Long ◽

Zhaohui Yuan ◽

...

Keyword(s):

Risk Factors ◽

Case Control Study ◽

Silicone Oil ◽

Vitreoretinal Surgery ◽

Light Perception ◽

Open Globe ◽

Intraocular Hemorrhage ◽

Control Study ◽

Better Than ◽

Open Globe Injuries

Purpose: To investigate the possible risk factors and prognosis of initial no light perception (NLP) in pediatric open globe injuries (POGI). Procedures: This retrospective, comparative, interventional case-control study included 865 eyes of POGI patients presenting to a tertiary referral ophthalmic center from 1 January 2011 to 31 December 2015. Eyes were divided into two groups: NLP group included eyes with initial NLP, and light perception(LP) group included eyes with initial LP or vision better than LP. Results: The following risk factors were significantly related to initial NLP: severe intraocular hemorrhage (OR=3.287, p=0.015), retinal detachment (RD) (OR=2.527, p=0.007), choroidal damage (OR=2.680, p=0.016) and endophthalmitis (OR=4.221, p＜0.001). Choroidal damage is related to remaining NLP after vitreoretinal surgery (OR=12.384, p=0.003). At the last visit, more eyes in the NLP group suffered from silicone oil–sustained status (OR=0.266, p=0.020) or ocular atrophy (OR=0.640, p=0.004), and less eyes benefitted from final LP (OR=41.061, p＜0.001) and anatomic success (OR=4.515, p＜0.001). Conclusion: Severe intraocular hemorrhage, RD, choroidal damage and endophthalmitis occurred more often in POGI with initial NLP. Choroidal damage was the major factor related to an NLP prognosis. Traumatized eyes with initial NLP could be anatomically and functionally preserved by vitreoretinal surgery.

Download Full-text