Low Endophthalmitis Rate and Absence of Sympathetic Ophthalmia after Open Globe Injuries - A Ten-Year Review of Open Globe Injury

2014 ◽  
Vol 05 (01) ◽  
Author(s):  
Emmy YuenMei Li
Keyword(s):  
Sympathetic Ophthalmia ◽  
Open Globe Injury ◽  
Open Globe ◽  
Open Globe Injuries

scholarly journals Microbial contamination in open globe injury

1970 ◽  
Vol 4 (1) ◽  
pp. 84-89 ◽  
Author(s):  
S Bhala ◽  
S Narang ◽  
S Sood ◽  
C Mithal ◽  
AK Arya ◽  
...  
Keyword(s):  
Visual Outcome ◽  
Bacillus Species ◽  
Open Globe Injury ◽  
Open Globe ◽  
A Prospective Study ◽  
Culture Positive ◽  
Initial Contamination ◽  
Final Visual Outcome ◽  
Open Globe Injuries

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

scholarly journals Complete Visual Rehabilitation in a Patient with No Light Perception after Surgical Management of a Penetrating Open-Globe Injury: A Case Report

2015 ◽  
Vol 6 (2) ◽  
pp. 204-209 ◽  
Author(s):  
Tania A. Baban ◽  
Fady K. Sammouh ◽  
Haytham M. El Ballouz ◽  
Elias L. Warrak
Keyword(s):  
Decision Making ◽  
Case Report ◽  
Poor Prognosis ◽  
Ocular Trauma ◽  
Light Perception ◽  
Patient Counseling ◽  
Open Globe Injury ◽  
Visual Rehabilitation ◽  
Open Globe ◽  
Open Globe Injuries

Open-globe injuries with no light perception (NLP) carry a poor prognosis, and many ophthalmologists select a primary enucleation or evisceration as a result. We present a case of complete visual rehabilitation in a patient who presented with NLP after a zone III penetrating open-globe injury. We recommend patient counseling regarding decision making and management of ocular trauma with NLP, since timely intervention and close follow-ups may restore useful or complete vision even in severely traumatized eyes.

scholarly journals Characterization of an anterior segment organ culture model for open globe injuries

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eric J. Snider ◽  
Emily N. Boice ◽  
Brandon Gross ◽  
Jacinque J. Butler ◽  
David O. Zamora
Keyword(s):  
Intraocular Pressure ◽  
Organ Culture ◽  
High Speed ◽  
Anterior Segment ◽  
Tissue Adhesive ◽  
Open Globe Injury ◽  
Current Standard ◽  
Post Injury ◽  
Open Globe ◽  
Open Globe Injuries

AbstractOpen-globe injuries have poor visual outcomes and have increased in frequency. The current standard of care is inadequate, and a therapeutic is needed to stabilize the injury until an ophthalmic specialist is reached. Unfortunately, current models or test platforms for open-globe injuries are insufficient. Here, we develop and characterize an open-globe injury model using an anterior segment organ-culture platform that allows therapeutic assessment for up to 72 h post-injury. Anterior segments maintained in organ culture were kept at physiological intraocular pressure throughout, and puncture injuries were created using a novel pneumatic-powered system. This system can create high-speed, military-relevant injuries up to 4.5 mm in diameter through the cornea. From intraocular pressure readings, we confirmed a loss of pressure across the 72 h after open-globe injury. Proof-of-concept studies with a Dermabond tissue adhesive were performed to show how this model system could track therapeutic performance for 72 h. Overall, the organ-culture platform was found to be a suitable next step towards modeling open-globe injuries and assessing wound closure over the critical 72 h post-injury. With improved models such as this, novel biomaterial therapeutics development can be accelerated, improving care, and, thus, improving the prognosis for the patients.

scholarly journals Clinical Characteristics, Visual Outcomes, and Prognostic Factors of Open Globe Injuries

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1198
Author(s):  
Edita Puodžiuvienė ◽  
Gabrielė Valeišaitė ◽  
Reda Žemaitienė
Keyword(s):  
Prognostic Factors ◽  
Visual Impairment ◽  
Univariate Analysis ◽  
Vitreous Hemorrhage ◽  
Open Globe Injury ◽  
Visual Outcomes ◽  
Eye Trauma ◽  
Open Globe ◽  
Vitreous Prolapse ◽  
Open Globe Injuries

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.

scholarly journals Open globe injuries in geriatric population in Iran: characteristics and outcomes

2021 ◽  
Vol 14 (8) ◽  
pp. 1237-1240
Author(s):  
Maryam Zamani ◽  
◽  
Akbar Fotouhi ◽  
Morteza Naderan ◽  
Mohammad Soleimani ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Ocular Trauma ◽  
Final Visual Acuity ◽  
Open Globe Injury ◽  
Geriatric Population ◽  
Cross Sectional ◽  
Female Ratio ◽  
Globe Rupture ◽  
Open Globe ◽  
Open Globe Injuries

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.

scholarly journals Comparative pathophysiological characteristic of intraocular immunological changes in open globe injury in the experiment at intravitreal and periocular administration of depot glucocorticoids

2013 ◽  
Vol 6 (3) ◽  
pp. 26-31
Author(s):  
Ernest Vitalievich Boiko ◽  
Sergei Ivanovich Grabovetskiy ◽  
Sergei Viktorovich Churashov ◽  
Timur Gennadievich Sazhin ◽  
Aleksey Nikolayevich Kulikov ◽  
...  
Keyword(s):  
Triamcinolone Acetonide ◽  
Comparative Assessment ◽  
Open Globe Injury ◽  
Eye Trauma ◽  
Open Globe ◽  
Injury Treatment ◽  
Immunological Changes ◽  
Immunologic Reactions ◽  
Open Globe Injuries ◽  
Inflammatory Effect

One of the most severe types of eye trauma - open globe injury - is a serious medical and societal problem. Short-acting glucocorticosteroids (dexamethasone and others) were widely used in open globe injury treatment. Over the last several years ophthalmologists treating this problem have used depot corticosteroids (triamcinolone acetonide and others), which have a pronounced anti-inflammatory effect and do not require multiple injections. However, up to now, there is no consensus concerning the route of depot steroids administration to patients with open globe injuries. In the present study, in experiments on rabbits, a comparative assessment of the influence of intravitreal and periocular triamcinolone acetonide administration on intraocular immunologic reactions during acute period of open globe injury was evaluated.

scholarly journals Work Related Open Globe Injury

2019 ◽  
Author(s):  
Lakshmi Kamala
Keyword(s):  
Ocular Trauma ◽  
Case Reports ◽  
Workplace Safety ◽  
Protective Equipment ◽  
Open Globe Injury ◽  
Work Related ◽  
Open Globe ◽  
Safety Guidelines ◽  
Open Globe Injuries

Traumatic open globe injuries are a leading cause of blindness/visual impairment in the world. A significant number of reported open globe injuries occur at the workplace and have been historically associated with non-compliance with workplace safety guidelines and not wearing eye related personal protective equipment (PPE). In this case report, we describe a 27-year-old man’s workplace related open globe injury despite wearing PPE. We explore the prognostic factors in determining final visual acuity and do a literature review of case reports with good outcomes despite poor initial prognostication in severe open globe injuries. The option of enucleation and its common indications are discussed. We also examine the factors determining patient satisfaction with ocular prosthesis along with an assessment of the role of PPEs in workplace related ocular trauma.

scholarly journals Tilt, Decentration, and Internal Higher-Order Aberrations of Sutured Posterior-Chamber Intraocular Lenses in Patients with Open Globe Injuries

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Xiangjia Zhu ◽  
Yinglei Zhang ◽  
Wenwen He ◽  
Hongfei Ye ◽  
Chunhui Jiang ◽  
...  
Keyword(s):  
Visual Quality ◽  
Higher Order ◽  
Intraocular Lenses ◽  
Quality Data ◽  
Posterior Chamber ◽  
Open Globe Injury ◽  
Higher Order Aberrations ◽  
Injury Group ◽  
Open Globe ◽  
Open Globe Injuries

Purpose. To evaluate the tilt, decentration, and internal higher-order aberrations (HOAs) of sutured posterior-chamber intraocular lenses (IOLs) in patients with open globe injuries. Methods. 46 consecutive patients (47 eyes) who underwent transsclerally sutured IOL implantation were enrolled in this prospective cohort study. Nineteen eyes had a history of open globe injury. The tilt and decentration of the IOLs and the visual quality were measured 1 month after surgery. Results. The horizontal tilt and decentration of the IOLs in the open-globe-injury group were significantly higher than those in the control group (both P<0.05). In the open-globe-injury group, the horizontal decentration was significantly greater in the limbus-sclera-involved group (n=11) than in the only-cornea-involved group (n=8, P=0.040). The internal coma, 3rd-order, and total HOA values at pupil sizes of 4 mm (P=0.006) and 6 mm (P=0.013) were significantly higher in the open-globe-injury group than in the controls. Consequently, the optical quality data for the modulation transfer function and the Strehl ratio (all P<0.05) were significantly poorer in the open-globe-injury group. Conclusions. Open globe injuries damage the structural integrity of the eyeball, resulting in more-misaligned sutured IOLs and poorer visual quality.

scholarly journals Оpen globe injury in children: epidemiology and predictors of an adverse outcome

2021 ◽  
Vol 6 (4) ◽  
pp. 132-141
Author(s):  
E. V. Gromakina ◽  
K. M. Saidzhamolov ◽  
V. G. Moses ◽  
N. V. Tyunina ◽  
K. B. Moses
Keyword(s):  
Low Income ◽  
Developed Countries ◽  
Late Complications ◽  
Low Income Countries ◽  
Open Globe Injury ◽  
Severe Injuries ◽  
Open Globe ◽  
Poor Outcomes ◽  
Active Recreation ◽  
Open Globe Injuries

Here we aimed to analyse the prevalence, clinical  course, and current approaches to the prevention and treatment of open globe injury in children as well as its complications: hyphema, retinal detachment, traumatic uveitis, and endophthalmitis. Currently, children are responsible for the 10-15% of open globe injuries. In developed countries, open globe injury is the leading cause of monocular blindness in children. Open globe injury mainly affects boys (60−70% cases), yet severe injuries are rare, and closed globe injury is the most common type of eye injury. Most injuries are accidental and occur at home in daily life (50−60%), outdoors (20−35%), at school (1−5%), or while playing sports (1−3%). Open globe injury most often affects cornea and is associated with a high risk of early and late complications and poor outcomes. Wearing of protective glasses during sports and active recreation is recognised as an efficient tool for primary prevention of open globe injury in children. The main problems in prevention of complications of open globe injury are the lack of specialised care in low-income countries and the limited awareness of parents.

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