Difference between penetrating versus blunt ocular trauma in diagnosis, treatment and complications

Ocular trauma can be broadly classified into open and closed injuries. However, many subclassifications were reported based on the causative object and extent of the injury. The diagnosis and management of the various ocular traumas are different based on the underlying etiology, the severity of the case and the potentially related complications. Accordingly, in the present study, we aimed to conduct a thorough discussion about the diagnosis, treatment, complications of the blunt and penetrating ocular traumas and the potential differences between the two types of injuries. Our findings indicated that the diagnosis of the conditions mainly differed in the step of obtaining an adequate history from the affected patients based on the diagnosis of the condition that can be established. Furthermore, a routine examination should also be performed for both cases to enhance the prognosis and preserve vision. In addition, prognosis is usually worse in cases of penetrating or perforating injuries where eye inoculation might be indicated in severe cases. A detailed description of this information is provided within the manuscript based on the etiology of the underlying ocular injury and the related prognostic outcomes.

Clinical Study To Evaluate The Outcome Of Primary AGV Implantation In Angle Recession Glaucoma Following Blunt Ocular Trauma In Indian Eyes

Purpose—To Highlight The Efficacy Of Primary AGV Implantation In Angle Recession Glaucoma Following Blunt Ocular Trauma In Indian Eyes.Design- A retrospective analytical studyMaterials & Methods— This study included 52 patients of angle recession glaucoma, who presented between Mar 2006 to Feb 2016, out of which 38 patients had undergone primary AGV implantation while the rest were managed with topical anti-glaucoma medications. Preoperative data included age, sex, type & mode of injury, duration of injury, assessment of BCVA and IOP. Extent of angle recession was observed by gonioscopy. The intraocular pressure, visual acuity and number of anti-glaucoma medications were measured postoperatively. The success of this technique was analyzed by using a Kaplan-Meier cumulative survival curve.Results—Following AGV implantation the mean IOP was significantly reduced to 8.7±2.2 at 1st day, 10.1±2.2 at 7th day, 14.2±3.4 at 3rd month, 15.6±3.7 at 1 year and 15.6±3.6 at 3rd year follow-up showing statistically significant values (p<0.001) at each visit. The IOP was successfully controlled at last follow up without topical treatment. Mean BCVA at 3 year post AGV was 0.41±1.5 (logMAR) which was statistically significant (p<0.001).The success rate by Kaplan- Meier survival curve analysis was 90% at the mean follow up duration of 29.47±3.39 months. Overall surgical complications were noted in the form of prolonged hypotony, hyphema in 7 patients (13.5%).Conclusions—In medically uncontrolled post-traumatic angle recession glaucoma Primary AGV Implantation is a safe and effective surgical procedure with lesser complication rates providing long term IOP control in younger population .

Central Retinal Vein Occlusion Secondary to Ocular Trauma in a Young Patient

Central retinal vein occlusions (CRVO) occurring in young patients or due to a traumatic etiology is uncommon. This paper outlines the case of a 33-year-old Asian male who presented with a chief complaint of blurry peripheral vision and photophobia in his left eye, one week after sustaining blunt ocular trauma. He was diagnosed with a traumatic CRVO based on history and exam findings.

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

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

A Case of Traumatic Choroidopathy With Subretinal Fluid

Purpose: We report a unique case of blunt ocular trauma with subretinal fluid (SRF), presumed to be traumatic choroidopathy as evidenced by multimodal imaging. Methods: A case report is presented. Results: A 22-year-old woman involved in a motor vehicle accident presented 1 day later to our emergency department with blurred vision in the left eye. Visual acuity was 20/40, significant SRF was present throughout the macula, and fluorescein angiography showed diffuse pooling and leakage. There were no retinal tears or intraocular inflammation. Indocyanine green angiography performed a week later showed patchy hypofluorescence in the affected area. One month later, visual acuity had improved to 20/20 and the SRF and the hypofluorescence on indocyanine green angiography had resolved. Conclusions: Subfoveal collection of SRF may be a cause of decreased vision following blunt ocular trauma. We hypothesize that in our case choroidal hypoperfusion and retinal pigment epithelial dysfunction contributed to the SRF collection.

A secondary iris cyst with 3 years of asymptomatic period following a blunt ocular trauma

Purpose: To present a relatively uncommon case with a secondary iris cyst in the anterior chamber and its successful management with an anterior chamber mass excision surgery. Case report: A 46-year-old Chinese woman presented with a dark shadow in her left eye for 6 months without any other discomfort. She had a history of blunt ocular trauma by a badminton strike 3 years ago. Slit-lamp examination showed a small, nearly circular, sharply demarcated, and movable mass in the anterior chamber OS, which could change its position with head tilt. The anterior segment optical coherence tomography revealed a well-circumscribed cystic lesion in the anterior chamber with higher reflective outer layer and lower internal reflectivity. An anterior chamber mass removal surgery was performed without recurrence up to 1 year. Conclusion: Secondary free-floating iris cyst following a blunt trauma is rarely reported. It is relatively stable and nonprogressive so it may remain asymptomatic for a long time. Appropriate imaging techniques are necessary for facilitating diagnosis and therapy. Therapeutic management should be considered if visual symptoms arise, especially when complications occur.