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Aim: Retrospective study of 74 eyes with open globe injuries requiring V-R Intervention & its correlation with ocular trauma score.Results: Commonest cause of injury: Hammer-chisel/stone in 32.43% (24) & Thorn/wooden stick 27% (20). Average age-30.5yrs. Average interval between trauma & intervention was -10.04days (4hrs – 52days).Discussion: Delay of presentation to ophthalmologist has lot of significance,high incidence of endophthalmitis & retinal detachment compared to other studies. Surgical outcome shows lower incidence of NO Light Perception & Significant reduction in number of cases with </=HM. Patients had better prognosis & visual outcome, higher incidence of 1/200- 20/50; 35.14% cases with >20/200. 60% of our cases had traumatic cataract, visual acuity may be underestimated in traumatic cataract. Faulty Projection of rays probably would be better criteria than RAPD. Extension of wound beyond pars plana, and aniridia (6.7%) are important risk factor.Conclusion: Modification of raw points is recommended in OTS criteria in Indian scenario.
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We reported a case of a 32 years old male presenting with a perforating gunshot injury in craniocerebral region 3 h after the assault. The bullet entered above the right zygomatic arch, travelling through the coronal plane, and exited from the left zygomatic arch. The patient was fully conscious at presentation and developed facial nerve palsy during his hospital stay. Non-contrast CT scan of the head revealed fractures of the right orbit, bilateral maxilla, bilateral pterygoid plates, ethmoid air cells, vomer and left zygoma, and without any cerebral damage. He was treated conservatively and the facial palsy was resolved. The patient survived without any complications. Such case has not been described in the available literature till date.
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@#AIM: To summarize the characteristics of ocular perforation caused by metallic foreign body, evaluate the effectiveness and safety of 23G vitrectomy, and analyze the factors that affect the final vision of patients with ocular trauma score. <p>METHODS: Continuous observation and analysis from July 1, 2014 to June 1, 2016, hospitalized in our hospital caused by metallic perforating ocular trauma for 23G vitrectomy in 38 cases(38 eyes). A prospective collection of patient included age, gender, eye, place of occurance of trauma, foreign body size, wound length, foreign body position, initial visual acuity and final visual acuity, macular etc.. The ocular trauma score(OTS)system was used to assess the effectiveness and prognosis of the patients. The follow-up time was over 6mo. <p>RESULTS: There were 38 eyes in 38 patients, including 37 males and 1 females, aged 16y-56y. Ocular trauma mainly occurred in the workplace, 33 cases accounted for 87%, followed by sports venues, 3 cases accounting for 8%. Corrected visual acuity more than 0.1 in eyes with intraocular foreign bodies underwent 23G vitrectomy were 21 cases, accounting for 55%. Preoperative retinal detachment, large foreign body(more than 5.0mm), damage of lens were important factors of poor prognosis. Foreign bodies were located in the vitreous body in 23 cases, accounting for 61%, located in the retina in 15 cases, accounting for 39%. When admitted to hospital, the patients suffered from retinal detachment in 21 cases(55%), endophthalmitis in 7 cases(18%), the size of intraocular foreign bodies(IFOB)was larger than 5.0mm in 7 cases(18%), severe postoperative proliferative vitreoretinopathy(PVR)was in 6 cases(16%), epiretinal membrance of macula in 5 cases(13%). Of the same OTS scores, visual acuity in 6mo was significantly better than preoperative; no matter preoperative vision or postoperative vision in 6mo, the higher the OTS scores, the better the visual acuity. <p>CONCLUSION: The ocular perforation caused by metallic foreign body mostly occurs in young men under 40y, and the main reason is injury in the workplace. No protective measures are adopted. The main factors affecting the final visual acuity are retinal detachment, foreign body greater than 5.0mm and postoperative PVR appearance after the injury, vitrectomy time has little effect. The 23G vitrectomy is safe, reliable and effective in the treatment of ocular penetrating injuries due to metallic foreign bodies. OTS score can be used effectively in patients with ocular perforation caused by metallic foreign bodies and make reasonable and useful postoperative visual acuity prediction.
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Ocular injuries or trauma to the eye can be caused by variety of objects resulting in a spectrum of lesions in the eye. We did a Pubmed/Google/Science Direct search to review the spectrum of ocular injuries in Malaysia. In our review, we included 28 papers providing information on ocular injuries which were published from Malaysia during the period 1991-2016 in different medical journals. Prevalence was more among males with an average age of 35 years. Among adults they were more common in the workplace but in children it occurred at home. Few wore protective glasses at work. The mode of injury was due to sharp objects hitting the eye, motor vehicle and domestic accidents, firecrackers, chemicals and rarer causes like superglue and durian fruit. Prognostic factors for outcome were the initial visual acuity, length of the wound, associated factors like hyphaema, intraocular foreign body and vitreous prolapse. Missing the diagnosis of perforation of the eyeball is possible without eliciting a proper history. Protective devices must be worn to prevent injuries. Display of health education charts showing the effect of injuries in the eye and their preventive measures in health centres, private hospitals, schools, factories and sports centres will increase the awareness of public about the ocular injuries. It is important to diagnose the tissues involved in ocular trauma by the general practitioners and primary care physicians and refer the patients to the Ophthalmologist urgently for treatment to salvage vision. Compensation mechanisms should then be put forth in terms of rehabilitation and for monetary loss.
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Objective To evaluate the effects of vitrectomy associated with extraction of intraocular foreign bodies in the posterior segment.Methods Retrospective analysis was done on clinical records of 11 patients (11 eyes) having undergone vitrectomy company with extraction of intraocular foreign bodies in the posterior segment.Results The intraocular foreign bodies in the posterior segment were extracted successfully in all cases, the retinal detachment and endophthalmitis were cured. Postoperation visual acuity was improved in 8 eyes and did not change in 3 eyes. None suffered from postoperative secondary intraocular hemorrahge, decompensation of corneal endothelium and other serious complications.Conclusion Vitrectomy combined with extraction of intraocular foreign bodies in the posterior segment is less damaging, accurate and safe, and enhances the cure rate. It is an effective method for treating intraocular foreign bodies.