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Background: Open globe injury is a serious sight threatening condition. Full-thickness, non-selfsealing corneal lacerations require repair in the operating room. During repair, debridement of the wound is an important step. Incarceration of the intraocular structures in the wound eg. Iris, lens capsule, vitreous leads to improper healing if not removed properly. Purpose: To demonstrate the technique of wound debridement in open globe injury. Synopsis: Manual removal of incarcerated tissue contents leads to incomplete cleaning & enormous traction on intra ocular contents. In this video, we have tried vitrectomy cutter with higher vacuum for cleaning the edges of the wound especially in the posterior aspect and debri removal, followed by easy suturing. All tissue in the wound edges are removed effectively without any traction on intraocular contents. Highlights: Vitrectomy cutter is a very useful and effective tool to clean wound edges and good apposition & suturing of wound
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Objective@#This study described the demographics of pediatric patients who sustained open globe injuries, determined the visual outcome of open globe injuries in pediatric patients and the factors associated with final visual acuity. @*Methodology@#The medical charts of 195 patients aged 0-18 years seen for open globe injury in a Philippine tertiary hospital for three years were reviewed. @*Results@#The average age of patients was 7.9 years with 41% belonging to the 5-9 years old group. Seventy-five percent (75%) of the patients were males. Ninety-five percent (95%) of the open globe injuries were accidental, mostly from play (67%). The most common agents of injury were metallic objects (42%) followed by wooden objects (24%). The cornea was injured in 80% of the cases, cornea and sclera in 10%, sclera in 7%, and globe rupture in 3%. Eighty-six percent (86%) of the patients underwent surgery. Initial visual acuity was associated with the presence of complication and the site of injury. Final visual acuity was associated with the initial visual acuity, the interval from injury to consultation, the site of injury, and the presence of complications. @*Conclusions@#The majority of the injuries were accidental and thus avoidable. The education of parents and caregivers on proper storage of potentially harmful objects at home and proper supervision of children at play are important in addition to early consultation after the injury as well as a timely intervention.
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NiñoRESUMEN
Paediatric ocular trauma is one of the most common causes of preventable visual morbidity in children. One third vision loss occurs in the first decade of life, which is crucial stage for visual development. We wanted to evaluate the final visual outcome of paediatric ocular trauma and determine the various aetiological factors contributing to ocular trauma.METHODSProspective data regarding age, sex, visual acuity, etiological factors of 100 children who visited the emergency in the department of ophthalmology was collected. Children below 18 years of age were included. Children who could not cooperate or lost to follow-up were excluded from the study. Chi square test was done. P values were considered statistically significant at 0.01% level.RESULTSOf the 100 cases, closed globe injury accounted for 69% and the sex ratio was 3.2:1.48 children had visual acuity > 6/12, 18 had visual acuity 6/18 – 6/36, and 3 children had no perception of light (NOPL).CONCLUSIONSPaediatric ocular trauma is a major cause of the non-congenital unilateral blindness. Such injuries cannot always be prevented, but by identifying the underlying aetiological factor of serious injuries, it may be possible to determine the most effective method of reducing the incidence of visually challenging trauma. Although prognosis is mainly dependent on the extent of injury, choice of appropriate management can favourably affect the visual outcome.
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<p><b>PURPOSE</b>Ocular trauma is one of the most common causes of acquired blindness in children. It measures about 8%-14% of total childhood injuries. This study aims to determine the epidemiological profile of ocular trauma in the pediatric age group attending a tertiary hospital in northern India.</p><p><b>METHODS</b>A retrospective study was conducted in our hospital between June 2014 to July 2015 and all the children aged 0-16 years presenting with ocular trauma in eye outpatient department and emergency were enrolled in the study. Various epidemiological parameters like age, sex distribution, duration of presentation, mode of injury, type of injury and final visual outcome were analyzed.</p><p><b>RESULTS</b>Of total 357 patients, 271 (76%) were below the age of 12 years; 41.1% of children with ocular trauma belonged to age group 2-6 years. The male to female ratio was 2.9:1. Out of total patients, 242 (67.8%) presented with closed globe injury. Among the closed globe injury, the history of fall was present in about 35% of children, followed by trauma while playing with bat/ball (15.7%) and finger nail trauma (13.2%). Among open globe injury, trauma with needle, knife, glass and pen were common causes. Home was the most common place of injury (47.8%), followed by streets (17.9%) and playground (14.9%).</p><p><b>CONCLUSION</b>Children are vulnerable to ocular trauma and need more supervision. Sharp objects like needles, knives, household chemicals like acids should be out of reach of children.</p>
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Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Lesiones Oculares , Epidemiología , India , Epidemiología , Estudios Retrospectivos , Centros de Atención TerciariaRESUMEN
Objective To evaluate the clinical effect of vitrectomy for open globe injuries with intraocular foreign bodies in 48 hours after injury.Methods Retrospective analysis was used to evaluate the patients with open globe injuries (OGIs) accompanied by intraocular foreign bodies (IOFB) who underwent vitrectomy of pars plana vitrectomy (PPV) within 48 hours during the period from January 1,2009 to March 1,2015 in our hospital.Results Among the 56 eyes,16 eyes with intraocular foreign bodies occurred endophthalmitis,while the other 40 eyes did not;the intraocular foreign bodies removal rate was 100％.Among all the patient eyes,52 eyes were saved after surgery,while 4 eyes failed.The pars plana vitrectomy operation ratio of the intraocular foreign bodies patients with endophthalmitis and operated within 24 to 48 hours was 2.09 times than that within 24 hours.There was no significant difference in terms of eye preservation,one time of retinal reposition and abnormal intraocular pressure no matter the PPV surgery was conducted within 24 hours or 24 to 48 hours after injury.Conclusion Early vitrectomy is a safe and effective method for the treatment of open globe injuries with intraocular foreign bodies.
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@#AIM: To study the clinical profile of ocular injuries in children in a tertiary care center in Northern India.<p>METHODS: This was a hospital based descriptive study. All children of ocular injuries up to 16y of age were included. Data regarding the socio-economic status, medical/surgical treatment, and condition at discharge were recorded. Follow-up to 3mo was done in the study. Initial and final visual acuity was recorded. Ocular Trauma Classification Group guidelines and Birmingham Eye Trauma Terminology were used for the definitions and classifications of ocular trauma. Socio-economic status grading is done according to modified B.G. Prasad classification and Kuppuswamy's socio-economic scale.<p>RESULTS: Out of 42 children, male to female ratio was 3.6:1.Maximum number(50%)of injuries occurred between 11-16y of age. Most of the children(59.52%)belonged to lower socio-economic class and were from arural background. Ocular injuries occurred at home in 20(47.61%)children followed by 6(14.28%)each in school, playground, and street. Open globe injuries were seen in 19(45.24%)children and 23(54.75%)children had closed globe injuries. Injuries by wooden stick, stone, firework, fall, toy were 12(28.57%), 5(11.90%), 3(7.14%), 3(7.14%), and 2(4.76%). Seventeen(40.47%)children required medical management and 25(59.53%)were treated surgically.<p>CONCLUSION:Male children in rural regions and of lower socio-economic background were more prone to ocular injuries. Children were more risk of ocular injuries at home. Wooden sticks and stone were the commonest cause of ocular injuries. Ocular morbidity and poor visual outcome were seen more in open globe injuries. Further population-based studies are required to reinforce findings of present study. Based on this, a long term strategy can be planned to prevent ocular injuries in children in this region.
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AIM:To evaluate the demographics, characteristics and visual outcomes of open globe injuries in children of amblyogenic age in Hong Kong. METHODS: All medical records of children aged between 0 to 8y old who sustained open globe injuries between Jan. 1st, 2005 and Jan. 1st, 2015 were reviewed retrospectively. The demographics, clinical features ( laterality, etiology and zone of injury, other associated ocular injuries ) , type of primary and secondary operations performed, preoperative and postoperative best spectacle corrected visual acuity ( BSCVA ) complications were collected and analysed. RESULTS: A total of 7 cases, 2 males and 5 females were identified. The median age of presentation was 5 years old. All suffered from penetrating injuries (100%). Four cases ( 57%) had improvement of visual acuity compared with preoperative visual acuity. Final visual acuity was hand movement in one (14%) patient, 20/200-20/50 in four ( 57%) patients, and 20/40 or better in two (29%) patients. CONCLUSION: There is a relative low rate of open globe injuries in young children in Hong Kong. Good visual outcomes may be obtained depending on the location and severity of the open globe injury together with prompt surgical management to restore the integrity of the globe and aggressive management of amblyopia.
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? AIM: To analyze clinical characteristics and postoperative outcomes after open globe injury.?METHODS: Demographic characteristics ( age, gender, eye trauma, profession, cause of injury and injured part ) , as well as complications and prognosis were analyzed in 152 cases (152 eyes) of open globe injury.? RESULTS: Patients with open globe injury had an average age of 40. 45±38. 32 years old with a 5. 9:1 male-to-female gender ratio. The left-to-right eye ratio was 1. 27:1. Most patients were workers, farmers, or retired. The most common etiologies were scratches, boxing, and falls. Zone Ⅲ was the most commonly injured part. Iridoptosis or iris incarceration, retinal detachment, vitreal prolapse, hyphema or hypopyon, and vitreous hemorrhage were the most common complications. Visual acuity improved in 86 cases postoperatively but ophthalmectomy was still required in 25 eyes.?CONCLUSION: Vision can be improved after surgery in open globe injury. However, patients are usually seriously injured and improvement is minimal, thereby resulting in a great loss to patients and society.
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AIM: To explore the relationship between different timing of vitreous surgery and prognosis after the open globe injuries. METHODS:Fifty-eight cases (58 eyes) with open globe injuries were chosen in our hospital from June 2011 to June 2013, and randomly divided into observation group and control group to have vitreous surgery in early phase and normal time respectively. Thirty cases ( 30 eyes ) in the observation group were received vitreous surgery during 3d, and 28 cases (28 eyes) in the control group from one to two weeks. The vitreous surgery of two groups of patients were finished by the author herself. The ocular injury before surgery, the effect of surgery treatment and the incidence of complications after surgery of the two groups of patients were compared. RESULTS: The eye damage situation such as lens rupture, vitreous hemorrhage, retinal detachment and corneal laceration of two groups of patients before surgery were no significant statistical difference ( P >0.05). The postoperative therapeutic effect of observation group was better than the control group (χ2=6. 869, P<0.05 ); the postoperative complications of observation group was obviously lower than the control group (P<0. 05). CONCLUSION: The timing of vitreous surgery of patients with open globe injuries correlate with the prognosis, which prompts that better therapeutic effect can be achieved and the occurrence of complications can be reduced in early vitreous surgery of the patients with open globe injuries.
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Purpose: To identify pre‑operative variables affecting the outcome of posterior open globe (zone III) injuries. Secondary objective was to re‑look at the definition or landmarks for zone III injury and its clinical significance for predicting visual prognosis following open globe injury. Materials and Methods: Retrospective review of medical records of all hospitalized patients with surgical repair of open globe injury over last 10 years at a tertiary referral eye care center in Singapore. Out of 172 eyes with open globe injury, 28 eyes (16.3%) with zone III injury was identified and reviewed further. Pre‑operative visual acuity (VA) and other variables, extent of scleral wound in reference to rectus insertion, relative afferent pupillary defect (RAPD) and final vision outcome were recorded. Results: Median age was 37 years with male predilection (92.9%). Mean follow‑up was 12.9 months. Pre‑operative VA was no light perception (NLP) in 16 (57.1%) eyes. Final VA remained NLP in 14 eyes (50.0%). The factors contributing to poor post‑operative vision based on univariate regression analysis were the presence of RAPD, poor pre‑operative VA, blunt trauma, extent of trauma, associated traumatic cataract, hyphema, vitreous loss and associated vitreo‑retinal trauma. Further on, zone III injuries with scleral wound limited anterior to rectus insertion (6 eyes) had better vision outcome than those with injuries extending beyond rectus insertion (22 eyes). Conclusion: Initial VA, blunt ocular trauma, visual axis involvement, loss of light perception, presence of RAPD, traumatic cataract, hyphema, vitreous loss were the important determinants for final visual outcome in patients with zone III injury. Wound extending posterior to rectus insertion has poorer outcome as those limited anterior to rectus insertion. We suggest that there may be a need to relook at zone III injuries with reference to rectus insertion for prognostic significance, and further studies are warranted.