Unrecognized intraorbital wooden foreign body

Intraorbital wooden foreign bodies may present difficulties in diagnosis due to their radiolucent nature. Delayed recognition and management can cause significant complications. We present a case report that demonstrates these problems and the sequela that can follow. A 56-year-old man presented with a 3-cm laceration in the right upper eyelid, sustained by a slipping accident. After computed tomography (CT) scanning and ophthalmology consultation, which revealed no fractures and suggested only pneumophthalmos, the wound was repaired by a plastic surgery resident. Ten days later, the patient’s eyelid displayed signs of infection including pus discharge. Antibiotics and revisional repair failed to solve the infection. Nearly 2 months after the initial repair, a CT scan revealed a large wooden fragment in the superomedial orbit. Surgical exploration successfully removed the foreign body and inflamed pocket, and the patient healed uneventfully. However, the prolonged intraorbital infection had caused irreversible damage to the superior rectus muscle, with upgaze diplopia persisting 1 year after surgery and only minimal muscle function remaining. We report this case to warn clinicians of the difficulties in early diagnosis of intraorbital wooden foreign bodies and the grave prognosis of delayed management.

Descriptive study on ocular survival, visual outcome and prognostic factors in open globe injuries.

A prospective observational study was done to assess ocular survival, visual outcome and prognostic factors of open globe injury. Eighty eyes of penetrating trauma between 2004 and 2006 were categorized according to the ocular trauma classification system. Primary repair was done and outcomes were assessed at one, three and six months. The final vision was categorized as per World Health Organization classification of visual impairment. Factors at presentation were evaluated for prognostic value towards visual outcome. Sixty-nine eyes with minimum one month follow-up were included for analysis. Statistical analysis was done using Univariate and Multivariate analysis. We found Grade IV visual acuity (<5/200) at presentation (64%) as the most important factor contributing to poor visual outcome. Statistically insignificant factors were time since injury, cataract, and presence of intraocular foreign body. Ocular survival was 97%. We concluded that initial visual acuity, hyphema, zone and length of injury, retinal detachment and vitreous hemorrhage are statistically significant factors affecting outcome in open globe injuries.

Clinical characteristics and the result of surgery for penetrating eye injury after mine explosion

Background: Penetrating eye injury caused by mine explosion is a severe ophthalmologic injury. It is rare in Viet Nam and there were no studies on this type of injury. Objectives: To describe the clinical characteristics and evaluate the outcomes of surgery for penetrating eye injury caused by mine explosions. Subjects and method: The prospective analysis was conducted on 34 patients (36 eyes) with penetrating eye injury presented at the Trauma Department of Viet Nam National Institute of Ophthalmology. They were followed up for two years. Results: Out of the \r\n', u'34 patients, 31 were men (91.2%). Types of injury: corneal tear 93.8%, lens damage: 100%, vitreous damage: 56.3%, retinal detachment 25%, intraocular foreign body 72.2%. Initial visual acuity less than 0.02 was 96.9%. The final visual acuity was improved to better than 0.02 in 58.3% of patients. The intraocular pressures were normalized in 72.2% of patients after treatment. Conclusion: Penetrating eye injury caused by exploding mines has very severe clinical features. Despite of improvements in surgical techniques and instruments, the final visual acuity was still poor. The visual outcomes primarily depended on initial damages to the eye.\r\n', u'

Assessment of the outcomes of surgical in the treatment of glaucoma after penetrating eye injury

Background: Penetrating eye injury is common cause blind or many long-term complications later. One of the complications such as glaucoma in the eye. There were some research on glaucoma after penetrating eye injury, but no reports about the treatment of glaucoma. Objectives: To describe the clinical characteristics and assess the outcomes of surgery in the treatment of glaucoma after penetrating eye injury. Subjects and method: The author performed a prospective analysis of 32 eyes the underwent surgery causes by glaucoma after penetrating eye injury at Trauma department of National Institute of Ophthalmology. Follow up period: 6 months. Data was processed by using medical statistics methods on SPSS 10.5 software. Results: Of the 32 patients, 21 were men (65.6%) and 11 were women (34.4%). Localization of the injury: in the cornea 93.8%; lens damages 100%; vitreous organization 56.3%; retinal detachment 12.5%. Functional success (visual acuity >0.02): 18.8%, 4 eyes were enucleated. The normal intraocular pressure after surgery was 71.9%. Conclusion: The clinical characteristics of glaucoma after penetrating eye injury are complicated and multivariable. The rate of normal pressure after treatment was 71.9%.

Evaluation of vitrectomy for severe penetrating eye injury in children

Background: Severe penetrating eye injury is a common emergency in ophthalmology. Objectives: The evaluation results and complications following vitrectomy in severe penetrating injury in children. Subjects and method: This study included 136 eyes with penetrating eye injury, who were treated at the Trauma department of National Institute of Ophthalmology, Hanoi \ufffd?Vietnam from 1999-2000. Vitrectomy was performed through the limbal and pars plana in 135 patients, 105 boys and 30 girls. Results: Remove intraocular foreign body: 11%, procedure for retinal detachments: 14%. The common functional success (visual acuity of 5/2000 or better) rate was 55,1%. Functional success: absent retinal detachment: 60,7%; present: 21,1%. Anatomic success rate was 66,2%. 4 eyes (2,9%) were eviscerated. Complications of the surgery were: iridocyclite, edema of the cornea, hemorrhage, hyphema. Conclusion:Vitrectomy techniques showed its good effect in treating penetrating eye injury in children. Presence retinal damage and endophthalmitis have significant effect on the final visual outcomes.

The Effect of Scleral Buckle in Experimental Penetrating Eye Injury

PURPOSE: Scleral buckles are frequently performed as an additional procedure in perforated ocular injury surgery, but little is known about their independent effect after ocular trauma. The authors made a posterior penetrating ocular injury model in rabbits to evaluate the isolated role of primary scleral buckle placement. METHODS: Twenty eyes underwent surgery. The penetrating injury consisted of two 5 mm circumferential incisions placed five clock hours apart and 7 mm behind the limbus. A segmental scleral buckle was placed over a randomly chosen penetrating injury site after wound closure. The degree of the fibrous proliferation, traction, and the presence of retinal detachment were evaluated on follow-up examination. After enucleation and fixation, tissue sectioning was performed including injury sites. The greatest dimension of the fibrous proliferation at both wound sites was measured. RESULTS: Two eyes were excluded from the study due to unsuccessful buckling. Four eyes developed a retinal detachment. The remaining 14 eyes showed varying degrees of proliferation and traction on the retina. The greatest dimension of the fibrous proliferation at the buckle site (1.69 +/- 0.29 mm) was significantly different from that at the non-buckle site (2.07 +/- 0.37 mm, P<0.05). CONCLUSION: Primary scleral buckle placement at the time of surgical repair reduces vitreous traction and decreases the degree of fibrous proliferation.