Concomitant ocular injuries with orbital fractures.

BACKGROUND AND OBJECTIVES: The orbital floor may fracture alone, and the fracture is then defined as "pure"; when there is a rim involvement, the fracture may be defined as "impure". Controversy exists as to the pathophysiology of orbital floor fractures and the incidence of orbital rim involvement. The purpose of this retrospective review was to determine the incidence of purity in orbital floor blowout fractures and the rate of ocular injuries in pure and impure floor fractures. METHODS AND MATERIALS: The charts of 250 patients with orbital fractures, treated at a primary trauma center between 1992 and 1996, were reviewed. All fractures had been examined by the Ophthalmology Service and confirmed by high-resolution computerized tomography scans. The average age of the patients was 45 years; more than 90% were male. Motor vehicle accidents were the most commonly documented mechanism of injury, followed by interpersonal violence and falls. Almost 50% could not be categorized for mechanism of injury. RESULTS AND/OR CONCLUSIONS: The incidence of ocular injuries in pure fractures (n = 54; 5.6%) was higher than in impure fractures (n = 26; 2.0%) (p = 0.05). Serious visual injuries following orbital fractures occurred in 17.1% of the patients; they were more common in patients with pure fractures.

Clinical survey of lens care in contact lens patients.

PURPOSE: Overall, contact lenses provide a safe and effective modality for vision correction. However, problems do occasionally arise. Up to 80% of contact lens complications can be traced to poor patient compliance with recommended lens care guidelines. We conducted a survey to evaluate the level of patient compliance in specific areas of lens care and maintenance and to assess patient knowledge of basic contact lens information. METHODS: Patients were asked to complete an anonymous 15 question survey that focused on lens care--specifically the use of contact lens cleaners, methods of disinfection, enzyme treatments, use of rewetting drops, and the frequency of follow-up exams. In addition, the survey included six true/false questions relating to contact lens care and safety. RESULTS: There were a total of 103 participants in the study. Approximately 24% of patients stated they never cleaned their lenses prior to disinfection, and 5% used saline solutions as their primary mode of disinfection. A sizable portion of those surveyed (43% of soft lens wearers and 71% of rigid gas permeable lens wearers) either never used enzyme cleaners or used them less than once a month. Seventy percent of patients either never used rewetting drops or used them less than once a day. Twenty-nine percent of patients consulted their eye care professionals every 2 years and 6% less often than every two years. Six questions assessed patient knowledge of contact lens care safety. Of a possible six out of six correct answers, the mean number of correct responses was 3.74. CONCLUSIONS: A sizable proportion of contact lens wearers do not adequately adhere to recommended contact lens care, and many have an inadequate understanding of contact lens care guidelines. Therefore, it is important that practitioners place more emphasis on patient education at the time of initial contact lens fitting and reinforce such instruction during follow-up visits.