ABSTRACT
As the rate of terrorism increases, it is important for health care providers to become familiar with the management of injuries inflicted by blasts and explosions. This article reviews the ocular injuries associated with explosive blasts, providing basic concepts with which to approach the blast-injured patient with eye trauma. We conducted a literature review of relevant articles indexed in PubMed between 1948 and 2007. Two hundred forty-four articles were reviewed. We concluded that ocular injury is a frequent cause of morbidity in blast victims, occurring in up to 28% of blast survivors. Secondary blast injuries, resulting from flying fragments and debris, cause the majority of eye injuries among blast victims. The most common blast eye injuries include corneal abrasions and foreign bodies, eyelid lacerations, open globe injuries, and intraocular foreign bodies. Injuries to the periorbital area can be a source of significant morbidity, and ocular blast injuries have the potential to result in severe vision loss.
Subject(s)
Blast Injuries/diagnosis , Blast Injuries/therapy , Emergency Medical Technicians , Emergency Medicine/methods , Eye Injuries/etiology , Vision Disorders/etiology , Blast Injuries/complications , Explosions , Eye Injuries/diagnosis , Eye Injuries/therapy , Humans , Terrorism , Vision Disorders/diagnosis , Vision Disorders/prevention & control , Vision Disorders/therapyABSTRACT
Infectious endophthalmitis is an uncommon but potentially devastating eye disease. Although the presence of a hypopyon is considered one of the hallmark clinical signs of infectious endophthalmitis, hypopyon associated with non-infectious causes may occur. Two patients with hypopyon and pseudoendophthalmitis secondary to chronic vitreous hemorrhage are described. In both cases, the hypopyon improved without the use of intravitreal antibiotics.
Subject(s)
Endophthalmitis/etiology , Suppuration/etiology , Vitreous Hemorrhage/complications , Adult , Chronic Disease , Endophthalmitis/physiopathology , Female , Humans , Middle Aged , Suppuration/physiopathologyABSTRACT
PURPOSE: To evaluate the safety and efficacy of intravitreal bevacizumab (Avastin, Genentech Inc.) for the treatment of neovascular age-related macular degeneration (ARMD). METHODS: A retrospective review was performed on consented patients with neovascular ARMD receiving intravitreal bevacizumab therapy. All patients received intravitreal bevacizumab at baseline with additional monthly injections given at the discretion of the treating physician. At each visit, a routine Snellen visual acuity assessment was performed followed by an ophthalmic examination and optical coherence tomography (OCT) imaging. RESULTS: Fifty-three eyes of 50 patients received an intravitreal bevacizumab injection between May and August 2005. Including the month 3 visit, the average number of injections was 2.3 out of a maximum of 4 injections. No serious drug-related ocular or systemic adverse events were identified. Improvements in visual acuity and central retinal thickness measurements were evident by week 1 and continued through month 3. At month 3, the mean visual acuity improved from 20/160 to 20/125 (P < 0.001) and the mean central retinal thickness decreased by 99.6 microm (P < 0.001). CONCLUSION: Off-label intravitreal bevacizumab therapy for neovascular ARMD was well tolerated over 3 months with improvements in visual acuity and OCT central retinal thickness measurements. While the long-term safety and efficacy of intravitreal bevacizumab remain unknown, these short-term results suggest that intravitreal bevacizumab may be the most cost effective therapy for the treatment of neovascular ARMD.
