Ocular injuries from paintball pellets.

OBJECTIVE: To evaluate the ocular effects of blunt trauma due to injury from a paintball pellet. DESIGN: Noncomparative case series. PARTICIPANTS: Thirteen patients who suffered ocular injury from paintballs are described. The patients presented to six different civilian and military emergency departments in tertiary care medical centers. INTERVENTION: Patients were treated for the ocular injury. MAIN OUTCOME MEASURES: Patients were evaluated for initial and final visual acuity. The reason for persistent loss of vision was delineated. RESULTS: There were 12 males and 1 female with an average age of 21 years (range, 12-33 years). Eleven of the 13 had no ocular protection at the time of the ocular injury. On initial examination, nine patients had a hyphema, nine had a vitreous hemorrhage, six had a retinal tear or detachment, three had corneal or corneal-scleral ruptures, and one had traumatic optic neuropathy. The final visual acuity was 20/40 or better in two patients, 20/50 to 20/150 in three patients, and 20/200 or worse in eight patients. CONCLUSION: Injuries due to paintball pellets can result in severe ocular damage and significant loss of vision. Eyecare professionals should be aware of the risks of this sport and must strongly advise participants to wear adequate protection when involved in this activity.

Anterior capsule contraction with foldable silicone intraocular lenses.

PURPOSE: To examine the causes signs, and symptoms of anterior capsule contraction syndrome and the response to neodymium YAG (Nd:YAG) anterior capsulotomy. SETTING: Madigan Army Medical Center, Tacoma, Washington, USA. METHODS: This retrospective review comprised 70 cases of phacoemulsification with foldable plate-haptic silicone intraocular lens (IOL) implantation. Patients who developed anterior capsule contraction postoperatively, defined as the anterior capsule being visible through an undilated pupil, had a radial anterior capsulotomy with an Nd:YAG laser. Variables analyzed were visual acuity, subjective complaints, associated inflammation, and IOL decentration. RESULTS: Ten eyes of 9 patients (14%) developed anterior capsule contraction and had Nd:YAG laser radial anterior capsulotomy. Three of 9 patients reported decreased visual acuity and glare. Two other patients had chronic anterior chamber inflammation unresponsive to steroids after surgery that resolved after Nd:YAG anterior capsulotomy. Intraocular lens decentration was observed in 3 patients before the Nd:YAG capsulotomy. Posterior lens dislocation occurred in 1 patient after capsulotomy and required surgical lens exchange. CONCLUSION: One-piece foldable silicone IOLs may not provide enough peripheral capsule expansion.

Glycogen depletion-induced lactate reductions attenuate reflex responses in exercising humans.

Post leg exercise circulatory arrest (PLE-CA) raises blood pressure (BP) and reduces peak forearm vascular conductance (C). This reflex is evoked by activation of muscle afferents that are often sensitive to lactic acid. We tested the hypothesis that lactic acid reductions induced by muscle glycogen depletion would attenuate the lower-limb metaboreceptor-mediated pressor and forearm vasoconstrictor responses. Eleven subjects had C measured (plethysmography) during post leg exercise circulatory arrest (PLE-CA) (supine bicycle exercise for 9 min, 10 s at 75% VO2max before and after undergoing a glycogen-depletion paradigm (24-h fast followed by 10 min of supine leg exercise at 75% VO2max). In six subjects with lower lactate values, C during PLE-CA was higher after glycogen depletion (0.39 +/- 0.05 vs. 0.21 +/- 0.01 ml.min-1.100 ml-1 x mmHg-1; P < 0.01) and BP was lower (113 +/- 6 vs. 128 +/- 6 mmHg, P < 0.01). In five subjects without attenuated lactate responses, C and BP during PLE-CA were not different. Muscle biopsies (n = 5) demonstrated that the paradigm lowered muscle glycogen concentrations. Thus glycogen depletion-induced reductions in muscle lactate are associated with reduced muscle metaboreceptor-mediated responses.