Silicone oil migrating into the conjunctival space and orbit after surgery for an eye-penetrating injury: A case report.

BACKGROUND: We report a case of eye-penetrating injury in which a massive silicone oil migration into the patient's subconjunctival space and orbit occurred after vitrectomy. CASE SUMMARY: A 30-year-old male patient sought medical attention at Ganzhou People's Hospital after experiencing pain and vision loss in his left eye due to a nail wound on December 9, 2023. Diagnosis of penetrating injury caused by magnetic foreign body retention in the left eye and hospitalization for treatment. On December 9, 2023, pars plana vitrectomy was performed on the left eye for intraocular foreign body removal, abnormal crystal extraction, retinal photocoagulation. Owing to the discovery of retinal detachment at the posterior pole during surgery, silicone oil was injected to fill the vitreous body, following which upper conjunctival bubble-like swelling was observed. Postoperative orbital computed tomography (CT) review indicated migration of silicone oil to the subconjunctival space and orbit through a self-permeable outlet. On December 18, 2023, the patient sought treatment at the First Affiliated Hospital of Nanchang University, China. The patient presented with a pronounced foreign body sensation following left eye surgery. On December 20, 2023, the foreign body was removed from the left eye frame and an intraocular examination was conducted. The posterior scleral tear had closed, leading to termination of the surgical procedure following supplementary laser treatment around the tear. The patient reported a significant reduction in ocular surface symptoms just one day after surgery. Furthermore, a notable decrease in the migration of silicone oil was observed in orbital CT scans. CONCLUSION: The timing of silicone oil injection for an eye-penetrating injury should be carefully evaluated to avoid the possibility of silicone oil migration.

Causative Activities and Prognostic Factors of Open-Globe Injury: A Registry-Based City-Wide Multicentre Study.

PURPOSE: Traumatic globe injury is classified into closed-globe and open-globe injury (OGI); OGI leads to a worse prognosis. We aimed to identify causative activities and prognostic factors of OGI in a metropolitan city in South Korea. METHODS: This retrospective observational study used a prospective eye-injury registry conducted in Daegu, South Korea, between 1 August 2016 and 31 July 2021. We identified epidemiology and visual outcomes of OGI at four tertiary hospitals. Those with the best visual acuity lower than counting fingers at the 6-month follow-up were considered to have poor visual outcome. RESULTS: Of 9,208 patients with eye injuries, 282 had OGI. Most OGI patients were male (261, 92.6%), with the largest proportion in their 50s (76, 27.0%). The most frequent causative activity was mowing (59, 20.9%), and poor visual outcome was most seen in assault (7, 87.5%) and sports activity (9, 81.8%). Hammering, metal work, and sports activity were prevalent in those under 30, and mowing was most prevalent in those in their 50s (16, 21.1%) and 60s (29, 40.3%). In the multivariable logistic regression analysis, OGI related to traffic accident and sports activity were presented poor prognosis (adjusted odds ratio [aOR] 13.259, 95% confidence interval [CI] 1.202-146.205 for traffic accident; aOR 6.801, 95% CI 1.064-43.487 for sports activity). CONCLUSION: We need to develop advanced vehicle safety equipment, implement public education promoting seat belt usage and hazards of OGI, establish eye protection standards for key causal activities, and provide eye protection equipment for sports activities and mowing.

An Unusual Presentation of Posterior Globe Rupture Detected During Pars Plana Vitrectomy.

A 54-year-old gentleman presented with a history of poor vision in the right eye for three months and a prior forgotten trauma. The anterior segment was normal. He was diagnosed with subtotal bullous rhegmatogenous retinal detachment (RRD), but no apparent tear was observed. Vitrectomy commenced, and upon exploration, there was a posterior globe rupture with retinal and vitreous incarceration. The scleral wound was sutured with heavy liquid in situ. Orbital imaging post-surgery revealed the presence of an intraorbital foreign body. This is a peculiar presentation of posterior globe rupture, as it was unperceived by the patient, and the slit lamp examination conducted indicated no clinical evidence. Identifying posterior globe rupture remains a challenge that necessitates a high index of suspicion and appropriate management.

[Structure of pediatric ophthalmic pathology in Uzbekistan]. / Struktura detskoi oftal'mopatologii v Uzbekistane.

PURPOSE: This study analyzes the structure of eye diseases in children of different age groups based on the materials of the ophthalmology department of the Tashkent Pediatric Medical Institute (TPMI) clinic for 2018-2021. MATERIAL AND METHODS: A retrospective analysis of statistical coupons was conducted, which included the medical records of 5613 patients of the ophthalmology department of the TPMI clinic. RESULTS: In the age structure of ophthalmopathology in children who received inpatient treatment at the TPMI clinic in 2018-2021, children aged 5 to 14 years (49.5%) and 1 to 5 years (30.7%) were significantly predominant. The proportion of patients under 1 year old was 11.2% and from 14 to 18 years old - 7.5%. Congenital glaucoma (41%) and lens diseases (30.4%) are characteristic of infants (from 0 to 1 year old); in patients aged 1 to 5 years, lens pathology (37%), congenital glaucoma (25.2%), and injuries (24.7%) were more common; in children aged 5 to 14 years, the pathology of the oculomotor apparatus (32%) and injuries (27.7%) prevailed; in the age group from 14 to 18 years, lens diseases (28.4%) and injuries of the organ of vision (28.1%) were detected more often. CONCLUSIONS: The revealed age aspects of nosologies are due to the timing of clinical manifestations of the pathology, late seeking ophthalmic care of parents, presence of a concomitant pathology in the child, which prevents surgical treatment. The results of the study will help optimize planned and emergency ophthalmological care for children in the regions of the republic.

Clinical evaluation of ophthalmic findings in active, amateur, adult, competitive male boxers in India.

Background: In the popular fighting sport of boxing, opponents strike each other above the belt line in the face, chest, and belly. The physical parts most exposed are therefore the nose and eyes. In amateur boxing, fights go only three rounds - three minutes for men and one minute for women - with a one-minute break in between. They wear gloves, but the head protection used in the men's game has been removed by AIBA due to the high likelihood of concussion when using head protection. Because chronic ocular changes may take longer than the expected short-term effects, this study included at least 3 years of competitive sports participation. Study design and setting: Institutional-based cross-sectional study. Materials and methods: To evaluate ophthalmic outcomes, 200 eyes of 100 active amateur, adult, and competitive male boxers were studied. Results: Of the 100 boxers, 51 had ophthalmic changes in at least one eye, and 49 had normal eyes. The average age of boxers was 24.98 years. The average duration of boxing training was 7.04 years. Healed eyelid scars, subconjunctival hemorrhages, conjunctival papillae, traumatic mydriasis, posterior synechiae, angulation abnormalities, traumatic cataracts, lens subluxation, increased intraocular pressure, and peripapillary atrophy were observed on the ocular side. None of these could be attributed to boxing. Conclusion: Boxing-related eye injuries are common in India and the most common vision-threatening eye abnormalities include traumatic cataracts, lens subluxation, and angle abnormalities. Surprisingly, no macular lesions were found on physical examination and OCT. Additional studies with a larger number of boxers will be needed to evaluate and prevent clinical symptoms. All boxers should have a complete eye exam regularly. Abbreviations: AIBA = Association Internationale de Boxe Amateur, OCT = Optical Coherence Tomography.

Orchard Sports Injury and Illness Classification System (OSIICS) Version 15.

BACKGROUND: Sports medicine (injury and illnesses) requires distinct coding systems because the International Classification of Diseases is insufficient for sports medicine coding. The Orchard Sports Injury and Illness Classification System (OSIICS) is one of two sports medicine coding systems recommended by the International Olympic Committee. Regular updates of coding systems are required. METHODS: For Version 15, updates for mental health conditions in athletes, sports cardiology, concussion sub-types, infectious diseases, and skin and eye conditions were considered particularly important. RESULTS: Recommended codes were added from a recent International Olympic Committee consensus statement on mental health conditions in athletes. Two landmark sports cardiology papers were used to update a more comprehensive list of sports cardiology codes. Rugby union protocols on head injury assessment were used to create additional concussion codes. CONCLUSION: It is planned that OSIICS Version 15 will be translated into multiple new languages in a timely fashion to facilitate international accessibility. The large number of recently published sport-specific and discipline-specific consensus statements on athlete surveillance warrant regular updating of OSIICS.

Patterns of concomitant traumatic brain injury and ocular trauma in US service members.

Background: Concomitant traumatic brain injury (TBI) and ocular trauma (OT) are caused by the same physical mechanisms, which may complicate therapeutic intervention if screening and evaluation of each condition are not promptly initiated. The aim of this study is to identify concomitant TBI in OT patients and characterize the pattern of those injured service members (SMs) in non-combat environments to assist in the early detection and treatment of both TBI and OT. Methods: Encounters matching the case definitions of TBI and OT for injured SMs were extracted from the Military Health System. Concomitant TBI and OT was identified as patients who were diagnosed with both medical conditions within 30 days. Incidence rates of concomitance were analyzed using a Poisson regression model. The odds of mechanisms and types of OT with concomitant TBI were analyzed using logistic regression models. Results: From 2017 to 2021, there were 71 689 SMs diagnosed with TBI, and 69 358 patients diagnosed with OT. There were 3251 concomitant cases identified. The overall concomitance rate in OT patients was 4.7%. Clinical presentations of concomitant OT had a higher rate of complications. Blast, transport accidents, assaults, alcohol, falls, and sports-related injuries (in decreasing order) were significantly associated with concomitance rates. Compared with closed globe injuries, OT with orbital fractures, rupture, laceration, adnexal periocular injury, and penetrating injury had higher risks of concomitant TBI. For patients with orbital fractures, nearly half (44.1%) sustained a concomitant TBI. Conclusions: A practical approach using temporal proximity of diagnostic data was developed to identify concomitant cases of TBI and OT which presented with more severe injury types than non-concomitant cases. These results indicate OT patients with orbital or open globe injuries sustained from high-impact mechanisms warrant further TBI screening to prompt early detection and treatment. Level of evidence: IV.

Ocular Chemical Burns: Epidemiological Trends in a Colombian Medical Center.

Ocular chemical burns are a significant cause of visual impairment. This study aims to characterize ocular chemical burns in a southwestern Colombia referral center and identify associated factors with low vision. A cross-sectional study was carried out based on the review of medical records of patients diagnosed with chemical eye burns who consulted the emergency ophthalmology service between January 2016 and December 2019. Descriptive statistics were performed. Associations with low vision (Best Corrected Visual Acuity, BCVA, ≥20/70 in Snellen chart) in the last follow-up appointment were identified using a multivariate logistic regression with odds ratios (OR) and 95% confidence intervals (95% CI). 219 eyes affected by chemical burns were identified from 174 patients with a mean age of 39 years (SD±20), out of which 57.5% (n=100) were men. We ran a multivariate model adjusted by sex, eye wash, type of chemical, and Dua's classification. We found that the odds of low vision for patients without eyewash before the consult were three times the odds of those who had it (Adjusted OR [aOR]=3.5, 95%CI=1.3-9.4) and almost five times for those with Dua's classification greater than 1 (aOR=4.7, 95%CI=1.7-12.9). The ocular chemical burns reported in this study occurred more in young people of productive age. Acids were the principal causal agent. The association between lack of early management and the severity of the chemical burn with low vision has been highlighted. Ocular burns remain a relevant cause of consultation on the ophthalmology service in Cali, and prevention strategies are required.

A Systematic Review on the Effectiveness of Eyewear in Reducing the Incidence and Severity of Eye Injuries in Racket Sports.

PURPOSE: To assess what eyewear (if any) reduces eye injury incidence and severity in squash, racketball, tennis and badminton. DESIGN: Systematic review following the 'Preferred Reporting Items for Systematic Reviews and Meta-Analyses' (PRISMA) and the 'implementing Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science' (PERSiST) guidelines. METHODS: PubMed, SportDiscus and Web of Science were searched on 22nd February 2023. All study types except reviews were eligible. Studies had to report the type of eyewear worn (if any) with a form of eye injury incidence and severity. RESULTS: 364 papers were initially retrieved and after the screening process 29 remained. A subgroup analysis was carried out on studies that had a sample size of five or above, were not only looking at a particular type of eye injury and that had sufficient data to allow the percentage of eye injuries that occurred when no eyewear was worn to be calculated. From this analysis, the median percentage of eye injuries that occurred when no eyewear was worn was found to be 93%. Some of these injuries were serious and required complex treatment. Prescription lenses, contact lenses and industrial eyewear made some injuries more severe. In squash and racketball, lensless eye guards were ineffective as the ball could deform on impact, still making contact with the eye. Only eyewear compliant with updated ASTM (or similar) standards was associated with no eye injuries and so provided adequate protection in all four sports. CONCLUSIONS: Although this systematic review only summarizes evidence on injuries requiring hospital treatment, it is recommended that national governing bodies and key decision makers within squash, racketball, tennis and badminton examine the evidence presented and consider extending existing rules or implementing new recommendations and policies on protective eyewear use to reduce eye injury incidence and severity in their sport.

Epidemiology of ophthalmic trauma in the United States from 2009-2018: A Nationwide Emergency Department Sample Analysis.

PURPOSE: To determine the incidence, characteristics, disposition, and economic burden of emergency department (ED) visits for ophthalmic trauma in the United States (US). DESIGN: Retrospective study. METHODS: The Nationwide Emergency Department Sample was used to calculate and characterize ED visits for ophthalmic trauma in the US from 2009 to 2018. Linear regression was used to estimate trends in annual incidence and mean inflation-adjusted ED charges. Logistic regression was used to assess variables associated with inpatient admission. RESULTS: There were over 7.3 million ED visits for ophthalmic trauma in the US over the 10 years, with an annual incidence of 233 per 100,000 population. Patients were predominantly male (65 %), 21-44 years old (39 %), and from low-income households (56 %). Only 1 % of patients were hospitalized. Older age, male sex, metropolitan teaching hospitals, and trauma centers were associated with significantly higher odds of inpatient admission. The mean inflation-adjusted ED charge per visit more than doubled over the decade ($1,333 to $3,187) with total charges exceeding $14 billion. Superficial injuries (44 %) and eyelid/orbit wounds (20 %) accounted for the majority of visits. Orbital floor fractures (4 %) and open globe injuries (2 %) accounted for a minority of visits but were responsible for most admissions (49 % and 29 %, respectively) and the highest mean ED charge ($7,157 and $6,808, respectively). CONCLUSIONS: Ophthalmic trauma represents an increasingly significant burden to EDs in the US. Preventive efforts should target young males from low socioeconomic backgrounds. Strategies to improve outpatient access and redirect non-urgent injuries may help alleviate costs.

An emergency room influx and trauma cases prediction in a Brazilian ophthalmological hospital by an ophthalmologist without code experience / Predição do influxo de atendimentos e casos de trauma em um serviço de urgência oftalmológico brasileiro realizado por um oftalmologista sem experiência em programação

ABSTRACT Purpose: The emergency medical service is a fundamental part of healthcare, albeit crowded emergency rooms lead to delayed and low-quality assistance in actual urgent cases. Machine-learning algorithms can provide a smart and effective estimation of emergency patients' volume, which was previously restricted to artificial intelligence (AI) experts in coding and computer science but is now feasible by anyone without any coding experience through auto machine learning. This study aimed to create a machine-learning model designed by an ophthalmologist without any coding experience using AutoML to predict the influx in the emergency department and trauma cases. Methods: A dataset of 356,611 visits at Hospital da Universidade Federal de São Paulo from January 01, 2014 to December 31, 2019 was included in the model training, which included visits/day and the international classification disease code. The training and prediction were made with the Amazon Forecast by 2 ophthalmologists with no prior coding experience. Results: The forecast period predicted a mean emergency patient volume of 216.27/day in p90, 180.75/day in p50, and 140.35/day in p10, and a mean of 7.42 trauma cases/ day in p90, 3.99/day in p50, and 0.56/day in p10. In January of 2020, there were a total of 6,604 patient visits and a mean of 206.37 patients/day, which is 13.5% less than the p50 prediction. This period involved a total of 199 trauma cases and a mean of 6.21 cases/day, which is 55.77% more traumas than that by the p50 prediction. Conclusions: The development of models was previously restricted to data scientists' experts in coding and computer science, but transfer learning autoML has enabled AI development by any person with no code experience mandatory. This study model showed a close value to the actual 2020 January visits, and the only factors that may have influenced the results between the two approaches are holidays and dataset size. This is the first study to apply AutoML in hospital visits forecast, showing a close prediction of the actual hospital influx.

RESUMO Objetivo: Esse estudo tem como objetivo criar um modelo de Machine Learning por um oftalmologista sem experiência em programação utilizando auto Machine Learning predizendo influxo de pacientes em serviço de emergência e casos de trauma. Métodos: Um dataset de 366,610 visitas em Hospital Universitário da Universidade Federal de São Paulo de 01 de janeiro de 2014 até 31 de dezembro de 2019 foi incluído no treinamento do modelo, incluindo visitas/dia e código internacional de doenças. O treinamento e predição foram realizados com o Amazon Forecast por dois oftalmologistas sem experiência com programação. Resultados: O período de previsão estimou um volume de 206,37 pacientes/dia em p90, 180,75 em p50, 140,35 em p10 e média de 7,42 casos de trauma/dia em p90, 3,99 em p50 e 0,56 em p10. Janeiro de 2020 teve um total de 6.604 pacientes e média de 206,37 pacientes/dia, 13,5% menos do que a predição em p50. O período teve um total de 199 casos de trauma e média de 6,21 casos/dia, 55,77% mais casos do que a predição em p50. Conclusão: O desenvolvimento de modelos era restrito a cientistas de dados com experiencia em programação, porém a transferência de ensino com a tecnologia de auto Machine Learning permite o desenvolvimento de algoritmos por qualquer pessoa sem experiencia em programação. Esse estudo mostra um modelo com valores preditos próximos ao que ocorreram em janeiro de 2020. Fatores que podem ter influenciados no resultado foram feriados e tamanho do banco de dados. Esse é o primeiro estudo que aplicada auto Machine Learning em predição de visitas hospitalares com resultados próximos aos que ocorreram.

Análise das lacerações de canalículo lacrimal atendidas em um hospital de referência em oftalmologia / Analysis of lacrimal canaliculus lacerations treated at a reference ophthalmology hospital

RESUMO Objetivo: Avaliar o perfil clínico-epidemiológico dos pacientes com trauma palpebral com laceração de canalículo lacrimal associado, fatores relacionados ao trauma e à intervenção cirúrgica e o sucesso anatômico e funcional pós-cirúrgico. Métodos: Estudo retrospectivo e analítico longitudinal, no qual foi realizada análise de prontuário dos pacientes com trauma palpebral e lesão canalicular associada, operados no período de 1° de janeiro de 2015 a 31 de julho de 2022. Os pacientes foram selecionados e contatados para avaliação presencial e aplicação de testes para análise do sucesso anatômico e funcional pós-cirúrgico. Resultados: Foram selecionados 84 pacientes, 28 compareceram para avaliação presencial. O sucesso anatômico foi obtido em 64,3%, e o funcional em 60,71% dos casos. A idade esteve associada ao mecanismo do trauma. Conclusão: A complexidade da lesão está associada ao sucesso anatômico e funcional finais, e o resultado do teste de Zappia-Milder guarda relação com a queixa de epífora.

ABSTRACT Objective: To assess the clinical-epidemiological profile of patients with eyelid trauma associated with lacrimal canaliculus laceration, factors related to trauma and surgical intervention, and to evaluate post-surgical anatomical and functional success. Methods: A retrospective and longitudinal analytical study was conducted, in which chart analysis was performed for patients with eyelid trauma and associated canalicular injury, who were operated on from January 1, 2015, to July 31, 2022. Patients were selected and contacted for in-person evaluation and tests to analyze post-surgical anatomical and functional success. Results: We selected 84 patients, and 28 of them attended the in-person evaluation. Anatomical success was achieved in 64.3% of them, and functional success in 60.71% of the cases. Age was associated with trauma traumatic mechanism. Conclusion: Injury complexity is associated with final anatomical and functional success, and the result of the Zappia-Milder test is related to patients' complaints of epiphora.

Missed games, financial losses, and characteristics of eye injuries in the National Basketball Association during the 2010-2011 to 2017-2018 seasons.

PURPOSE: The purpose is to report financial loss, demographic metrics, and mechanisms of injury associated with eye injuries in the National Basketball Association (NBA) from the 2010-2011 to 2017-2018 seasons. METHODS: We performed a retrospective review of eye injuries in the NBA from the 2010-2011 to 2017-2018 seasons using publicly available information from Basketball Reference and the Pro Sports Transactions websites. Only injuries of the eye and adnexa that caused players to miss games in the regular season and playoffs were included in the study. Financial loss was calculated based on the regular season salary of the players and normalized for inflation with 2018 as the base year. RESULTS: There were 30 eye injuries causing a total of 106 missed games and $7,486,770 in financial losses across eight seasons. Linear regressions showed a moderately positive increase in eye injuries (Pearson's r = 0.68, P = 0.07, and 0.79 injuries per year/1000 game-days increase) and financial losses (Pearson's r = 0.67, P = 0.07, and $185.75 increase per year/1000 game-days) over time. There were significantly more games missed due to orbital fractures than games missed due to contusions/lacerations (11.5 vs. 2.8 missed games, P = 0.01). CONCLUSION: We demonstrate an increasing trend of eye injuries in the NBA, resulting in increased financial loss. Injuries may be varied in type and affect the number of games missed.

Community-Level Awareness of Proper Immediate Steps Regarding Ocular Chemical Injury in Qassim Region, Saudi Arabia.

Background An ocular chemical injury is a critical medical condition that results in harm to many components within the orbit, including the epithelium, cornea, and anterior segment. Most accidents tend to transpire among individuals in younger age groups, primarily as a result of their exposure to hazardous conditions either within their domestic environment or in occupational settings. Objective The objective of this study is to evaluate the extent of community awareness of chemical eye injuries and the appropriate measures for urgent care, focusing on different age groups within the Al-Qassim region. Methods A cross-sectional study was utilized in this research, employing data from a sample of 384 individuals residing in Qassim. The participants completed a self-administered questionnaire, which was administered online and ensured anonymity. The questionnaire used in this study had been previously validated. Results The study included a total of 384 participants who were not affiliated with the medical field, selected from the Al-Qassim region. Most of the respondents demonstrated fairly good level of awareness regarding ocular chemical injury (69%). There was a statistically significant relationship between age and the level of awareness (p-value=0.00001<0.05). Most participants believed that ocular chemical injury could cause ocular complications (93.8%) and identified chloride and detergents (92.2%) as the main materials that cause ocular injuries. Conclusion Overall summary, this study's findings suggest that there exists a moderate degree of knowledge among the public regarding chemical injuries to the eye and the appropriate rapid response to such injuries. Majority of the community members were aware that ocular chemical injury can cause ocular complications, blindness, perforation, scarring, and cataracts. Additionally, chloride and detergents were found to be the most common causes of ocular injuries among the population. The study found the most common immediate action when exposed to ocular chemical injury was to irrigate the eye with large amount of water. The study established a statistically significant association between the age and awareness about ocular chemical injury; thus, age appears to be a key factor influencing the amount of awareness seen.

Complete transection of the inferior rectus following blunt trauma: a case report.

This report describes a rare case of complete transection of the inferior rectus resulting from blunt trauma to the orbit. Only eight other cases were identified in the literature. Computed tomography scans should be examined carefully for potential extraocular muscle injury.

Heridas de guerra en el Perú del siglo XIX: la lesión ocular de Andrés Avelino Cáceres / War wounds in nineteenth century Peru: the eye injury of Andrés Avelino Cáceres

RESUMEN Andrés Avelino Cáceres (1836-1923) fue un destacado político y militar peruano que ocupó la presidencia en dos periodos y lideró al ejército peruano durante la Guerra del Pacífico, por lo que es considerado un héroe nacional. Al inicio de su carrera militar, durante el sitio a la ciudad de Arequipa en 1858, sufrió una lesión ocular cuya cicatriz se observa en las fotografías que se le tomaron posteriormente a lo largo de su vida, lo que hizo que fuera apodado "El Tuerto" aunque al parecer su agudeza visual estuvo indemne. En este trabajo describiremos las circunstancias en las que se produjo la lesión oftálmica de Andrés Avelino Cáceres, las secuelas que pudo tener este traumatismo oftálmico y el tratamiento médico que pudo haber recibido, en base al propio relato del héroe y a las imágenes suyas que se conservan.

ABSTRACT Andrés Avelino Cáceres (1836-1923) was a prominent Peruvian politician and military man who held the presidency for two terms and led the Peruvian army during the Pacific War, for which he is considered a national hero. At the beginning of his military career, during the siege of the city of Arequipa in 1856, he suffered an eye injury whose scar can be seen in the photographs that were taken of him later throughout his life, which led to him being nicknamed "El Tuerto". We will describe the circumstances in which the ophthalmic injury of Andrés Avelino Cáceres occurred, the consequences that this ophthalmic trauma could have had and the treatment he could have received, based on the hero's own story and the images of him that are preserved.

Bilateral Angle Recession and Chronic Post-Traumatic Glaucoma: A Review of the Literature and a Case Report.

Ocular trauma affects millions of people worldwide and is a leading cause of secondary glaucoma. Angle recession is the main cause of post-traumatic glaucoma after blunt eye trauma, and it is usually unilateral. The aim of this paper is to investigate the possible causes of angle recession with a bilateral presentation. Airbag activation during traffic accidents is a likely cause to be ruled out, along with repeated head or eye trauma, due to contact sports or a history of physical abuse. These aspects can aid in early detection, appropriate management, and improved outcomes for patients with ocular trauma. Finally, we report the case of a 75-year-old Caucasian man who developed a bilateral angle recession after an airbag impact, with advanced glaucoma in the right eye and ocular hypertension in the left eye. To our knowledge, this is the first case in the literature of chronic post-traumatic glaucoma probably caused by an airbag.

Ocular Trauma Trends during COVID-19 Pandemic.

Background: The article aims to study the demographics and clinical characteristics of ocular trauma patients presenting to the Eye Casualty Clinic between COVID-19 and non-COVID-19 era in Ampang Hospital, Malaysia. Methods: In this cross-sectional study, data of patients presented with ocular trauma injury to the Ampang Hospital during the COVID-19 era from 18 March 2020 to 17 September 2020 were retrieved and compared with the similar period of the previous non-COVID-19 era year. Results: Among the total number of 453 patients, 76.82% (n = 348) were predominantly males. The commonest age group was between 21 years old-40 years old (49.45%, n = 224), and the commonest location of ocular trauma injury occurred at the workplace (38.19%, n = 173); welding was the commonest work-related injury (13.83% in 2019; 12.50% in 2020). Injury-to-treatment time was significantly longer during the COVID-19 era, where patients who sought treatment within a day of injury were 27.27% (n = 69) in 2019 and 18.50% (n = 37) in 2020 (P = 0.030). During the COVID-19 pandemic, patients with vision worse than 6/60 on presentation were higher at 8% compared with 3.56% before the COVID-19 pandemic (OR = 2.35; 95% CI: 1.01, 5.48; P = 0.047). Similarly, patients with a vision worse than 6/60 post-treatment during the COVID-19 period were significantly higher at 7.00% compared with 1.58% before the COVID-19 pandemic (OR = 4.72; 95% CI: 1.53, 14.62; P = 0.007). Conclusion: The majority of ocular trauma cases in this study population were male adults between 21 years old and 40 years old, and welding was the commonest work-related injury. COVID-19 era has a higher percentage of patients presented with severe visual impairment, longer injury-to-treatment time and poorer post-treatment visual outcomes.

Case report: Bilateral eye injuries in members of one family due to a cluster munition in Ukraine.

The aim of the study was to report the effects of surgical treatment of three victims of a cluster munition in Ukraine. A 32-year-old woman and her sons-6-year-old male twins-presented in Poland after 18 days of delay in treatment. All ocular injuries were bilateral. One of the boys presented with total retinal detachment and a post-traumatic cataract as well as corneal sutures in one eye and a post-traumatic cataract in the other eye. The other boy had already developed atrophy in one eye and a vitreous hemorrhage in the other eye. The woman suffered from bilateral post-traumatic cataract with multiple glass intraocular foreign bodies (IOFBs). The surgical treatment included cataract surgery with intraocular lens implantation in three eyes, removal of IOFBs in one eye, and enucleation of the atrophic eye with implantation of an ocular prosthesis preventing constriction of face tissues. The eye with retinal detachment underwent pars plana vitrectomy, and the vitreous hemorrhage resolved itself. Postoperatively, visual acuity improved significantly in four of six eyes. Only in the eye with an open-globe injury and persistent retinal detachment, the final visual acuity was still poor. In conclusion, cluster munition may lead to bilateral ocular trauma with IOFBs, open-and close-globe injuries, and severe vision loss if left untreated. Modern ophthalmic surgery leads to vision with IOL improvement and solving the eyes after severe combat injury.

Analysis of Operated Patients with Ocular Trauma: A 10-Year Retrospective Study.

Background: Ocular trauma is one of the most common causes of hospitalization in patients with ocular injuries. It imposes many direct and indirect physical and psychological costs on the patient and the community. Materials and Methods: The present descriptive cross-sectional and retrospective study includes all patients with ocular trauma who underwent surgery in the referral center's ophthalmic operating room for 10 years. A checklist was completed for each patient, including demographic information and the variables required for the study. A total of 927 patients who underwent eye surgery due to ocular trauma were eligible for the study. All descriptive data were reported as the mean plus standard deviation for quantitative variables and distribution tables and frequency percentage for qualitative variables. Inferential tests such as independent t-test and Chi-square test were used to evaluate the research questions. Results: This study showed that most ocular traumas occur at a young age and mostly in males. The types of trauma in the studied eyes were divided into penetrating and non-penetrating in different age groups. The results showed that the most common type of surgery was corneal laceration repair, and in all patients, visual acuity improved significantly after surgery. In this study, a total of 81% of patients underwent only one operation. Conclusions: Training and caring for children and adolescents about high-risk behaviors and educating industry professionals to wear goggles, and increase workplace safety can reduce these types of trauma.