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Biomedical subjects

R M Feist

Publications and source records attributed to R M Feist.

28 records · Page 2Linked to original sources

Field evaluation of polycarbonate versus conventional safety glasses.

Of all the causes of eye injury, gunshot has recently been cited as resulting in the highest rate of blindness and the lowest rate of visual recovery. Many of these cases are hunting accidents in which safety glasses could have prevented or lessened ocular damage. To evaluate the effectiveness of various types of safety glasses, we fired a Remington automatic shotgun at mannequin heads fitted with one of four types of safety lenses. From a distance of 10 yards, only polycarbonate lenses provided even partial protection. At 30 yards, polycarbonate and heat-treated lenses provided the best protection, whereas chemically treated and CR39 lenses provided significantly less protection. We recommend that hunters using shotguns in areas of poor visibility wear widely available polycarbonate safety glasses as well as "hunter's orange" to minimize their risk of devastating ocular gunshot injury.

Accidents↗

Bilateral ocular shotgun injury.

We retrospectively studied 14 patients with bilateral ocular shotgun injury in order to determine overall visual prognosis and factors affecting individual prognosis. Although only eight of 28 eyes (29%) in this series recovered visual acuity of 20/100 or better, six of 14 patients (43%) recovered at least 20/100 and eight of 14 patients (57%) recovered visual acuity of at least 20/400. Tissue destruction in the form of severe ocular disorganization or direct injury of optic nerve or macula was the primary limiting factor to visual recovery in 16 of 20 eyes (80%) not recovering to 20/100, while retinal detachment was the limiting factor in only four of these 20 eyes (20%). While extensive ocular disorganization, direct optic nerve or macular injury, no light perception on initial examination, and multiple pellet injuries were predictive of poor outcome, retinal detachment and double perforating injury were not.

Adolescent↗

Recovery of vision after presumed direct optic nerve injury.

Immediate loss of light perception after direct optic nerve injury is usually irreversible. Our patient sustained presumed direct optic nerve injury because of a shotgun injury with loss of light perception, absent pupillary response, and absent visual-evoked potential. A small pupillary response was noted 12 days after injury, light perception returned by 15 days, and visual acuity was 20/100 at 4 months. A variety of pathophysiologic mechanisms may lead to visual loss after direct optic nerve injury. It is important to recognize that blindness is not always permanent in these cases despite the results of initial clinical and electrophysiologic testing.

Adolescent↗

Eye Injury Registry of Alabama (preliminary report): demographics and prognosis of severe eye injury.

Each year an estimated 1.3 million Americans suffer eye injuries. There is little information in the literature regarding the prevalence, demographic characteristics, and prognosis of these patients. The Eye Injury Registry of Alabama (EIRA) serves as the first and only statewide system of its kind for the collection of information on serious eye injuries. We have analyzed 736 cases of serious eye injury (injury involving permanent structural or functional change) accumulated by the EIRA between August 1982 and May 1986. Prognosis was found to be related to early diagnosis and initial vision. Individuals with follow-up vision of 20/40 or better were found in all early diagnostic groups, and 13% of patients with no light perception on initial examination had some improvement on follow-up. The worst visual prognosis was among those patients suffering blunt eyeball rupture, of whom 40% had no light perception and 25% regained vision of 20/100 or better.

Accidents, Home↗