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PubMed1994

Self-inflicted eye injuries: case presentations and a literature review.

OBJECTIVE: The authors' aim was to determine demographic and clinical correlates of self-inflicted eye injury. METHODS: The authors reviewed 41 cases of patients with self-inflicted eye injuries identified through MEDLARS searches of medical literature for the period from 1980 to 1993 and four cases from the first author's clinical practice. RESULTS: Most patients with self-inflicted eye injuries were male, about 31 years old, and had a diagnosis of schizophrenia, drug or alcohol abuse, depressive disorders, or other psychosis. Some patients experienced cognitive distortions, often involving religious and sexual ideation, and intense fear around the time they injured themselves. Thirty-three percent of the patients with self-inflicted eye injuries also showed other types of self-injurious behavior. CONCLUSIONS: Enucleation of the eye may serve as a defense against witnessing or experiencing a forbidden act. Psychodynamic theories addressing self-mutilation do not explain self-induced eye injury particularly well but may assist the therapist in understanding motivation and in restructuring patients' behavior. Management of these patients requires multidisciplinary, multimodal efforts involving medical specialists, patients, family members, and staff.

Adolescent↗
PubMedDate not supplied

[Perforating eye injuries in children].

The author studied 140 cases of perforating eye injury in children up to 15 years old admitted at the Clinic Hospital of the Medical College of the University of São Paulo (Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo) from January 1989 to December 1993. These cases represent 24.71% of the total of the perforating eye injuries seen during this period, showing a ratio of 76.42% of males, a ratio of 2/1 in the group from 0 to 6 years old, 7/1 in the group from 7 to 11 years old and a ratio of 3/1 in the group from 12 to 15 years old. The most common perforating eye injuries were due to sharp objects (54.71%), contusion (20%), explosions (7.85%) and flying objects (5.71%). The relation between the severity of the injury and the prognosis is emphasized. Safety precautions should be effective in order to reduce frequence and morbidity of these perforating ocular injuries.

Adolescent↗
PubMed2007

Head, face, and eye injuries in scholastic and collegiate lacrosse: a 4-year prospective study.

BACKGROUND: Risks and mechanisms of head, face, and eye injuries in high school and college lacrosse are not well documented. PURPOSE: To identify (1) primary mechanisms of head, face, and eye injuries in lacrosse and (2) differences in injury risk between the men's and women's game and between high school and collegiate levels. STUDY DESIGN: Descriptive epidemiological study. METHODS: The authors gathered data on 507,000 girls' and boys' high school and 649,573 women's and men's college lacrosse athletic exposures using sport-specific injury surveillance systems over 4 seasons. They identified the most common scenarios for head, face, and eye injuries. RESULTS: The high school girls' head, face, and eye injury rate (0.54 per 1000 athletic exposures) was significantly higher (incident rate ratio, 1.42; 95% confidence interval, 1.09-1.86) than that for boys (0.38 per 1000 athletic exposures); college women (0.77 per 1000 athletic exposures) sustained a higher rate of injuries (incident rate ratio, 1.76; 95% confidence interval, 1.42-2.19) than did men (0.44 per 1000 athletic exposures). Concussions constituted a higher percentage of injuries among boys (73%) and men (85%) than among girls (40%) and women (41%). Men sustained few facial injuries, whereas a substantial proportion of women's injuries involved the face and orbital area. CONCLUSION: Although permitting only incidental contact, women's lacrosse had higher rates of head, face, and eye injuries at both the high school and collegiate levels. Concussion was the most common injury. For men, the primary injury mechanism was player-to-player contact; women's injuries primarily resulted from stick or ball contact. High school injury rates were lower than were college rates, but the nature of injuries, body parts affected, and mechanisms were similar.

Adolescent↗
PubMed1991

Eye injuries in northern Sweden.

An analysis of 927 eye injuries treated at the University Hospital of Umeå, Northern Sweden, during a one-year period has been made. The estimated incidence was 8.1 per 1000 population. 86% of the injured were men. An overrepresentation of severe injuries were found in children and young adults, aged 10-19 years. 94.5% of the injuries were minor. The most common diagnosis was foreign body adherent to cornea or conjunctiva (40%). All chemical injuries were superficial. One-third of the sports injuries were caused by hockey-bockey and indoor bandy. Most of these were major injuries. The total cost of the injuries was assessed at SEK 1300,000. More information to the public concerning use of safety glasses and potential risks of eye trauma could reduce eye injury incidence.

Adolescent↗
PubMed2003

Preliminary experience of combined peri- and retrobulbar block in surgery for penetrating eye injuries.

BACKGROUND AND OBJECTIVE: Regional anaesthesia has not been recommended as an anaesthetic method for penetrating eye injuries because it is suspected to aggravate the injury already present. After having successfully managed the treatment of a penetrating eye injury under combined peri- and retrobulbar block in an ASA IV patient, it was decided to evaluate this anaesthetic method further in the treatment of such emergency cases. METHODS: Twenty adult patients with penetrating eye injuries with a maximum wound length of 8 mm extending up to 4 mm posteriorly from the limbus were operated on under combined peri- and retrobulbar anaesthesia. Eighteen patients receiving general anaesthesia served as controls. RESULTS: The mean (range) volume injected for a satisfactory peribulbar retrobulbar block was 7.4 (6.5-8.0) mL, six patients needed an additional retrobulbar injection before surgery (2.9, range 2-4, mL). All patients receiving regional anaesthesia were satisfied with the anaesthetic method and the surgeons considered the surgical conditions as good. No problems relating to local anaesthesia were observed or reported by any of the patients. CONCLUSIONS: In the hands of an experienced anaesthesiologist and under certain conditions, regional anaesthesia appears to be suitable for adult patients having penetrating eye injuries.

Adolescent↗
PubMed1985

Eye injuries in Canadian amateur hockey.

The incidence of eye injury in Canadian amateur hockey has declined sharply, from 257 cases in the 1974-75 season to 124 in the 1983-84 season, since face protectors certified by the Canadian Standards Association (CSA) and attached to CSA-certified helmets became mandatory for minor hockey players in this country. None of the reported cases in 1983-84 were in players wearing such equipment. The average age of the injured players was 14 years in 1974-75 but 24 years in 1983-84; that is, younger players are now protected, but older players are not. Hockey sticks and pucks were the top two causes of eye injury in both seasons, but hyphema became the commonest type of injury in 1983-84, surpassing soft tissue damage. The frequency of legal blindness as the visual outcome fell from 19% in 1974-75 to 11% in 1983-84. A suitable face protector must now be developed for older players.

Adolescent↗
PubMed1994

Clostridium bifermentans panophthalmitis after penetrating eye injury.

BACKGROUND: Intraocular and orbital anaerobic infections usually result from penetrating eye injuries with soil-contaminated foreign bodies. The outcome of these infections almost always has been loss of the globe, despite appropriate antibiotic and surgical treatment. The most prevalent etiologic microbe of anaerobic panophthalmitis is Clostridium perfringens. CASE REPORT: To the authors' knowledge, this is the first report of panophthalmitis caused by Clostridium bifermentans after penetrating eye injury. The patient had severe signs and symptoms of intraocular and orbital infection, with early total loss of visual function. Parenteral and intravitreal therapy with penicillin and clindamycin, administered according to antibiotic sensitivity studies of cultures from the anterior chamber and vitreous, did not restore vision. CONCLUSIONS: Due to the early devastating outcome, penetrating eye injuries with soil-contaminated foreign bodies should be regarded as being at high risk for clostridial infection and should be treated promptly with vitrectomy and antibiotic therapy for aerobic and anaerobic infection.

Adolescent↗
PubMed2003

The incidence of eye injuries at three U.S. Army installations.

Studies addressing the impact of eye injuries on U.S. Army readiness and the effectiveness of countermeasures are lacking. In 1989, the U.S. Army Environmental Hygiene Agency undertook a prospective, multicenter study of military units in the peacetime Army at selected installations to define the incidence of eye injuries, assess associated variables, and identify targets for intervention. During the first 5 months of 1989 at Fort Bragg, North Carolina, Fort Campbell, Kentucky, and Fort Lewis, Washington, health care providers saw 103 new eye injuries with an overall rate of 14.18 injuries per 1,000 personnel annually. Almost one-half of the injuries (48 cases, 46.60%) occurred during on-duty work and training. Most (93 cases, 90.29%) of the soldiers were not wearing eye protection when injured. This study identifies possible targets for intervention and provides a baseline against which the interventions of the last decade may be assessed for effectiveness.

Adult↗
PubMed2003

Traumatic eye injuries due to large unusual foreign bodies: a Singapore case series.

PURPOSE: Traumatic eye injuries due to large foreign bodies (FB) are rare. The visual prognosis is often poor in these cases because of severe ocular damage. Staged surgical procedures with eventual enucleation or evisceration are often indicated. METHODS: Case series. RESULTS: The authors describe two patients with eye injury due to large FB with visual acuity of no light perception at presentation. Both had initial repair of the ocular injuries and removal of the FB. One patient with an intraocular FB eventually underwent enucleation; the other, with intraorbital FB, had evisceration as a secondary procedure. Orbital implantations were done in both. Neither of the patients had developed sympathetic ophthalmia at the last review. CONCLUSIONS: The visual outcome of eye injuries due to large FB is poor. Both enucleation and evisceration can be performed with low risk of sympathetic ophthalmia. Prevention remains the best approach to such devastating injuries.

Adult↗
PubMed1998

Epidemiology of severe childhood eye injuries that required hospitalisation.

We conducted a retrospective study of all paediatric ocular injuries that were treated at the Prince of Wales Hospital between October 1991 and January 1997. Of the 60 injuries reviewed, eight (13.3%) resulted in some degree of visual deficit. The mean age was 5.5 years and the average male to female ratio was 2.75:1. The distribution of injuries was as follows: contusions, 29 (48.3%); non-penetrating lacerations, 14 (23.3%); penetrating lacerations, six (10.0%); chemical burns, six (10%) and superficial foreign bodies, five (8.3%). Thirteen (21.7%) ocular injuries were associated with common household items, seven (11.7%) injuries were due to toy gun pellets, and five (8.3%) injuries were sports-related. A total of 28 operations were performed on 21 patients, and the mean duration of hospital stay was 3.6 days. The visual outcome depended mainly on the type and severity of the injury. Some childhood eye injuries are preventable by means of more public education, improved safety measures, and closer adult supervision.

Journal Article↗
PubMed1994

Eye injuries from traditional sports in Aosta Valley.

We reviewed the records of the patients hospitalised for eye injuries in Aosta Valley between January 1976 and June 1993. Eye injuries from traditional regional sports accounted for 27 cases (41.5% of all ocular sport injuries), of which 21 (77.8%) occurred during the game 'tsan', the most popular one. Injuries led to legal blindness in 3 (11.1%) cases and to a permanent visual loss in 2 (7.4%). Although our data do not allow to assess either a significantly higher incidence or severity of eye injuries from Aosta Valley regional games as compared with other sports, the possibility of severe trauma with visual loss suggests to extend the use of protection devices.

Adolescent↗
PubMed1990

[Eye injuries in sports].

On the basis of personal material from 6 years (70 patients, 104 eyes) the author discusses, the eye injuries inflicted during sport activities and their incidence in various sport disciplines. In 5-10 per cent of such injuries the final visual acuity was 0.1 or less. The possibilities of prophylaxis are also presented; suggested is the wear of protective glasses made of polycarbonate.

Athletic Injuries↗
PubMed1999

Increasing paintball related eye trauma reported to a state eye injury registry.

OBJECTIVES: To evaluate an apparent increase in documented trauma from paintball related eye injuries reported to the Eye Injury Registry of Indiana. METHODS: A retrospective review of cases reported to the database is reported, with representative case histories. RESULTS: No injuries from paintball were reported during the period June 1992 to June 1996. Over the next two years 11 injuries were reported, representing 4% of all ocular trauma reports over this period. Visual outcome is poor in many of these eyes and more than one half present with posterior segment ocular injury. CONCLUSIONS: Severe ocular trauma results from impacts from paintball pellets, and the occurrence of injuries appears to be increasing due to growth in popularity of this war game. Diligent use of eye protection by all participants is necessary to prevent a continuing rise in ocular trauma prevalence from this activity.

Adolescent↗
PubMed1989

Epidemiological and social aspects of perforating eye injuries.

The epidemiology of 387 consecutive perforating eye injuries (PEI) treated at the Helsinki University Eye Hospital in 1980-1986 was evaluated. Eighty-six percent of patients were males. The age group of 16-45 years predominated among males, 0-15 years among females. The mean age of all patients was 33.7 years. Forty percent of the male injuries were occupational, 38% domestic and 11% caused by assault. The corresponding figures for females were 9%, 53% and 23%, respectively. The occupation groups most often associated with accidents at work were construction (42%) and industry (30%). Five percent of all PEIs were caused by traffic accidents, and 3% were sports-related. After treatment 91% of the economically active patients were able to return to their pre-accident work, 4% had to change profession, and 5% became permanently disabled and unable to work.

Accidents, Occupational↗
PubMed1993

Eye injury in sport: incidence, biomechanics, clinical effects and prevention.

The incidence of eye injury in sport is rising and is a matter for concern. The mechanics of blunt eye injury and its clinical effects are described. The sports causing particular concern are squash and badminton, where protective spectacles are used too infrequently. The need for, and methods of, injury prevention in sport are discussed.

Athletic Injuries↗
PubMed1992

Penetrating eye injuries related to assault. The National Eye Trauma System Registry.

From 1985 to 1991, 648 cases of assault-related penetrating ocular injury were reported to the National Eye Trauma System Registry. We examined the circumstances surrounding and initial clinical findings related to this case series of injuries. Eighty-three percent of the patients were male. The median age was 28 years; 77% were younger than age 40 years, and 17% were younger than age 20 years. The ocular injury was part of multiple trauma in 34% of cases. There was evidence of alcohol and illicit drug use by at least 48% and 6% of the injured persons, respectively. Seventeen percent of the injuries involved powder or nonpowder firearms. Fists, glass fragments, metal rods or pipes, knives, and scissors were among the other objects causing injury. Posterior segment trauma, which occurred in 70% of cases, included vitreous hemorrhage (40% of cases), retinal detachment (11%), presence of intraocular foreign bodies (6%), and optic nerve damage (4%). The initial visual acuity after injury was hand motion or worse in 74% of the cases. Strategies to prevent such injuries focus on the origins of violence in general and are more difficult to devise than strategies to prevent eye injuries in other settings. Public health efforts to reduce the use of alcohol, drugs, and firearms may reduce the incidence of these injuries.

Adolescent↗
PubMedDate not supplied

Eye injuries among pennant squash players and their attitudes towards protective eyewear.

A questionnaire survey on eye injuries and attitudes towards protective eyewear was conducted among 165 metropolitan pennant squash players; 163 (99%) valid responses were received. The incidence of eye injuries in the survey sample was found to be 17.5 per 100,000 playing hours with a significant proportion (26%) indicating that they had suffered at least one eye injury. Racquets were more common as the source of injury (61%) than squash balls. A large proportion of those injured consulted a doctor (63%) with approximately one-third (or 5% of the total survey sample) having been admitted to hospital for the injury. Only 8% of the sample used appropriate protective eyewear with an additional 2% believing their prescription lenses were a form of protection. The main reason given for using protective eyewear was previous injury to self or others (65% of cases). Doctors and media promotion rated poorly in causing players to use eyewear (6% for each). Most respondents believed eyewear to be of benefit, but fewer than half felt that eyewear should be made compulsory for all players. Only 6% of players said that they would give up the game if use of eyewear was made compulsory.

Attitude to Health↗
PubMed2005

Welding related occupational eye injuries: a narrative analysis.

OBJECTIVE: To determine the activities and circumstances proximal to a welding related occupational eye injury, a hybrid narrative coding approach derived from two well developed classification systems was developed to categorize and describe the activity, initiating process, mechanism of injury, object and/or substance, and the use of protective eyewear from the narrative text data reported for each injury. METHODS: Routinely collected workers' compensation claims over a one year period (2000) were analyzed from a large US insurance provider. An index term search algorithm of occupation, incident, and injury description fields identified 2209 potential welding related eye injury claims. After detailed review of these claims, 1353 welders and 822 non-welders were analyzed. RESULTS: During 2000, eye(s) as the primary injured body part accounted for 5% (n = 26 413) of all compensation claims. Eye injuries accounted for 25% of all claims for welders. Subjects were mainly male (97.1%) and from manufacturing (70.4%), service (11.8%), or construction (8.4%) related industries. Most injuries were foreign body (71.7%) or burn (22.2%) and 17.6% were bilateral. Common activities include welding (31.9%) and/or grinding (22.5%). Being struck by an airborne object occurred in 56.3% of cases. Non-welders showed similar patterns except that burns (43.8%) were more frequent and more often initiated by another worker (13.9%). CONCLUSIONS: Narrative injury text provides valuable data to supplement traditional epidemiologic analyses. Workers performing welding tasks or working nearby welders should be trained to recognize potential hazards and the effective use of proper safety equipment to prevent ocular injury.

Accidents, Occupational↗