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PubMed2001

Airbags and bilateral eye injury: five case reports and a review of the literature.

We report five cases of bilateral eye injuries from airbag deployment in motor vehicle crashes and review the world's literature on ocular injuries associated with airbags. The cases in the literature were identified by cross-referencing Medline searches from airbags and ocular injuries. Additional cases were identified after review of references from each article in the search. An additional 89 cases from the literature were identified and are included for discussion. Patients were treated individually in a noncontrolled, nonrandomized fashion according to the nature of each injury with regular follow-up examinations in clinic. Of the 94 cases studied, 24 (27%) were bilateral eye injuries, and 15 (16%) patients were wearing spectacles at the time of the accident. The most common injuries included corneal abrasions, eyelid trauma, and hyphemas. Outcomes ranged from complete resolution of symptoms and return of normal visual acuity to primary enucleation. This report describes the wide spectrum of eye injuries that may occur after airbag deployment. We suggest a management plan for the evaluation and treatment of the ocular complications of airbag-related trauma.

Accidents, Traffic↗
PubMed2005

[Eye injuries in outpatient clinic of Department of Ophthalmology Medical University Gdansk in 1992-1993 and 2002-2003 years].

The aim of this study was the statistical and epidemiological analysis of patients with eye injuries. We analyzed all patients attending the emergency department of Department of Ophthalmology Medical University in Gdansk over the period of 1992-1993 and 2002-2003 years. We determined the visual function (visual acuity- distance and near Snellen acuity test, intraocular pressure measurement, biomicroscopy, ophthalmoscopy, X- ray examination and US -examination) in two groups of subjects. The 6427 patients were subjected in the first period (37% with eye injuries). In the second period we examined 10512 patients (44% with eye injuries). A total of visits have been examined in the first period: 24.1% of patients were between 19-25 and 48% between 26-50 years. In the second group of patients 35.7% of patients were between 19-25 and 30.3% were between 26-50 years. In the both periods we observed mainly corneal injuries. Corneal foreign body and corneal abrasion were the most common etiology among close eye injuries in both groups. A total of visits have been examined: 7.78% with the first group and 8.95% was with burns. There were 1.89% in the first and 5.75% in the second period of severe eye injury such as penetrating ocular trauma, orbital fracture and intraocular foreign body. The main causative activity of ocular injuries in both groups was work (5.80% group I and 23.80% group II), assault (36.20% group I and 47.75% group II) and traffic accidents (4.84% group I and 12.05% group II). Results of our work indicated that ocular trauma is a common cause of improvement of visual acuity and a common cause of visit to the Emergency Department of Department of Ophthalmology.

Adult↗
PubMed2005

Penetrating eye injuries in South African children: aetiology and visual outcome.

PURPOSE: To assess the aetiology, prognosis, and visual outcome of penetrating eye injuries in South African children. METHODS: In all, 100 consecutive patients, aged 16 years and under, with penetrating ocular injuries undergoing surgery between January 2001 and November 2002 were prospectively evaluated. RESULTS: Most children (66%) were injured during play. In all, 55% of penetrating eye injuries occurred at home, and all injuries to children under the age of 6 years occurred there. Most injuries occurred in the absence of a caregiver (85%). Sticks, wire, and glass caused half of all injuries (48%). The most common mechanism of injury was impact with a sharp object (46%). Only 25% of injured presented to the hospital within 24 h of injury; the more severe the sustained injury and the younger the patient, the earlier was attendance at the clinic. Most patients (71%) regained best-corrected visual acuity (Snellen equivalent) of 20/200 or better, and 51% regained 20/40 or better. Patient age and delay of presentation were not of prognostic value. Indicators of poor visual outcome were identified as wound size greater than 11 mm in length, mixed corneoscleral type wounding, and involvement of the lens and posterior segment in the injury. CONCLUSIONS: Penetrating eye injuries in African children, reviewed here, generally occur when children are at play in a domestic setting. Effective prevention should stress parental awareness, careful supervision, greater home safety, safe toys, and avoidance of hazardous games.

Adolescent↗
PubMed1995

Aetiology and prevalence of eye injuries within the United Kingdom fire service.

A survey was conducted on a sample of 1552 firefighting personnel to determine the incidence of eye injuries within the United Kingdom fire service. In total, 3.5% (n = 22/637) of firefighters per year will sustain an eye injury requiring 'medical attention'. This represents one ocular injury per 50,000 working hours. In 80% of cases eye protection was not being worn at the time of injury. Analysis of 75 accident report forms indicates that the vast majority (69/75) of eye injuries were sustained whilst on operational duty. These statistics are comparable to other professions which are considered to have an unacceptably high risk of injury and in which eye protection has therefore been actively enforced. It would follow that similar steps should be taken within the fire service to ensure firefighters wear eye protection on operational duty. This should apply even if there is no immediate recognition of a perceived danger. A firefighter presenting to an optometrist or medical practitioner, with or without an eye injury, should be counselled as to the advantages of eye protection.

Accidents, Occupational↗
PubMed2004

Self-inflicted eye injuries: a review.

PURPOSE: To review the pathogenesis, clinical characteristics, and management of self-inflicted eye injuries. METHODS: Review of the medical literature. RESULTS: Psychiatric theories of pathogenesis for self-inflicted behaviour include religious and sexual ideation, symbolism, guilt, and displacement. Biological theories include disorders of serotonergic, dopaminergic, and opiate neurotransmitters. Clinical characteristics of self-mutilators include acute or chronic psychoses, drug-induced psychoses, other psychiatric conditions, and certain organic states. The majority are young-to-early middle-aged male subjects, though it can also rarely occur in children. Management of self-inflicted eye injury requires close cooperation between ophthalmologists and psychiatrists as well as other medical specialists, to ensure quick resuscitation of the patient, prompt diagnosis and treatment of any injuries, and treatment of the underlying behaviour that led to the injuries. CONCLUSIONS: Self-inflicted eye injuries are a rare but important group of ophthalmic conditions that require close cooperation between different medical specialties to ensure optimum care of the often severely disturbed patient.

Adult↗
PubMed1997

[Occupational accidents and eye injuries treated at the Rambam Medical Center].

To determine the prevalence of occupation-related eye injuries, we analyzed the records of 24,632 patients treated at our emergency surgical department over a 3-year period. Occupational accidents accounted for 17.6% of such cases. A third of them (1374 patients) were referred to the ophthalmic emergency room for further examination. In 89% (1223) of these, at least 1 pathological ocular finding was detected, and 8.3% (114) of them were hospitalized. Penetrating eye injuries were found in 5.2% (72). The commonest eye injury was corneal foreign body found in 42.8%.

Accidents, Occupational↗
PubMed1993

Intravenous cefazolin in penetrating eye injuries. Treatment of experimental posttraumatic endophthalmitis.

The use of intravenous antibiotics as prophylaxis in penetrating eye injuries is strictly empiric and not based on scientific data supporting their use. To determine the efficacy of prophylactic intravenous cefazolin in penetrating eye injuries, a rabbit model of posttraumatic endophthalmitis was developed. Forty rabbits received penetrating eye injuries followed immediately by an intravitreal inoculum of live Staphylococcus epidermidis. The rabbits then were randomly divided into four groups: group 1 received three doses of intravenous cefazolin; group 2 received six doses, and group 3 received nine doses; group 4 received no treatment and served as controls. All control rabbits developed 4+ vitreitis; rabbits receiving three doses of the antibiotic developed 2+ vitreitis, and those receiving six or nine doses of cefazolin showed no vitreous inflammation (P < or = 0.0001). Histologic examination of control eyes showed an exuberant reaction with formation of retrolental membranes, vitreous abscess, and retinal detachment. Eyes treated with nine doses of cefazolin were devoid of inflammatory cells. These findings suggest that intravenous cefazolin is effective in preventing the development of posttraumatic endophthalmitis in a rabbit model.

Animals↗
PubMed1994

The epidemiology of occupational penetrating eye injuries in Ireland.

This paper is designed to establish the risk factors associated with serious occupational eye injuries so that preventive measures can be targeted at those most at risk. Few such studies have been published for the United Kingdom and the Republic of Ireland. The incidence of these occupational eye injuries is over three times that of the non-occupational category. Present preventive measures appear to be inadequate. An association with certain socio-economic groups was found. A significantly increased incidence of penetrating eye injury was noted in farm labourers and in skilled manual labourers. The left eye was significantly more at risk of serious injury than the right eye. The paper suggests improvements which should be made, particularly in the occupational setting.

Accidents, Occupational↗
PubMedDate not supplied

[Eye injuries in water transport].

The author analyzes occupational and medicosocial aspects of ocular traumatism in the Northern basin water transport over 13 years. Wounds, foreign bodies, contusions, and burns predominated in the structure of injuries. Groups at high risk for eye injuries were distinguished with consideration for the subject's occupation, age, length of service, and type of work done. The author emphasizes the role of early urgent aid in favorable outcomes of injuries to the eye.

Accidents, Occupational↗
PubMed2006

Assessment of occupational eye injury risk and severity: an analysis of Rhode Island workers' compensation data 1998-2002.

BACKGROUND: Occupational eye injuries have been recognized as a serious health risk to workers and are in need of further investigation to develop effective interventions. METHODS: Rhode Island workers' compensation claims of ocular injury between 1998 through 2002 (n=8,877) were examined. The Current Population Survey was used to estimate occupational employment levels as a baseline for rate calculations. RESULTS: The estimated ocular injury claim rate was 32.9 per 10,000 workers (95% CI=32.3-33.6), with the cost of claims totaling $1,514,666 and averaging $171 per claim. The highest estimated claim rate of all occupations was found for construction laborers of 373.7 per 10,000 workers (95% CI=267.1-480.3). Relative to the durable manufacturing industry, the highest risk of injury resulting in disability indemnification was the wholesale trade industry (OR=2.18, 95% CI=1.19-4.01, P<0.05). CONCLUSIONS: Many of the eye injuries reported were likely preventable. Greater diligence, training, and safety precautions are needed to reduce the risk of eye injury to employees.

Accidents, Occupational↗
PubMed1985

Effect of urokinase on posterior penetrating eye injuries.

We studied the effect of urokinase on the natural course of posterior penetrating eye injury in an animal model that consistently results in late tractional retinal detachment. A standard penetrating injury was performed on both eyes of 20 rabbits. Each eye received 0.4 mL of heterologous rabbit plasma. Then 10 000 U of urokinase was injected in one randomly chosen eye of each animal; an equal volume of balanced salt solution (BSS) was injected in the other. By 5 to 6 weeks after the surgery 13 (65%) of the 20 urokinase-injected eyes and 15 (75%) of the 20 BSS-injected eyes showed retinal detachment; the proportions are not significantly different. Gross and microscopic study of the enucleated, sectioned eyes failed to reveal any features distinguishing the control and urokinase-treated eyes. Thus, urokinase did not appreciably alter the natural course of development of late tractional retinal detachment after posterior penetrating eye injury.

Animals↗
PubMed2006

Epidemiology of blinding trauma in the United States Eye Injury Registry.

PURPOSE: To analyze the epidemiology and clinical characteristics of serious eye injuries leading to legal blindness. METHODS: Analysis of information on 11,320 eyes in the United States Eye Injury Registry (USEIR) database. Legal blindness in this study was defined as visual acuity of worse than 20/200. RESULTS: No less than 27% of eyes with serious injury had < 20/200 final vision, although the rate varied greatly with injury type. Several risk factors were found to statistically significantly increase the chance of eye trauma resulting in blindness: age over 60 years, injury by assault, sustained on street/highway, or occurring during fall or by gunshot. Trauma to the left eye carried a statistically significantly poor prognosis as did two injury types, rupture and perforating. Involvement of the posterior segment was another factor indicating poor outcome; in particular, vitreous hemorrhage, retinal detachment, choroidal rupture, and endophthalmitis were found to increase the risk of blindness. Conversely, young age, contusion and intraocular foreign body injuries, among others, signaled a better than average chance of good outcome. Overall, 60.5% of injured eyes showed visual improvement after treatment. CONCLUSIONS: This large study identified multiple risk factors whose presence significantly increases the chance of the injured eye becoming "legally blind." Continued efforts to improve treatment and develop/implement prevention measures based on risk analysis should reduce the incidence of blinding trauma.

Adult↗
PubMed2006

Eye injuries on the battlefields of Iraq and Afghanistan: public health implications.

BACKGROUND: The U.S. Army faces major challenges in balancing the need to protect a soldier from harm while not impeding his ability to fight. Unfortunately, the incidence of combat eye injuries has increased over time, despite the development of protective measures. METHODS: A cross-sectional study of soldiers evacuated from Operation Iraqi Freedom and Operation Enduring Freedom with eye injuries was performed from March 2003 through December 2004. Data for this study came from the Military Office of the Surgeon General (OTSG) Patient Tracking Database. RESULTS: A total of 368 patients (451 eyes) were evacuated for eye-related problems. From March 2003 through December 2004, 15.8% (258 of 1,635 patients, 309 eyes) of all medical evacuations were a result of battle eye injuries (BI), 17.3% (283 of 1,635 patients, 337 eyes) were a result of eye injuries (BI and nonbattle injuries [NBI] combined), and 22.5% (368 of 1,635 patients, 451 eyes) of all evacuations were because of eye-related complaints alone (BI, NBI, or disease) or in combination with other bodily injuries. CONCLUSION: Developing combat eye protection that meets the unique requirements of the military, issuing eyewear to soldiers, and supporting and enforcing its use, will provide the best eye protection for American soldiers during military training exercises and future conflicts.

Afghanistan↗
PubMedDate not supplied

Airbags and eye injuries: epidemiology, spectrum of injury, and analysis of risk factors.

Although airbags measurably reduce the overall risk of injury to adults (including eye injury), and death from motor vehicle accidents, injuries attributed to airbag deployment have been reported. To identify reported cases of ocular trauma related to airbag deployment, a MEDLINE search from 1991 to 2000 was performed. A total of 263 injuries in 101 patients were identified. Patient demographics, details of the accident, specific ocular structures injured, and visual outcomes when available where tabulated and analyzed. The most common of these affect the eyes. Damage to the orbit and virtually every ocular and adnexal structure has been seen. Although most injuries are self-limited and do not significantly compromise vision, some result in severe, permanent visual loss. Most common is damage to anterior structures due to either blunt, contusive forces and/or chemical injury. Posterior segment trauma is less common but generally more visually devastating because of the involvement of the retina or optic nerve. Data are not available to determine whether the wearing of eyeglasses or previous intraocular surgery affects the nature, severity, or outcome of these injuries. Awareness of the spectrum of airbag-associated ocular trauma will help physicians recognize these problems early and optimize their management. Data derived from analyses of these injuries will be critical to the development of safer, more effective devices.

Accidents, Traffic↗
PubMed2004

The mechanism and prevention of soccer eye injuries.

AIMS: To study the mechanism and the means of preventing soccer eye injuries. METHODS: Kicked soccer ball velocities were measured for a range of ages and experience. Soccer balls (sizes 3, 4, and 5), inflated to 3, 6, and 9 psi, were impacted onto an artificial orbit and the results analysed at 1000 frames per second. Protective eyewear was fitted to a headform then impacted and evaluated. RESULTS: The mean peak ball velocity was 20.4 (SD 6.2) m/s. Soccer balls at 18 m/s entered the orbit between 7.5 and 8.7 mm. There was no significant difference in orbital penetration as a result of ball size or pressure. The soccer ball stayed in the orbit approximately 10 ms and appeared to have a suction effect as it withdrew. Protective eyewear that complied with sports protective eyewear standard ASTM F803 prevented contact of the ball to the eye. CONCLUSIONS: The soccer ball causes eye injury by entering the orbit. Protectors that pass ASTM F803 would prevent orbital intrusion.

Adolescent↗
PubMed2003

Laser eye injuries in military occupations.

INTRODUCTION: Lasers (light amplification by stimulated emission of radiation) play an important role in our world and their use is increasing. They are powerful tools for good, but can also cause tragedy, especially in an aviation environment. Information about injuries associated with lasers is limited. This study highlights several laser eye injuries in the U.S. military and discusses issues pertaining to them. METHODS: We gathered data from the U.S. Army Safety Center, the U.S. Army Center for Health Promotion and Preventive Medicine, and the Walter Reed Army Institute of Research. This paper describes ten representative cases of laser eye injury that occurred in the U.S. military between 1984 and 2000. RESULTS: Patients suffered retinal damage, though no corneal injury occurred. Most were caused by accidental exposure to a Q-switched, Neodynium:YAG (Nd:YAG) laser at 1064 nm wavelength. The incidents occurred both on and off duty, indoors and outdoors, and from close and long ranges. None of the victims were wearing eye protection. Inadequate training and poor equipment design were major factors in at least six of the nine unintentional cases. The tenth occurred during military operations in the Persian Gulf. All of the victims needed several months medical care and follow up. Two received medical discharges as a result of their injuries. DISCUSSION: As illustrated by these cases, human and societal costs from unintentional laser eye injuries can be reduced by improving operator training, safety procedure compliance, and equipment design. In addition, intentional laser eye injuries are a growing concern and further research is needed to design appropriate protection, treatment and countermeasures.

Adult↗
PubMed1992

Eye injuries at work: a prospective population-based survey within the chemical industry.

A population of 63,000 chemical industry workers was studied prospectively over approximately 10,000,000 man-hours of work. A total of 133 eye injuries were reported (8.4% of all injuries), of which 22% needed medical attention. Eye protection was often not worn, some protectors may have been wrongly recommended for a particular task, and some protectors may have failed to perform adequately. In this population, an eye injury occurred once every 75,000 man-hours of work on average (injury incidence 23:1000:year). Most injuries were avoidable. Revision of protection protocols at work, and improved education of personnel are needed to reduce the incidence of occupational eye injury.

Accidents, Occupational↗
PubMed2004

Penetrating eye injuries from southeastern Anatolia region of Turkey.

OBJECTIVES: This study analysed 420 patients with penetrating eye injuries who presented for treatment at the Eye Clinic of Dicle University Hospital in Turkey. The aim of the study was to identify preventable risk factors. METHODS: A retrospective evaluation of patients who presented between January 1995 and December 2000 was undertaken. Cases were examined with regard to age, sex, profession, which eye was traumatized, reason for the trauma, nature of the trauma, time between injury and operation, and accompanying pathologies. RESULTS: This study found that most penetrating eye injuries occurred in children aged 0-15 years, and these were mainly caused by accidents during play. For patients aged 16-60 years, penetrating eye injuries were mainly caused by work-related accidents. CONCLUSION: Most penetrating eye injuries were caused by preventable accidents. Many accidents and their resulting injuries could have been prevented by education, greater intensive care and workplace safety.

Adolescent↗