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3 cases of eye injuries from playing squash are reported. The most common injuries in such cases involve the cornea, the anterior chamber and the retina. It is recommended that the wearing of polycarbonate protective lenses while playing squash be made mandatory in Israel.
We present a case of bilateral eye injury caused by a high-pressure water jet from a fire hose. Eye injury secondary to high-pressure water jets are relatively rare, but invariably result in severe damage to all ocular structures. A 51-year-old woman was admitted to our ophthalmologic department for treatment following a direct hit in the face by a water jet from a fire hose from a distance of about one meter. The patient had bilateral extensive eyelid edema and ecchymosis, conjunctival chemosis with hemorrhage, vitreous hemorrhages in the right eye and iridodialysis with hyphema in the left eye, a transient decrease in intraocular pressure, bilateral superior commotio retinae with macular edema, and bilateral impairment of vision. The patient was treated with topical corticosteroids. Four months later she was re-admitted to our department for surgical repair of iridodialysis in the left eye. Iridodialysis had affected the entire superior nasal portion of the iris, and the pupil was displaced downward temporally. The iris partly obscured the visual axis. After surgical repair the visual axis was free. At a follow-up examination two years later, the ocular findings were the same. The best corrected visual acuity was 0.1 in the right eye and 0.3 in the left eye. Visual impairment was a consequence of permanent posttraumatic posterior fundus changes, particularly of the macula in both eyes. Intraocular pressure was within normal limits in both eyes. Injuries caused by high-pressure water jets are usually bilateral. The injuries are mainly confined to the lower anterior portions of the eye (Bell's phenomenon). Our patient had bent forward during the accident, therefore the central and upper chorioretinal portions were also affected. Such injuries usually cause severe damage to the anterior and posterior portions of the eyes and greatly reduce visual acuity in both eyes. Because of the risk of late complications (cataract, glaucoma, retinal detachment), long-term follow-up is recommended in such patients.
A structured approach to the management of a perforating ballistic eye injury is illustrated in this case, where initial treatment was limited to simple corneal wound closure and antibiotic prophylaxis. A pellet had passed completely through the globe but the retina remained attached, and it was decided to manage the case conservatively. Two retained foreign bodies were extruded spontaneously some months after the injury when suture removal and delayed cataract surgery led to a virtually perfect visual outcome. The patient has had no further complications at least three years after initial injury. The management of this civilian case illustrates some basic concepts in treating ballistic eye injuries that may be applicable in a military setting.
Records of 15 patients presenting with pressurised bottled drinks related eye injuries between January 1996 and 2001 were reviewed to identify factors contributing to accidental eye injuries from pressurised bottled drinks, reason for poor outcome and to make recommendations. In all, 16 eyes of 15 patients were studied out of which 7 were males (M:F, ratio 1:1.1). Age range, 3 years-49 years, mean 23.6 years. The majority of those affected were students 46.7%, and traders 26.7%. The commonest activity leading to injury was explosion during the process of arranging the bottles or crates of drinks (43.8%) and accidental fall of bottle from hand or height (37.5%). Drinks implicated include, Coca-cola 50%, beer 25%, others (Fanta, Legend stout, Mirinda, Grape juice) 25%. Complications arising from the injury included, hyphema 43.8%, vitreous haemorrhage 12.5%, and retinal detachment 12.5%. The globes were retained in 12 (75%) cases, 3 defaulted and one eye became phthisical. The final visual acuity was 6/18 or better in 25%, between 6/24 and 6/60 in 12.5% and less than 6/60 in 31.3%. The final visual acuities of three patients who were lost to follow up were unknown. Reason for poor visual outcome include severity of injury with resultant serious complications, and delay with instituting surgical treatment. Eye injuries resulting from exploding bottled drinks are potentially very serious and therefore best prevented. It is recommended that conversion of bottled drinks to canned or plastic containers be considered by the manufacturers. Greater care should be taken with the handling of bottled drinks by the sellers, factory workers and consumers. High risk occupations such as bottled drink sellers and factory workers may need to wear protective goggles during handling. Public health education on need to seek prompt and proper treatment as well as need for Government to institute the National health insurance scheme to cater for indigent patients.
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The poor intraocular penetration of systemically administered antibiotics has raised questions regarding their usefulness as prophylactic agents in the management of penetrating eye injuries. Cefazolin was administered intravenously to rabbits with penetrating eye injuries to determine the influence of trauma on ocular pharmacokinetics. Following a standardized penetrating eye injury in 27 New Zealand white rabbits, animals were divided into three groups that received either three, six, or nine doses of intravenous cefazolin every 8 h. Cefazolin levels were then measured in the traumatized eye, the non-traumatized (control) fellow eye, and in the serum of each animal. In the three treatment groups vitreous concentrations of cefazolin were significantly higher in traumatized eyes than in the non-injured eyes. After three doses, vitreous concentrations of cefazolin in traumatized eyes averaged 9.1 mg/l; mean concentrations of cefazolin in non-injured eyes were 0.6 mg/l (P < 0.0002). After six doses of intravenous cefazolin, vitreous concentrations in traumatized eyes averaged 7.3 mg/l; cefazolin levels in non-injured eyes were 0.6 mg/l in the non-traumatized eyes (P < 0.0005). After nine doses, vitreous cefazolin concentrations in traumatized eyes averaged 9.7 mg/l, while mean levels in the non-traumatized eyes were all 0.05 mg/l (P < 0.0002). This work suggests that penetrating injuries of the eye alter ocular pharmacokinetics, resulting in high intraocular concentrations of systemically administered cefazolin.
A 3-year survey was conducted of all children with eye injuries admitted to Wills Eye Hospital to determine demographic, etiologic, and prophylactic factors. There were 278 cases, representing 22% of all ocular injuries in children requiring admission. The frequency of childhood ocular injuries is high, often resulting in serious visual impairment. Many of these injuries are preventable. The causes of pediatric eye injuries and preventive measures are discussed.
War games, an outdoor activity combining recreation, military maneuvers and fantasy, are becoming a popular recreational sport. Increasing numbers of players are suffering eye injuries. In the last year 26 cases of serious eye injuries were reported to Canadian ophthalmologists; in 15 eyes vision was reduced to 6/24 or less. Although eyeguards are provided, all the injuries had occurred when the participants were not wearing them. Methods of preventing eye injuries in war games are discussed.
Over 4000 eye injuries, including 449 blind eyes, have been reported in sports and recreational activities in Canada over the past 20 years. This is not only a great personal loss but also a financial loss, both to the injured person and to the community. Statistics should be tabulated on catastrophic injuries that leave the person with a physical or mental deficit, such as a blind eye, and efforts should be directed toward preventing such injuries. Changing and enforcing game rules and providing proper eye protection has proved very beneficial in Canadian hockey, racket sports and war games. Educational programs supported by the media and government that alert players to the need for eye protection are required. Such measures may lead to the prevention of up to 90% of injuries in sports and recreational activities in Canada.
PURPOSE: To establish the aetiology and visual outcome after penetrating eye injures in rural environments. MATERIALS AND METHODS: The records of 182 patients (184 eyes) with penetrating eye injuries treated in the 1 st Eye Hospital, Lublin, Poland, between 1994 and 2002, were reviewed. Twenty eight of the 184 eyes (15.6 %) were work-related agriculture penetrating eye injuries. Distribution by age, sex, season variation, cause of injury, place of entrance wound, visual acuity and late complications were estimated. RESULTS: Of the group of 28 patients, 24 (85.7 %) were male and 4 (14.3 %) female, with the age range between 11-76 (mean 48.2) years. Most injuries were a result of repair and maintenance work in 35.7 %, wood chopping in 25 %, machine use in 17.9 %, simple instruments use in 10.7 %, fall from one level to another in 7.1 %, and cow butting with a horn in 3.6 %. Eighteen eyes (64 %) were blind with visual acuity less than 0.05 at their most recent review. CONCLUSIONS: Our study has shown that perforating ocular injuries in rural environment are still a big therapeutic, social and economic problem.
During 1993, U.S. farm workers incurred an estimated 13,500 eye injuries that resulted in lost work time (1); many of these injuries could have been prevented. To determine the incidence of eye injuries and use of eye protection among farm workers, the Minnesota Occupational Health Nurses in Agricultural Communities (OHNAC)* examined data from the Minnesota Farming Health Survey (MFHS) conducted during January-April 1992 and December 1992-April 1993. This report summarizes the results of this analysis.
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Explosions of car batteries have become a frequent cause of eye injuries. A total of 62 patients were seen in our clinic during eight consecutive months. A wide range of injuries were discovered that extended from the anterior segment to the retina. The most common injuries were acid-induced conjunctivitis, corneal abrasions, and iridocyclitis. Hospitalization and surgery were required in some cases.
BACKGROUND: A recent trend in automotive interior design has the airbag placed behind a seamless module cover. Airbag deployment through these seamless module covers may release foam particles at high velocities that could result in eye injuries. METHODS: Twenty-one tests (n = 21) were performed in which foam particles, similar to those observed from airbag deployments, were impacted onto porcine eyes. Injury analysis was performed by using fluorescein dye, ophthalmic ultrasound, and necropsy. RESULTS: As seen in case reports of airbag-induced eye injuries, corneal abrasions were the most recorded injuries in the porcine eye impact tests. A logistic regression analysis demonstrated that kinetic energy was the most significant contributor to injury (p = 0.0023), whereas foam type was a poor contributor to the model (p = 0.45). An injury risk curve was generated based on kinetic energy that gave a 50% risk of corneal abrasion at 0.183 J. CONCLUSION: If the production of foam particles during airbag deployment is unavoidable, the injury risk function presented for the kinetic energy of the particles offers a design guide to minimize corneal abrasions.
The dental office can be a source of ocular injury due to mechanical, chemical, microbiological, and electromagnetic insult. Survey questionnaires were sent to all Indian Health Service dentists in the Oklahoma area to assess knowledge of and compliance with measures to prevent eye injuries. After distribution of eye safety information, a second questionnaire was sent to assess any changes in compliance with wearing protective eyewear. Recommendations are given for measures to prevent eye injuries in the dental office.