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At least 253 records · Page 14Linked to original sources
PubMed2006

Eye injuries in Singapore--don't risk it. Do more. A prospective study.

INTRODUCTION: The purpose of this study was to characterise and describe the epidemiology of all eye injuries presenting to the National University Hospital (NUH). MATERIALS AND METHODS: A prospective study was conducted over a 7-week period (11/4/2005 to 29/5/2005) on all ophthalmic trauma patients seen by the Department of Ophthalmology in NUH. Data on patient presentation, source of injury and intervention were collected via a standardised interview and examination, and documented using a validated datasheet. RESULTS: A total of 133 patients, and 139 eyes, were included in the study. The average age was 33.5 years, with a range of 5 years to 88 years, and 84.2% (n = 112) were men. Close to half (46.6%, n = 62) of the patients studied were non-Singaporeans. 56.4% (n = 75) of all eye injuries were work-related and only 5% (n = 7) of eyes were open-globe injuries. Common sources of eye trauma included: Use of high-powered tools in activities such as grinding, welding and hammering (38.3%, n = 51), human-inflicted injuries (12.0%, n =16) and road traffic accidents (8.3%, n = 11). Of the work-related eye injuries, 29.3% (n = 22) reported to having used personal protective equipment (PPE) at the time of injury, 38.7% (n = 29) had been issued PPE but had not used them, while 32% (n = 24) reported that PPE had not been issued. An initial visual acuity of 6/12 or better was found in 63.0% (n = 88) of patients and a reading of 6/60 or worse was found in 10.0% (n =14). Superficial foreign bodies (22.4%, n = 55) were the most common clinical finding, followed by periorbital bruise (12.2%, n = 30), lid ecchymoses (6.9%, n = 17), orbital fractures (6.5%, n = 16), lid laceration (6.1%, n = 15) and corneal abrasions (5.7%, n = 14). CONCLUSION: There is a broad spectrum of causes, mechanisms and severity of ophthalmic injuries seen in the hospital, of which work-related trauma makes up a significant proportion. The patients who suffer occupational injuries are a well-defined group: Young, non-Singaporean males, working with power tools in the construction industry are at particular risk. Although preventive strategies are in place for this high-risk group, the lack of awareness and compliance limit their effectiveness. The adequacy and functionality of PPE should be emphasised. In addition, preventive efforts are equally important in domestic, recreational, sports and transport settings. Eye trauma research and prevention can be further aided by a collaborative registry of eye injuries. A long-term islandwide database of all ophthalmic injuries is recommended.

Accident Prevention↗
PubMed2000

Mardi Gras eye injury survey, 1998-1999.

BACKGROUND: We studied the nature of associated ocular trauma during the 1998 and 1999 New Orleans parade seasons and whether trends were observable from previous surveys. METHODS: A prospective survey and retrospective analysis included 18 emergency rooms (ERs) in the New Orleans area. RESULTS: Sixteen surveys representing eight ERs were completed between February 19 and 24, 1998, and 32 surveys representing five ERs were completed between February 5 and 17, 1999. In both years, the most common ocular complaints were pain, blur, foreign body sensation, tearing, and photophobia. The most common slit lamp findings in 1998 were within normal limits, corneal abrasion, and conjunctival hyperemia. In 1999, the most common findings were subconjunctival hemorrhage, corneal abrasion, cell and flare, and lid laceration. CONCLUSIONS: Projectile injuries of the eyes are common during Mardi Gras due to the nature of interaction between paradegoers and float riders. We found no identifiable trend in the number or type of injuries reported in 1986, 1987, and 1998 Mardi Gras surveys.

Adult↗
PubMed2003

Modern sports eye injuries.

AIMS: To determine the severity and long term sequelae of eye injuries caused by modern sports that could be responsible for significant ocular trauma in the future. METHODS: Prospective observational study of 24 (25 eyes) athletes with sports related ocular injuries from health clubs, war games, adventure, radical and new types of soccer, presenting to an eye emergency department between 1992 and 2002 (10 years). RESULTS: Modern sports were responsible for 8.3% of the 288 total sports eye injuries reported. Squash (29.2%) was the most common cause, followed by paintball (20.8%) and motocross (16.6%). The most common diagnosis during the follow up period was retinal breaks (20%). 18 (75%) patients sustained a severe injury. The final visual acuity remained <20/100 in two paintball players. CONCLUSIONS: Ocular injuries resulting from modern sports are often severe. Adequate instruction of the participants in the games, proper use of eye protectors, and a routine complete ophthalmological examination after an eye trauma should be mandatory.

Adolescent↗
PubMed1985

Pellet-gun eye injuries.

Twelve male patients with pellet-gun eye injuries are presented. Most were young teenagers. Six patients had a significant loss of vision due to retinal injury, and in one of these cases the eye was enucleated. The injuries ranged in severity from contusion with a small hyphema to rupture of the globe with uveal prolapse, retinal hemorrhage and detachment, optic nerve contusion, glaucoma and intracranial penetration.

Adolescent↗
PubMed1991

Self-inflicted eye injuries.

Five cases of self-inflicted eye injury are described and discussed. A review of the literature shows that several psychiatric diagnoses have been assigned to people who damage their eyes. A variety of mechanisms to explain this phenomenon are described.

Adult↗
PubMed1987

Self-inflicted eye-injuries.

Three cases of self-inflicted eye injuries are described and discussed. A review of the literature shows that several psychiatric diagnoses have been assigned to those who mutilate their eyes, and various unconscious mechanisms proposed to explain this unusual phenomenon.

Adult↗
PubMed1980

Loss of contrast sensitivity following contusional eye injury.

Contrast sensitivity was evaluated in 95 patients who regained a visual acuity of 6/6 following a contusional injury of one eye. The injuries occurred 2 to 12 years prior to examination. A book of printed sinusoidal grating patterns of varying contrasts and spatial frequencies was used, and 15 patients were found to have a significant difference in contrast sensitivity between injured and uninjured eye. Eight patients had abnormalities of the media or fundus, and in 2 patients amblyopia was probably a factor. Five patients had a defect in contrast sensitivity in their injured eye, although no structural abnormalities could be detected on full clinical examination. Alterations in contrast sensitivity appeared to be a sensitive indicator of functional abnormality in eyes which appeared normal on ophthalmoscopy and other clinical investigations.

Adolescent↗
PubMed1986

Severe eye injuries in cricket.

We report five cases of severe eye injury sustained in cricket, including retinal detachment and rupture of the globe. The eye is at particular risk from a rising ball. We comment on the need for appropriate facial protection for batsmen and close fielders.

Adolescent↗
PubMed1991

Midfacial fractures and the eye: the development of a system for detecting patients at risk of eye injury.

Maxillofacial trauma is often complicated by injury to the eye. Such injuries may be difficult to detect and may therefore be missed. Detailed ophthalmic examinations were carried out prospectively on 363 patients who had sustained midfacial fractures. Fifty four parameters comprising maxillofacial, radiological and ophthalmic data were recorded and coded for each patient. All encoded data were divided into predictors (the data potentially available to the maxillofacial surgeon) and outcome (the data potentially available to the ophthalmologist). Statistical methods of regression, and the analysis of contingency tables, led to the identification of the principal predictors indicative of underlying ophthalmic injury and thence to a scoring system which predicts the severity of such injuries. Impaired visual acuity is the principal predictor and when employed alone gives a sensitivity value of 80%. Pure blow-out fracture or comminuted facial fracture, double vision and amnesia emerged as additional factors which yielded an efficient scoring system with a sensitivity of 89% and specificity of 90% for the population upon which it was based. A score sheet is provided in the paper. These predictors can be remembered from the acronym Blow-out fracture, Acuity, Diplopia, Amnesia, Comminuted Trauma. As many such injuries result from a BAD ACT, it is easily remembered. This scoring system requires to be tested upon a new population of individuals in order to determine its efficacy.

Amnesia↗
PubMed1996

Lenticular astigmatism after penetrating eye injury.

Lenticular astigmatism of 5.00 diopters developed after penetrating injury in the eye of a 16-year-old boy. Full visual acuity, refraction, and crystalline lens clarity remained stable for more than 2 years. The high astigmatism, in conjunction with a spherical cornea and posterior lens capsule striae, indicates the lenticular origin of the astigmatism.

Adolescent↗
PubMedDate not supplied

Childhood penetrating eye injuries.

We reviewed 41 children with penetrating eye injuries from birth to 15 years of age between August 1982 to May 1990. Male to female ratio was 3.56:1. Thirteen (33%) cases resulted in monocular blindness. The distribution of penetrating injuries was based on the site of perforation: corneal, corneoscleral and scleral groups. The commonest cause of injury was child related from a thrown object (42%) and hazardous toys (21%).

Adolescent↗
PubMed1987

[Eye injuries in childhood].

The records of 500 eye injuries were analyzed according to age, causes, type of injury and place and time of accident. Children accounted for 16% of the cases, almost half of them between 11 and 15 years old. Forty percent of the injuries were the result of accidents while playing. An increase in the number of injuries in April, July, and on Saturdays was observed. On the basis of this investigation the authors have attempted to recommend a number of sensible preventive measures.

Adolescent↗
PubMed1976

Office treatment of eye injury. 2. Injury from sharp instruments or blunt trauma.

Eye injuries caused by sharp instruments range from superficial scratches of the corneal epithelium to serious lacerations of the globe of the eye. Scratches, conjunctival lacerations, and some eyelid lacerations can be dealth with by the primary physician in the office, but damage to the globe requires immediate referral to an ophthalmologist. Among possible results of blunt trauma to the area of the eye are ecchymosis, hyphema, blow-out fracture, subluxation or dislocation of the lens, or retinal detachment. Most of thes require thoroguh ophthalmologic examination and specialized treatment. The primary physician may be the first to examine a patient with serious head injury. For future reference the status of each eye should be carefully documented as soon as possible after injury.

Craniocerebral Trauma↗
PubMed1997

Causes and visual outcome of childhood eye injuries in Nigeria.

Two hundred and twenty-eight children of both sexes (152 males and 76 females) aged between 1 and 15 years treated for eye injuries at the University of Nigeria Teaching Hospital, Enugu, Nigeria were studied. The injuries were commonly sustained during domestic activities (29.8%), at play or sports (23.7%), in the schoolroom (16.7%) and during farm work (10.1%). Causative agents were mostly sticks, followed by stone missiles and other flying objects. There was a general delay in reporting to hospital in all types and degrees of severity of injuries, with only 28.5% reporting in the first 24 hours and as many as 10.5% after 1 month. How quickly the patient came to hospital was determined more by social and economic factors than by sex, age and type of injury. Visual outcome was best in patients with mild non-penetrating injuries and worst in those with severe penetrating injuries. Amongst the latter the outcome was worse when the posterior segment was involved than when the injury involved only the anterior segment. Our study showed that there has been a change in the causation of childhood eye injuries in the country compared with reports of 25 years ago. The visual outcome in our patients was worse than in reports from developed countries. This was due mainly to delay in seeking specialist treatment and lack of sophistication of the treatment, especially in severe cases.

Adolescent↗
PubMed1998

Finding a nursing role in the prevention of eye injuries in the construction trades.

Construction workers have mostly preventable eye injuries. This pilot study investigated a convenience sample of 75 (72 men, 3 women) apprentice operating engineers. Most (52%) of the apprentices had been injured twice on the job. Injury was associated with age and longevity in the construction industry. There were no significant differences in health perceptions as measured by the Health Self-determinism Index when the safety glasses wearers were compared with non wearers of safety glasses (t[52] = -.94, P > .05) and the injured group was compared with the noninjured group (t[62] = -.38, P > .05). Literacy issues, recall, and underreporting of injuries may have affected the results. Nurses need to teach health promotion strategies to operating engineers.

Accidents, Occupational↗
PubMed2004

Prognostic factors in open eye injury managed with vitrectomy: retrospective study.

AIM: To evaluate surgery results and establish prognostic factors that predicted final functional (good or poor vision) and anatomic (final retinal detachment) outcome in open eye injury involving the posterior segment managed with pars plana vitrectomy. METHODS: Medical records of 52 consecutive patients with open eye injury involving the posterior segment were retrospectively reviewed. Specific variables of a system for classifying mechanical injuries of the eye were analyzed: the type of injury (defined by the mechanism of injury), grade of injury (defined by initial visual acuity), zone of injury (defined by the location of the wound), and relative afferent pupillary defect. Additional variables, such as wound length, retinal detachment, endophthalmitis, and timing of vitrectomy, were also included in the analysis. Final visual outcome and retinal attachment rate were recorded. Data were analyzed with chi-square test, univariate analysis for predictors, and multivariate logistic regression analysis. RESULTS: After a mean follow up of 20.0+/-10.5 months, 50% of eyes achieved visual acuity 0.5 or better, 27% of eyes achieved visual acuity 0.1 or worse, and 10% of eyes had final retinal detachment. According to univariate analysis results, the following parameters were predictors of good vision (visual acuity > or =0.5 in comparison with visual acuity <0.5): grade of injury (p=0.008), zone of injury (p=0.01), afferent pupillary response (p<0.001), wound length (p=0.002), and initial retinal detachment (p=0.009). The predictors of poor vision (visual acuity < or =0.1 in comparison with visual acuity >0.1) were zone of injury (p<0.001), relative afferent pupillary defect (p<0.001), wound length (p=0.002), and initial retinal detachment (p<0.001). Relative afferent pupillary defect (p=0.003) and initial retinal detachment (p<0.001) were predictors of final retinal detachment with proliferative vitreoretinopathy. However, multivariate logistic regression analyses revealed that relative afferent pupillary defect was the only significant factor for poor visual acuity (odds ratio, 10.3; 95% confidence interval, 1.1-92; p=0.04). On the other hand, none of the variables was a significant independent predictor for either good visual acuity or final retinal detachment. CONCLUSION: Half of the eyes with a good final visual outcome in our study were successfully managed with pars plana vitrectomy for open eye injury after trauma. The classification system may become useful prognostic tool for visual outcome in posterior segment ocular injuries managed with vitrectomy. Relative afferent pupillary defect as a functional test is a good predictor for visual outcome.

Adolescent↗
PubMed2006

Anesthetic management of preschool children with penetrating eye injuries: postal survey of pediatric anesthetists and review of the available evidence.

BACKGROUND: Pediatric anesthetists were surveyed regarding their anesthesia management of a screaming child with a penetrating eye injury. The results are reviewed in relation to the available evidence in the literature. METHODS: A postal survey was sent to all the members of the APA living in the UK. Seven clinical questions were asked regarding the management of penetrating eye injury and two questions regarding seniority and the number of cases seen. RESULTS: Of the 318 questionnaires sent out 238 were evaluated. Of the responders indicating the number of cases seen, 21.2% had never seen a single case, 55.1% had seen <5, 17.8% had seen 5-10, and 5.9% had seen >10 cases. Suxamethonium was used more often by respondents who had handled more cases; 42.9% of those doing >10 compared with 10% of those doing less than five cases. Senior anesthetists preferred the use of techniques without relaxants and to extubate children under deep anesthesia. CONCLUSIONS: Few people have extensive experience managing a penetrating eye injury in a child. A variety of anesthesia techniques are used for induction with anesthetists avoiding suxamethonium, despite there being little evidence in the literature that the use of suxamethonium is harmful to the open globe.

Anesthesia↗
PubMed2000

[Penetrating and perforating eye injuries in 343 patients due to auto accidents before and after compulsory seat belt legislation resulting in fines (1966-1998)].

BACKGROUND: Constructional improvements of passengers safety in cars alone did not result in a significant decline of open globe injuries in traffic accidents. Only after compulsory seat belt legislation was introduced in Germany and Great Britain, a 60%-75% reduction in ocular injuries was observed. We examined, how the characteristics of severe eye injuries in car accidents changed during the last 28 years. PATIENTS AND METHODS: The case records of 343 patients, who suffered from open globe injuries during car accidents between 1966 and 1993 and were primarily admitted in the University Eye Hospitals of Freiburg and Würzburg, have been analyzed retrospectively. Injuries were evaluated for their extent, time of injury (hour and season), age, sex and outcome of visual acuity after surgery. RESULTS: Between 1966 and 1984 wind-screen injuries declined slowly from 25/year to 16/year. Since the introduction of compulsory seat belt legislation in Germany in 1984 we observed a sudden reduction to 4 injuries/year, followed by an additional slow decline to 2.5 injuries/year. Male/female ratio changed from 2.1/1 before to 9/1 after 1984. Due to the seat belt legislation, injuries declined during summer season (april through september) by factor 7.6, during winter season (october through march) by factor 3.8. Injuries during daylight (6 a.m. to 6 p.m.) decreased more rapidly (by factor 14) than during nighttime (6 p.m. to 6 a.m.: factor 4). The decline of eye injuries was most pronounced among those with an age of less than 23 years (by factor 10.8) and those who were 31-50 years old (by factor 6.8), but least among those between 23 and 30 years of age (2.2). Since 1984, open globe injuries combined with mid-facial and cranial fractures increased resulting in a poorer visual outcome: 29% of eyes became blind before 1984 and 40% since then due to the higher survival probability of very severe accidents. A majority of injured persons still had not fastened their seat belt and about 50% were drunk. CONCLUSION: Compulsory seat belt legislation introduced in Germany in 1984 was most effective in preventing eye injuries among female passengers, during daytime or among persons younger than 23 years. However, 23-30 year old male drivers who had not fastened their seat belt, drove in darkness or during winter and had drunk alcohol, were still at highest risk for an open globe injury. The increase of victims with a combination of open globe injuries and midfacial injuries, polytrauma or cerebral trauma may be related to the airbag and other improved safety measures.

Accidents, Traffic↗