[An unusual exposition of unusual eye injuries].
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A standardised experimental posterior penetrating eye injury in the rhesus monkey with the vitreous-lens admixture resulted in limited fibrous ingrowth from the wound and minimal traction on the peripheral retina. Microscopically inflammation was noted in the iris, ciliary body, and as a perivascular infiltrate of the inner retina. Periretinal membranes did not occur, and cellular proliferation within the vitreous was less marked than observed after an identical wound and simulated vitreous haemorrhage in previously reported studies. The lens may be a less important stimulus to intravitreal fibroblastic proliferation than previously assumed.
Traumatic retinal detachment can occur in combat eye injuries and has numerous complications. We presume that the incidence would be much higher if we omitted to perform argon laser prophylactic treatment in cases of (1) traumatic retinal rupture, (2) retained retinal foreign body (before and after surgery), and (3) vitreoretinal proliferation with or without sector traction detachment. In these cases we performed a modified method of blockade with confluent, two-row laser spots, which proved to be more efficient clinically and formed stronger retina-choroid adhesions in experimental studies. In a total of 78 performed laser coagulations, retinal detachment occurred in three, all of them with already present traction retinal detachment.
The long-term results of 95 consecutive eyes with a perforating eye injury and an intraocular foreign body (IOFB) treated with or without pars plana vitrectomy are reported. With the mean follow-up time of 30.0 months (median 22.8 months) 10 eyes (11%) were enucleated and another 17% became blind (visual acuity less than 0.05). The enucleation rate was considerably decreased and the visual outcome improved as compared with previous studies in Finland. The visual outcome was affected unfavourably by posterior location of the perforation, blunt injury, prolapse of intraocular tissue and poor initial visual acuity. There was no significant difference in the visual outcome between eyes with posterior segment IOFBs treated with or without vitrectomy. In the posterior perforation group the visual outcome was slightly better in eyes in which vitrectomy was performed (P = 0.336), and early vitrectomy within 1 week gave best visual results (P = 0.692). In 79% of the non-enucleated eyes the retina was attached. The anatomic success rate was similar regardless of the timing of vitrectomy.
The assessment of visual function in a series of 130 consecutive patients of perforating eye injuries, revealed that visual acuity of 6/12 or better was regained in 63 per cent, between 6/60 and 6/18 in 9-2 per cent, less than 6/60 in 15-3 per cent, and enucleation was necessary in 9-2 per cent. In 3 per cent, the eyes were retained as blind, symptomfree, and cosmetically satisfactory organs. Two eyes were found to develop complete traumatic aniridia. None in the series was found to have sympathetic ophthalmitis.
PURPOSE: To evaluate associations between baseline structural and functional ocular characteristics and the risk of developing posttraumatic glaucoma after penetrating ocular injury. DESIGN: Prospective cohort study. METHODS: Data from the United States Eye Injury Registry (USEIR) were obtained from a total of 3,627 patients who experienced penetrating ocular injury. The risk of posttraumatic glaucoma and associated structural and functional ocular risk factors was estimated. RESULTS: The risk of developing posttraumatic glaucoma was 2.67%. The development of glaucoma was independently associated with several baseline characteristics including advancing age (relative risk 1.02/yr 95% confidence interval [1.00, 1.03]), lens injury (1.56 [1.03, 2.35]), poor baseline visual acuity (2.59 [1.62, 4.14]), and inflammation (3.02 [1.52, 6.02]). CONCLUSIONS: This study provides an estimate for the risk of developing glaucoma after penetrating ocular injury in a large cohort of patients and determined several factors that are significantly associated with the development of post-traumatic glaucoma, including advancing age, lens injury, poor visual acuity, and intraocular inflammation.
Cataract extraction, posterior chamber intraocular lens (PC-IOL) implantation, and complete vitrectomy combined in a one-stage procedure were performed in 16 eyes (16 patients) with traumatic eye injuries undergoing anterior lensectomy (seven eyes), extracapsular cataract extraction (six eyes), or pars plana lensectomy (three eyes). Membrane peeling and intraocular foreign-body removal (13 eyes, 6 with intraretinal foreign bodies) were performed as needed. Surgery was performed from 1 week to 10 years after injury. After an average follow up of 8 months, 13 eyes (81%) had a visual acuity of at least 20/200; 50%, at least 20/40.
PURPOSE: To review the epidemiology of penetrating eye injuries and ruptured globes presenting to the Royal Adelaide Hospital, South Australia. METHODS: A retrospective case review over a 4-year period. RESULTS: There were 109 penetrated or ruptured globes in 105 patients. The average age was 41 years and 80.2% were men. Over half were from rural areas. The commonest cause of injury was hammering metal followed by motor vehicle accidents. Falls in the elderly were the commenest cause of globe ruptures. A final visual acuity of 6/12 or better was found in 40% of eyes and no perception of light in 27%. CONCLUSIONS: At the Royal Adelaide Hospital, the predominant referral centre for serious ocular injury in South Australia, approximately 25 open globe injuries are encountered a year. Although the epidemiology of these injuries was found to be similar to those previously reported in Victoria and rural New South Wales, differences were thought to reflect to the ageing population of South Australia. Rupture of an old, healed large-incision cataract extraction wound was the commonest cause of ruptured globe. An effective preventive strategy to reduce the incidence of severe ocular trauma has yet to be implemented. The concept of a national population-based severe ocular trauma database is considered.
This is a study of epidemiological and medico-social aspects of eye injuries in children. It refers to 624 cases, over the period 1996-1999; only 108 of them needed admission. The analysed factors are: the alleged person, the traumatic agent, the socio-climatic environment and the medical aspects of the accident. Only mechanical traumas are considered. The study reveals the quantitative indicators of various aspects such as: medical attendance, surgery, drug treatment, decreases of vision.
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