The basis of specific treatment for eye injuries
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The risk of damage to the eyes of the patient, the dentist and his assistant should be recognized. Protection can be achieved by the wearing of specially designed spectacles using CR 39 plastic tinted lenses. Contact lenses should be removed by patients who are to undergo general anaesthesia.
The authors report their experience concerning intraocular implantation of artificial lenses during primary management of the eye war injuries as well as during secondary management, after shorter or longer period of consolidation, on 16 eyes of the same number of patients. Primary intraocular implantation was performed on 5 eyes simultaneously with primary management of the injured eye, while secondary implantation was performed on 11 eyes later, after more or less time of consolidation of the primary wound treatment. In regard to anatomical and functional consequences of severe trauma of the eye and the surgery itself, the functional state of the eyes operated on was satisfactory. The most frequent chronic complications were deformities of the pupil and, to a lesser degree, secondary cataract.
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The paper describes results after primary surgical treatment in 131 children, aged from 2 to 14 years, with severe combined trauma of the anterior segment of the eye complicated by lens injury in 84.4%, prolapse of eye coats in 34.9%, injury of the iris in 12.8%, extensive hemorrhages in 12.8%, intraocular foreign bodies in 6.4%. Besides sutural fixation of corneal and scleral wounds, there were simultaneously made iridoplasty, aspiration of a swelling lens, anterior vitrectomy, removal of a foreign body, organized hyphema and exudate tectonic corneoscleroplasty, and, if indicated, IOL implantation. The functional outcomes (a cure with visual acuity 0.3-1.0 was recorded in 45% of patients) speak in favor of such a method of rendering urgent aid and allow to recommend it into a wide ophthalmological practice.
AIMS: To investigate the current causes and outcomes of paediatric ocular trauma. METHODS: A prospective observational study of all children admitted to hospital with ocular trauma in Scotland over a 1 year period. RESULTS: The commonest mechanism of injury was blunt trauma, accounting for 65% of the total. 60% of the patients were admitted with a hyphaema. Injuries necessitating admission occurred most frequently at home (51%). Sporting activities were the commonest cause of injury in the 5-14 age group. There were no injuries caused by road traffic accidents or fireworks. Patients were admitted to hospital for a mean of 4.2 days (range 1-25 days). One (1%) child had an acuity in the "visually impaired" range (6/18-6/60) and one (1%) was "blind" (6/60) in the affected eye. No child was bilaterally blinded by injury and none required blind or partial sight registration. CONCLUSION: This study has shown that the incidence of eye injuries affecting children has fallen. The outcome of ocular trauma has improved significantly, and for the first time paediatric injuries appear to have a better prognosis than injuries affecting adults.
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The detailed consideration of enucleated eyes after traumatic perforations--material of a period of 20 years--shows some of age related facts. The largest part of enucleations comes from the age of 15 to 30, though the prognosis of preservation of the eye is favourable in this group of age. The rate of enucleations of the examinated material ascends with the age in males. Females have in the age of 46-60 years the highest rate of enucleations.
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We have shown previously that a 1.696 kb upstream fragment of the goldfish alpha1-tubulin promoter was capable of driving green fluorescent protein (GFP) expression in the developing and regenerating zebrafish CNS in a pattern closely mimicking the endogenous alpha1-tubulin gene. Comparison of fish and rat alpha1-tubulin promoters identified a 64 bp region with a conserved repetitive homeodomain (HD) consensus sequence core (TAAT) and a nearby basic helix-loop-helix binding E-box sequence (CANNTG), which led us to speculate that it could be of importance for regulating alpha1-tubulin gene transcription. To address this issue, we examined the ability of deletion mutants of the 1.696 kb promoter to drive expression of GFP in zebrafish retinal cells under normal conditions and after injury. Interestingly, although wild-type 1.696 kb and mutant promoters, lacking the E-box and/or HD sequences, exhibited rather similar patterns of GFP expression in the developing retina, significant differences were noticed in the mature retina. First, although the 1.696 kb promoter directed transgene expression to retinal neurons and progenitor cells, the activity of mutant promoters was drastically reduced. Second, we found that the E-box and HD sequences were necessary for transgene reinduction during optic nerve regeneration, but were not as important for transgene expression in regenerating retinal neurons after eye injury. In this latter lesion model, remarkably, both 1.696 kb and mutant promoters targeted GFP expression to Müller glia-like cells, some of which re-entered the cell cycle. These new findings will be useful for identifying the molecular signals necessary for successful CNS regeneration.
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