[2 cases of unusual eye injuries].
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Elevation of intraocular pressure is often seen immediately after blunt trauma of the eye, but it can occur even years after the primary impact. A retrospective study was performed in 144 patients with contusion to the eye. After a mean observation period of 6.1 years, a significant rise in intraocular pressure was found in the engaged eye (P < 0.05). In more than 8% of the patients the level of intraocular pressure exceeded 22 mmHg, but only 3 cases developed a glaucomatous visual field and optic nerve head changes. Thus, the risk of secondary glaucoma after contusion of the eye is low.
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Chorioretinal neovascular membranes are a recognised but rare cause of late visual loss in eyes suffering contusional injuries. A series of eight cases is presented all with indirect choroidal ruptures involving the perifoveal region. Two main patterns of 'at risk' rupture were noted: a temporally situated rupture passing almost directly through the fovea, and a rupture which curves inferior or superior to the optic disc stopping just short of the fovea. In six of eight cases there was only a partial thickness rupture of the choroid. These neovascular membranes may present at any time after the original injury, either early (within six months of the injury), which could be related to persistence of the normal reparative neovascular response, or late (at least one year after the injury), which are more likely to have resulted from a secondary breakdown of the outer blood-retina barrier.
A 17-year-old girl attended a rock concert where promotional compact discs were being thrown into the audience as prizes. She suffered an extensive corneoscleral laceration with vitreous hemorrhage and retinal detachment when a compact disc struck her in the eye. An alternative, safer method must be used for distributing compact discs as prizes.
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