Search

Introduction/Objective. Ocular trauma is a globally important cause of visual impairment. The aim of our study was to analyses demographic, epidemiological, and clinical characteristics of blunt ocular trauma. Methods. The retrospective study enrolled patients with blunt ocular trauma, hospitalized at the Eye Clinic, University Clinical Centre of Serbia in Belgrade during a four-year period (2018–2022). Demographic characteristics, mechanism of injury, best corrected visual acuity on admission and discharge and injured eye structure were analyzed. Results. Out of 283 patients, the majority (n = 233, 82%) were men. People aged 61 and over (n = 82, 29%) were at greatest risk for blunt ocular trauma. Injuries from splitting wood (n = 78, 28%) and various blunt tools and objects (n = 70, 25%) were the most common mechanism in the entire study group, both in men and in women. Visual acuity on admission was better than 0.6 in 147 (52%) patients and at discharge in 185 (65%). The most common eye structure affected are pathological findings in anterior chamber (n = 160, 56%), which are mainly related to hyphemia. Conclusion. Present study showed that blunt ocular trauma affects all age groups, but most often elderly and children. Men are injured more often than women. Splitting wood and manipulating blunt tools and objects are activities with the highest risk of blunt ocular trauma.

Introduction. Valsalva retinopathy is an uncommon disorder that usually presents with acute onset of unilateral, or less frequently, bilateral visual impairment varying from subtle scotoma to total vision loss. It occurs as a result of Valsalva’s maneuver. In the vast majority of cases, hemorrhage is preretinal although subretinal, intraretinal and vitreous hemorrhage can be found. Valsalva retinopathy often develops due to numerous triggering activities such as vomiting, coughing, heavy weight lifting, intense aerobic exercise, labor, and general anesthesia. Management options are either clinical observation or invasive techniques. We report a case of premacular hemorrhage due to Valsalva retinopathy induced by gym training. Case outline. A 34-year-old woman was referred to the Eye Clinic, University Clinical Center of Serbia, complaining of sudden and painless unilateral decrease in vision occurred during intense physical activity. Best corrected visual acuity was measured as counting fingers at five meters distance. Dilated fundoscopy demonstrated a large, well demarcated premacular subhyaloid hemorrhage with visible rupture of the retinal vein branch. The patient was treated conservatively. Three months after the onset of symptoms, hemorrhage absorbed and best corrected visual acuity was 20/20. Conclusion. Valsalva retinopathy, although a rare condition, should not be omitted as a differential diagnosis of retinal and vitreous hemorrhages. Standard, observational treatment is generally sufficient for complete vision recovery; however, literature suggests that an individualized approach to each patient is required.

Introduction. Severe ocular injuries caused by fishing equipment are relatively rare. The visual prognosis for fishing-related injuries depends on the involved ocular structures, the presence of complications, and surgical techniques applied. Case outline. A 40-year-old man reported a sudden severe sharp pain and a loss of vision in his left eye while he was pulling the fishing rod during recreational fishing. At admission, his best corrected visual acuity (BCVA) of the left eye was 1/60. Clinical examination revealed a laceration in the temporal quadrant of the bulbar conjunctiva 0.2–0.3 mm in size and a dark tumefaction under the conjunctiva in the same region. It was identified during primary surgical exploration as a fishing sinker 1 cm in size lodged under the lateral rectus muscle. The bulbar wall was intact and the fishing sinker was safely removed. Phacoemulsification with the implantation of an artificial foldable intraocular lens and 23G pars plana vitrectomy were performed. During vitrectomy, subretinal hemorrhage in the macular region and large retinal dialysis in the temporal segment were revealed. Vitrectomy was finished with silicone oil tamponade. One week later, the patient’s BCVA of the left eye was 2/60. Eight months after surgery, spontaneous resorption of subretinal hemorrhage in the macular region and the attached retina was observed. The patient’s BCVA was 3/60 due to the destruction of photoreceptors and retinal pigment epithelium and the formation of epiretinal membrane. Conclusion. To our knowledge, this is the first case report of a severe blunt ocular injury associated with large retinal dialysis caused by a fishing sinker.

Introduction. Leber’s hereditary optic neuropathy (LHON) typically affects young adults, with a higher prevalence in men, but can ultimately occur at any age, as well as in women. LHON is caused by point mutations in the mitochondrial DNA. Classically, LHON presents as a subacute unilateral loss of visual acuity, dyschromatopsia in the red–green axis and a central or centrocecal scotoma. The contralateral eye usually develops similar symptoms within 3–6 months of the disease onset. Case outline. A 55-year-old male patient presented to a neurologist 20 days after the onset of vision loss. The patient was admitted as an emergency case to the Clinic for Eye Diseases due to a sudden vision loss in both eyes. The best corrected visual acuity in both eyes was 4/60. The intraocular pressure on both eyes was normal. Oedema of the optic nerve head was found on the right eye and a disc with blurred borders was seen on the left eye. During hospitalization, several consultative examinations and diagnostic procedures were performed, together with blood laboratory and visual field perimetry. Genetic testing for LHON as well as antibodies to AQ4, immunoserology, virology, and lumbar puncture were performed, as well as the visual evoked potential and ultrasound examinations. Conclusion. In our patient, the presence of a heteroplasmic mutation m.11778 G>A (MT-ND4) in the mitochondrial DNA analyzed from a peripheral blood sample was shown. In the available literature, this is the first documented LHON case demonstrating complete restitution of visual acuity in both eyes.

Introduction. Dislocation of intraocular lens (IOL) after ocular trauma is an emergency situation requiring prompt surgery. Dislocation of IOL into the subconjunctival space or pseudophacocoele is a rare event after blunt ocular trauma. Case outline. We report a case of a pseudophakic patient with a dislocation of the anterior chamber IOL (ACIOL) into subconjunctival space following blunt trauma to the right eye. A 76-year-old man presented with ACIOL dislocation into subconjunctival space, adapted old scleral wound and preserved corneal integrity. Fifteen years previously he suffered right eye globe rupture after blunt trauma, which was surgically closed and ACIOL was inserted. Conclusion. This case highlights a rare mechanism of ACIOL dislocation into subconjunctival space following blunt ocular trauma with preserved corneal integrity and adapted old scleral wound. In cases of post-traumatic aphakia, IOL dislocation into the subconjunctival space should be suspected.

Background and Objectives: Partially thrombosed aneurysms represent a subset primarily found within large and giant aneurysms. The presence of an intraluminal thrombus can cause an aneurysm to present in different shapes upon angiographic examination. We present a series of five cases of "donut-shaped" aneurysms observed over the past decade at the Clinic for Neurosurgery in the University Clinical Centre of Serbia. Materials and Methods: The management of "donut-shaped" aneurysms was accomplished through endovascular interventions, employing techniques such as the deployment of flow-diverting stents or a combination of stent placement and coil embolization. Results: Four out of five patients underwent endovascular treatment, yielding positive outcomes with complete thrombosis of the aneurysms during follow-up. The fifth patient was successfully diagnosed; however, due to their deteriorating condition, treatment was not feasible. Conclusions: Given the potential life-threatening complications associated with this entity, accurate diagnosis and appropriate management are crucial. In our cohort, endovascular interventions demonstrated efficacy in the majority of cases, underscoring the significance of this approach in treating "donut-shaped" aneurysms. Nevertheless, considering the rarity of this condition, further research is justified to refine diagnostic and therapeutic strategies for these complex intracranial vascular anomalies. [ABSTRACT FROM AUTHOR]