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Eye examination plays an important role when living individuals are forensically investigated. The iris colour, retinal scans and other biometric features may be used for identification purposes while visual impairments may have legal implications in employment, driving and accidents. Ocular manifestations provide clues regarding substance abuse, poisoning and toxicity, and evidence of trauma, abuse or disease can be revealed along with psychological traits and lifestyle. Thus, the eye is a valuable tool in forensic investigations of living subjects, providing identifying characteristics along with health information. This review focuses on the medico-legal aspects of the eye's contribution when the living are subjected to forensic examination. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusions and RelevanceElectric scooters (e-scooters) have rapidly become a mainstream method of transportation in the U.S. but there is consequently limited data on their safety profile. This study evaluates ophthalmic injuries related to e-scooters compared to non-motorized scooters and off-road vehicles (ORV).This retrospective study uses the National Electronic Injury Surveillance System (2014 to 2023). Ocular injury profiles associated with conventional scooters, e-scooters, and off-road vehicles were included.E-scooter ocular injuries rose by 1950% between 2014 and 2023. E-scooter riders were 4.3 times more likely to sustain orbital fractures and 2.7 times more likely to be hospitalized than non-motorized scooter riders. ORV and e-scooter riders had comparable injury and hospitalization patterns. Alcohol use and lack of helmet use were significant contributors to injury severity.Injury patterns and hospitalization rates in e-scooter accidents resemble those of ORV incidents. Findings highlight the need for public health interventions to reduce the burden of e-scooter-related injuries. [ABSTRACT FROM AUTHOR]

Purpose: The objective is to investigate trends in cases of motor vehicle accident-associated (MVA-associated) ocular trauma in which the patient was the driver of the motor vehicle. Methods: The study utilizes data from the 2007–2014 National Trauma Databank (NTDB), a national trauma registry. Status as the driver of the motor vehicle was identified using E-Codes from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Trauma diagnoses were identified using D-Codes from the ICD-9-CM. Statistics were performed using IBM SPSS Version 23. Results: We identified 49,660 cases of ocular trauma secondary to an MVA with a 25.3% increase in injuries over the 8-year time period. Men comprised 68.6% (34,057) of cases. Orbital floor fractures (OFFs) were the most commonly observed ocular injury, occurring in 17,647 (35.5%) cases. There were 2,787 cases of open globe injury (OGI) with the highest proportion of cases in the 65 + age group (6.5%). OGIs were seen in 3.0% of cases with OFFs vs. 7.1% in those without. Drivers under 18 were more likely to have optic pathway/cranial nerve injuries (4.4%) and ocular/adnexal contusions (41.2%) than adult drivers. The mortality rate was 4.3% and was highest in the 65 + age group (9.4%). Conclusion: Men and young adults comprised the majority of cases of MVA-associated ocular trauma. OFFs were seen in approximately one-third of cases of ocular trauma. OGIs were less commonly observed when a concurrent OFF was observed. Though the overall mortality was 4.3%, there was significant variation by age group. [ABSTRACT FROM AUTHOR]

We conducted a retrospective review of patients (< 18 years) between 2013 and 2021 to determine risk factors of pediatric patients receiving a glaucoma drainage device (GDD) needing a scleral buckle (SB) and vice versa. The first population underwent an SB placement with no prior GDD. The second underwent a GDD implantation with no prior SB. We analyzed 133 eyes in the SB-first group. The common indications were retinal detachment associated with a syndrome/disease (41.2%), blunt trauma (21%), and non-syndromic pathologic myopia (11%). Twelve eyes (9%) required subsequent GDD implantation with a mean time to reoperation of 19.73 months (median 2.3 months). Eyes with trauma had a 5-fold risk (hazard ratio [HR] 4.81, p = 0.0069) of requiring a subsequent GDD. Each additional glaucoma medication before initial SB surgery increased the risk by 1.81 (p = 0.0096). 135 eyes were in the GDD-first group. Four eyes (3%) required a subsequent SB. The mean time to reoperation was 17 months (median 9.2 months). There was a statistically significant association with trauma (HR 12.3, p = 0.0341) only. Pediatric eyes with a history of trauma and/or multiple glaucoma medications before intervention have a high risk of requiring both an SB and GDD. [ABSTRACT FROM AUTHOR]

Introduction: Central retinal artery occlusion (CRAO) is a serious ophthalmic disease predominantly affecting older individuals with cardiovascular risk factors. While most cases are attributed to thrombus formation from atheromatous plaques or cardioembolic events, trauma-related CRAO, though rare, presents unique diagnostic and therapeutic challenges. Case Presentation: A 47-year-old woman with multiple controlled comorbidities presented to the emergency department with right eye pain and erythema following a traumatic injury involving a knitting needle. Initial examinations revealed hand motion visual acuity in the right eye, a partial thickness scleral laceration, and conjunctival laceration, which were surgically repaired. Postoperatively, she developed blurred vision, hyphema, and signs of CRAO, prompting anterior chamber paracentesis. OCT imaging revealed marked hyperreflectivity and thickening of the inner retinal layers, indicating significant ischemic damage. Despite normal inflammatory markers, the patient’s visual acuity gradually improved from 2/10 to 5/10 with intervention and eventually reached 10/10 with myopic correction after the hyphema resolved. Conclusion: The case emphasizes the necessity of early recognition and intervention in managing traumatic CRAO to mitigate irreversible retinal damage. It underscores the need for enhanced diagnostic and therapeutic strategies as understanding the condition’s pathophysiology advances. [ABSTRACT FROM AUTHOR]

Objective: To determine the impacts of pain nursing intervention of patients with craniocerebral trauma combined with ocular trauma after decompressive craniotomy. Method: This was retrospective study. Eighty patients with craniocerebral trauma combined with ocular trauma who underwent unilateral decompressive craniectomy in Baoding No.1 Central Hospital from January 2023 to November 2023 were included and divided into the observation group(n=40) and the control group(n=40) according to different nursing methods. Patients in the control group received conventional nursing intervention, while those in the observation group received pain nursing intervention. The differences in sleep quality, self-care ability, quality of life, psychological state and nursing satisfaction were compared between the two groups. Results: After intervention, the pain degree of both groups was significantly reduced compared with that before intervention, and the reduction degree of the observation group was more than that of the control group, with a statistically significant difference (p<0.05). The SS-QOL scores of both groups were significantly improved compared with before intervention, and the improvement degree of the observation group was significantly better than that of the control group, with a statistically significant difference (p<0.05). The nursing satisfaction score of the observation group was (93.35±3.83) points, which was higher than (83.38±3.59) points of the control group, with a statistically significant difference (t=12.019, P=0.000). Conclusion: Pain nursing intervention shows a variety of benefits in the treatment of patients with craniocerebral trauma combined with ocular trauma after decompressive craniectomy, improving their quality of life, self-care ability and nursing satisfaction. [ABSTRACT FROM AUTHOR]

Abstract We conducted a retrospective review of patients (

Introduction: Central retinal artery occlusion (CRAO) is a serious ophthalmic disease predominantly affecting older individuals with cardiovascular risk factors. While most cases are attributed to thrombus formation from atheromatous plaques or cardioembolic events, trauma-related CRAO, though rare, presents unique diagnostic and therapeutic challenges. Case Presentation: A 47-year-old woman with multiple controlled comorbidities presented to the emergency department with right eye pain and erythema following a traumatic injury involving a knitting needle. Initial examinations revealed hand motion visual acuity in the right eye, a partial thickness scleral laceration, and conjunctival laceration, which were surgically repaired. Postoperatively, she developed blurred vision, hyphema, and signs of CRAO, prompting anterior chamber paracentesis. OCT imaging revealed marked hyperreflectivity and thickening of the inner retinal layers, indicating significant ischemic damage. Despite normal inflammatory markers, the patient’s visual acuity gradually improved from 2/10 to 5/10 with intervention and eventually reached 10/10 with myopic correction after the hyphema resolved. Conclusion: The case emphasizes the necessity of early recognition and intervention in managing traumatic CRAO to mitigate irreversible retinal damage. It underscores the need for enhanced diagnostic and therapeutic strategies as understanding the condition’s pathophysiology advances.

AIM:To investigate the application of virtual reality(VR)technology in ocular trauma teaching for medical students.METHODS: A total of 90 medical students who participated in the Ophthalmology teaching program between November 2022 and April 2024 were recruited as subjects. Using a case-control method, 45 students in the case group attended traditional ocular trauma teaching program combined with VR virtual simulation experiments, and 45 students in the control group solely attended traditional ocular trauma teaching program. After the teaching practice, the two groups were compared in terms of their examination performance of theoretical knowledge and case analysis, learning ability(evaluated by the Self-Directed Learning Rating Scale), and the satisfaction survey on the quality of teaching; the statistical analyses were performed using t-test or Chi-square test.RESULTS: The scores of theoretical knowledge and case analysis examinations of the case group were significantly higher than those of the control group, and the differences were statistically significant(scores of theoretical knowledge examination: 57.27±2.78 vs 53.91±3.20; scores of case analysis examination: 35.71±3.73 vs 32.67±5.52, both P

Aya Ikeda, Asami Shimokawa, Kazuhiro Harada, Tomoko Tsukahara-Kawamura, Jane Huang, Hiroaki Ozaki, Eiichi Uchio Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, JapanCorrespondence: Eiichi Uchio, Department of Ophthalmology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan, Tel +81 92 801 1011, Fax +81 92 865 4445, Email euchio@fukuoka-u.ac.jpBackground: We have previously studied the physiological and mechanical responses of the eye to blunt trauma in various situations using finite element analysis (FEA). In this study, we evaluated the volume kinetics of an airbag impact on the eye using FEA to sequentially determine the volume change rates of intraocular segments at various airbag deployment velocities.Methods: The human eye model we created was used in simulations with the FEA program PAM-GENERISTM (Nihon ESI, Tokyo, Japan). Different airbag deployment velocities, 30, 40, 50, 60 and 70 m/s, were applied in the forward direction. The volume of the deformed eye impacted by the airbag was calculated as the integrated value of all meshes in each segment, and the decrease rate was calculated as the ratio of the decreased volume of each segment at particular timepoints to the value before the airbag impact.Results: The minimum volume of the anterior chamber was 63%, 69% and 50% at 50, 60 and 70 m/s airbag impact velocity, respectively, showing a curve with a sharp decline followed by gradual recovery. In contrast to the anterior chamber, the volume of the lens recovered promptly, reaching 80– 90% at the end of observation, except for the case of 60 m/s. Following the decrease, the volume increased to more than that of baseline at 60 m/s. The rate of volume change of the vitreous was distributed in a narrow range, 99.2– 100.4%.Conclusion: In this study, we found a large, prolonged decrease of volume in the anterior chamber, a similar large decrease followed by prompt recovery of volume in the lens, and a time-lag in the volume decrease between these tissues. These novel findings may provide an important insight into the pathophysiological mechanism of airbag ocular injuries through this further evaluation, employing a refined FEA model representing cuboidal deformation, to develop a more safe airbag system.Keywords: airbag, ocular trauma, computer simulation, lens, anterior chamber, vitreous body, finite element analysis, volume

Objectives: To characterize the epidemiology of simultaneous traumatic brain injury (TBI) and ocular trauma. Materials and Methods: In this retrospective, observational study, de-identified data from patients admitted with ocular trauma and TBI was extracted from the National Trauma Data Bank (2008-2014) using International Classification of Diseases 9th Revision, Clinical Modification diagnostic codes and E-codes relating to injury circumstances. Mechanisms, types of ocular and head injuries, intention, and demographic distribution were determined. Association of variables was calculated with Student’s t and chi-squared tests and logistic regression analysis. Results: Of 316,485 patients admitted with ocular trauma, 184,124 (58.2%) also had TBI. The mean (standard deviation [SD]) age was 41.8 (23) years. Most were males (69.8%). Race/ethnicity distribution was 68.5% white, 13.3% black, and 11.4% Hispanic patients. The mean (SD) Glasgow Coma Score (GCS) was 12.4 (4.4) and Injury Severity Score (ISS) was 17 (10.6). Frequent injuries were orbital fractures (49.3%) and eye/adnexa contusions (38.3%). Common mechanisms were falls (27.7%) and motor vehicle-occupant (22.6%). Firearm-related trauma (5.2%) had the greatest odds of very severe injury (ISS >24) (odds ratio [OR]: 4.29; p

Abstract The purpose of this study was to examine how demographics, etiology, and clinical examination findings are related to visual outcomes in subjects with open globe injury (OGI) across a large and generalizable sample. A retrospective cohort analysis was performed using data collected from the electronic medical records of four tertiary university centers for subjects with OGI presenting from 2018 to 2021. Demographic information, injury mechanisms, clinical exam findings, visual acuity (VA) at presentation and most recent follow-up were recorded. In subjects with bilateral OGIs, only right eyes were included. A modified ocular trauma score (OTS) using presenting VA, the presence of perforating injury, OGI, and afferent pupillary defect was calculated. The risk of subjects’ demographic characteristics, ocular trauma etiology, clinical findings and modified OTS on the presence of monocular blindness at follow-up were assessed using univariable and multivariable regression models. 1426 eyes were identified. The mean age was 48.3 years (SD: ± 22.4 years) and the majority of subjects were men (N = 1069, 75.0%). Univariable analysis demonstrated that subjects of Black race were 66% (OR: 1.66 [1.25–2.20]; P

Background: World-wide ocular trauma in work places is one of the major cause of blindness. It has a significant socio-economic impact as it affects mostly the younger individuals of society who are only incumbent in most of the families. Objectives: To provide epidemiological data and occupational profile on ocular injuries in adult population that may help in future planning and implementation of preventive and safety strategies. Methodology: A descriptive, observational, cross-sectional study was conducted from January 2019 to December 2019. By a non-probability based sampling technique 151 patients were selected who complied with the inclusion criteria. After taking a detailed history, patients were subjected to proper clinical examination and required investigations were done. Result: The mean age of the study population was 34.28±2.49 years. 57.62% of the population suffered an injury in work place. 63.63% people were aware of using protective measure in work place but only 11% knew that employer was bound to provide the same, for which despite of the knowledge only 17.27% were actually using it. People with higher education were significantly more knowledgeable (p< 0.00001) and more keener (p=0.01) to use the protective devices. Conclusion: Employees are to be made well aware about their rights, risks in job and usage of protective devices by health education and awareness campaign.

Background and Aims: Ocular trauma (OT) is a a major cause of ocular morbidity and blindness. This study was systematically conducted to determine the factors contributing to OT in Iran. Methods: In this study, a systematic review of all published articles in Persian and English languages from 2000 to 2023 was conducted to investigate the factors affecting OT in Iran. The included studies encompassed cross‐sectional, cohort, and case‐control designs. Articles were selected from internationally recognized databases, including PubMed, Web of Science, Scopus, and Google Scholar, as well as Persian databases such as SID and Magiran. The search strategy involved using keywords aligned with the (MeSH) terms, such as "oculars," "trauma," and "Iran." Initially, 403 articles were identified, and ultimately, 14 articles met the inclusion criteria. To ensure the prevention of bias and assess the quality of the selected articles, the Newcastle‐Ottawa Scale was utilized. Result: In the present study, the majority of individuals in the reviewed articles were categorized as having mild eye injuries (13.8%). A higher percentage of injuries was observed in males compared to females, and a higher prevalence of injuries was also observed in the age group of over 30 years compared to other age groups. Among the mechanical causes, sharp trauma had the highest prevalence rate (72.5%), while falls had the lowest prevalence rate (14%), followed by sport‐related injuries (29%). Non‐mechanical injuries were mentioned in only one article and had a prevalence rate of 1.5% Conclusion: The results of the current research have shown that among the mechanical injuries, accidents involving motorcycles and sharp objects are the leading causes of OT in Iranians. Therefore, the use of protective equipment such as goggles and adherence to traffic laws play a particularly important role, especially in men higher the age of 30. These findings highlight the necessity for targeted educational and preventive measures to reduce OT in Iran. [ABSTRACT FROM AUTHOR]

Objectives: To characterize the epidemiology of simultaneous traumatic brain injury (TBI) and ocular trauma. Materials and Methods: In this retrospective, observational study, de-identified data from patients admitted with ocular trauma and TBI was extracted from the National Trauma Data Bank (2008-2014) using International Classification of Diseases 9th Revision, Clinical Modification diagnostic codes and E-codes relating to injury circumstances. Mechanisms, types of ocular and head injuries, intention, and demographic distribution were determined. Association of variables was calculated with Student's t and chi-squared tests and logistic regression analysis. Results: Of 316,485 patients admitted with ocular trauma, 184,124 (58.2%) also had TBI. The mean (standard deviation [SD]) age was 41.8 (23) years. Most were males (69.8%). Race/ethnicity distribution was 68.5% white, 13.3% black, and 11.4% Hispanic patients. The mean (SD) Glasgow Coma Score (GCS) was 12.4 (4.4) and Injury Severity Score (ISS) was 17 (10.6). Frequent injuries were orbital fractures (49.3%) and eye/adnexa contusions (38.3%). Common mechanisms were falls (27.7%) and motor vehicle-occupant (22.6%). Firearm-related trauma (5.2%) had the greatest odds of very severe injury (ISS >24) (odds ratio [OR]: 4.29; p<0.001) and severe TBI (GCS <8) (OR: 5.38; p<0.001). Assault injuries were associated with the greatest odds of mild TBI (OR: 1.36; p<0.001) and self-inflicted injuries with severe TBI (OR: 8.06; p<0.001). Eye/adnexal contusions were most associated with mild TBI (OR: 1.25; p<0.001). Optic nerve/visual pathway injuries had greater odds of severe TBI (OR: 2.91; p<0.001) and mortality (OR: 2.27; p<0.001) than other injuries. Of associated head injuries, the odds of severe TBI were greatest with skull base fractures (OR: 4.07; p<0.001) and mortality with intracerebral hemorrhages (OR: 4.28; p<0.001). Mortality occurred in 5.9% of patients. Conclusion: TBI occurred in nearly two-thirds of ocular trauma admissions. The mortality rate was low with implications for challenging rehabilitation and long-term disability in survivors. [ABSTRACT FROM AUTHOR]

To evaluate the association between ocular trauma and activation of ocular toxoplasmosis. Retrospective review of 686 patients with ocular toxoplasmosis and its association with trauma to the eye or the head within 1 week of activation. Ten patients with a history of trauma and activation of ocular toxoplasmosis were detected (10/686; 1.45%). Nine patients showed a primary focus of retinitis without a previous scar and one patient had a recurrent form of ocular toxoplasmosis. From these 10 patients, Toxoplasma IgG was positive in eight of them. The median age of the patients was 35.8 years-old (range 17 to 65). These cases suggest that trauma can be associated with activation of retinal bradyzoite cysts in ocular toxoplasmosis. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine how demographics, etiology, and clinical examination findings are related to visual outcomes in subjects with open globe injury (OGI) across a large and generalizable sample. A retrospective cohort analysis was performed using data collected from the electronic medical records of four tertiary university centers for subjects with OGI presenting from 2018 to 2021. Demographic information, injury mechanisms, clinical exam findings, visual acuity (VA) at presentation and most recent follow-up were recorded. In subjects with bilateral OGIs, only right eyes were included. A modified ocular trauma score (OTS) using presenting VA, the presence of perforating injury, OGI, and afferent pupillary defect was calculated. The risk of subjects' demographic characteristics, ocular trauma etiology, clinical findings and modified OTS on the presence of monocular blindness at follow-up were assessed using univariable and multivariable regression models. 1426 eyes were identified. The mean age was 48.3 years (SD: ± 22.4 years) and the majority of subjects were men (N = 1069, 75.0%). Univariable analysis demonstrated that subjects of Black race were 66% (OR: 1.66 [1.25–2.20]; P < 0.001) more likely to have monocular blindness relative to White race at follow-up. OTS Class 1 was the strongest predictor of blindness (OR: 38.35 [21.33–68.93]; P < 0.001). Based on multivariable analysis, lower OTS category (OTS Class 1 OR: 23.88 [16.44–45.85]; P < 0.001) moderately predicted visual outcomes (R2 = 0.275, P < 0.001). OGI has many risks of poor visual outcome across patient groups that vary by demographic category, mechanism of injury, and clinical presentation. Our findings validate that a modified OTS remains a strong predictor of visual prognosis following OGI in a large and generalizable sample. [ABSTRACT FROM AUTHOR]

In this era of industrialization and high-speed traffic, the incidence of trauma is increasing in general. According to research, ocular trauma is also one of the causes of quite high rates of blindness. A male patient, 35 years old, came to the Bhayangkara Denpasar Eye Clinic initially on October 3 2023 with a complaint. The patient complained of pain in the right eye after being hit by a shuttlecock approximately 1 hour before the patient came to the hospital. Complaints are accompanied by red eyes, blurred vision, pain and watering. The patient said he had not received therapy for his complaint. Denied history of complaints of fever, cough, runny nose, shortness of breath. blunt ocular trauma which causes complications of hyphema and secondary glaucoma. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to evaluate the demographic and clinical characteristics of evisceration cases and to assess the psychosocial effects of prosthesis usage using the newly defined Global Ocular Prosthesis Score (GOPS). Methods: The records of 245 patients who underwent evisceration surgery between January 2010 and May 2021 were retrospectively reviewed. The study included 216 eyes of 216 patients who had regular follow-up of at least 6 months. Their demographic characteristics, indications for surgery, surgical methods, implant size, and complications were recorded. A total of 175 patients with ocular prostheses were evaluated using a 20-item questionnaire called GOPS. Results: About 154 of the 216 patients were male (71.3%), and 62 were female (28.7%), with a mean age of 34.9 years (range: 3-83). The mean follow-up duration was 52.5±34.2 months (range: 6-125). Among the cases, 101 (46.7%) had a penetrating globe injury, 91 (42.1%) had painful absolute eyes, 10 (4.6%) had corneal abscess, 8 (3.7%) had painless blind eyes due to Behçet's disease, 7 (3.2%) had endophthalmitis, 1 (0.04%) had prematurity retinopathy, 1 (0.04%) had corneal melting due to toxic epidermal necrolysis, and phthisis bulbi. Most of the traumas (74.5%) were caused by young (mean age 33.6 years) males. Sphere extrusion was observed in 16 (7.4%) patients at an average of 3 months (15 days to 6 months). Tenon cyst excision was performed in two patients. The mean GOPS was 71.74. Conclusion: It has been observed that the most common reasons for evisceration in a tertiary eye hospital are globe injuries and painful eyes. Although losing an eye can have negative physical and psychological effects on patients and may prevent them from fulfilling their social roles, it has been observed that the use of ocular prostheses positively impacts patient satisfaction. The use of the GOPS questionnaire can be helpful in assessing the quality of life of evisceration patients. [ABSTRACT FROM AUTHOR]

Objectives: Early diagnosis of relative afferent pupillary defects (RAPDs) in patients with ocular trauma is crucial for timely management and improved outcomes. However, clinical examination can be challenging for patients with periorbital ecchymosis. This study aimed to compare the diagnostic accuracy of point‐of‐care ultrasound (POCUS) and clinical examination by emergency physicians for detecting RAPD in adult ocular trauma patients and to evaluate the proportion of RAPD in patients with ocular trauma who presented to the ED. Methods: This prospective cohort study was conducted at an academic emergency department in South India. Adult ocular trauma patients were assessed for RAPD using clinical examinations by emergency physicians and POCUS. The diagnostic accuracies of both methods were compared, with the ophthalmologist's final diagnosis serving as the gold standard. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for both techniques. Results: A total of 376 patients (median age, 35 years) were included in this study. RAPD was identified in 14.63% of the patients. The sensitivity and specificity of POCUS in detecting RAPD were 92.73% and 99.38%, respectively, which were higher than those of clinical examination, with a sensitivity of 81.82% and specificity of 99.07%. The PPV and NPV of the clinical examination were 93.75% and 96.95%, respectively, whereas the PPV and NPV of POCUS were 96.23% and 98.76%, respectively. POCUS accurately diagnosed RAPD in patients with periorbital ecchymosis. Conclusion: POCUS‐guided RAPD assessment proves to be a better diagnostic adjunct compared to clinical examination in patients with ocular trauma presenting to the emergency department. [ABSTRACT FROM AUTHOR]

Purpose: To report a rare case of globe rupture with broken calcified senile scleral plaque (SSP). Observations: A 94-year-old male patient presented with left eye pain and severely decreased left vision immediately after the injury while farming. Examination of the left eye revealed edematous cornea, diffuse subconjunctival hemorrhage, total hyphema and iris prolapse. Preoperative computed tomography (CT) scan revealed calcified SSP in both eyes, and the calcified SSP was found to be broken during surgery. Although it was impossible to thread the broken calcified SSP, threading and suturing with long bites outside of the broken calcified SSP was effective for wound closure. Postoperatively, we were able to observe the broken calcified SSP and the wound closure using anterior segment optical coherence tomography (AS-OCT). Conclusions and importance: In a case of globe rupture with calcified SSP on preoperative CT, the possibility that the SSP has also ruptured should be considered. AS-OCT is also useful to observe the wound in a case of globe rupture with broken SSP during follow-up.

Sympathetic ophthalmia (SO) is a rare bilateral diffuse granulomatous intraocular inflammation, which occurs days or months following surgery or trauma to one eye. After penetrating ocular injuries and during intraocular surgery, the incidence of SO varies from 0.2% to 0.5% and 0.01%, respectively. Other risk factors include cyclodestructive operations and vitreoretinal surgery. With 80% of cases appearing within three months following injury to the exciting eye and 90% occurring within one year, the temporal interval between ocular injury and the onset of SO varies widely, ranging from a few days to decades. The diagnosis is based on clinical findings. It manifests as bilateral diffuse uveitis. In the sympathetic, uninjured eye, patients describe a sneaky beginning of blurred vision, discomfort, epiphora and photophobia. Typically, this is accompanied by conjunctival injection and a granulomatous anterior chamber reaction, resulting in mutton fat keratic precipitates (KPs). The degree of inflammation in the posterior chamber can differ. One of the initial lines of treatment for SO is systemic corticosteroids. Long-term immunomodulatory therapy may involve azathioprine, mycophenolate mofetil, cyclosporine or other immunosuppressive drugs if patients do not respond to steroid therapy or if their side effects are clinically substantial.

Aim: The study was aimed to assess the clinical features of ocular trauma and to classify and compare mechanical ocular injuries. Materials and Methods: This retrospective study was done on 299 patients with ocular injuries from January 2018 to May 2019. We reviewed case record forms for visual acuity (VA) and anterior segment findings. Fundus findings and intraocular pressure values were also noted. When indicated, radiological examinations such as computed tomography, magnetic resonance imaging, B-scan, and X-ray orbit were performed. The SPSS 11.0 package was used for data analysis. Results: Of the 299 instances in this study, 104 (34.78%) were in the 30–45 age group. The impact on males was 4.8 times greater than that on females. The most frequent cause among the 102 participants (34.11%) was industrial work. Out of 216 cases of closed-globe injuries, more than half, i.e., 113 cases (52.31%), were in zone I. Conclusion: Ocular trauma is more common among young males, with industrial work being the most common cause. A unilateral, closed-globe injury was more common compared to bilateral and open injuries. In open-globe injuries, zone II was more commonly affected, while in closed injuries, zone I was more common. Visual impairment was more severe in open-globe injuries. With regard to the prediction of final VA, our results were comparable to the ocular trauma score study, thus affirming its utility.

OBJECTIVES: One major contributor to avoidable ocular morbidity is ocular trauma (OT). The study aimed to document the epidemiological factors, pattern of injury, and outcome among patients with OT presenting to the emergency department (ED). METHODS: This was a prospective observational study conducted in the ED of a tertiary care teaching hospital in Eastern India after due approval from the institutional ethics committee. The data were collected during the period from March 2021 to February 2022. Data pertaining to age, sex, type of injury, mechanism of injury, time and place of injury, details of tissue involvement, visual acuity, any prior history of injury, initial diagnosis, and management were noted. To estimate the severity of the injury and the probable visual outcome, we calculated through OT score (OTS), including one raw score and OTS. Statistical analysis was performed using the R, version 4.6.1. RESULTS: A total of 180 patient’s data were included for final analysis. The median (interquartile range) age of the patients was 32 (24–45) years. The majority were males (n = 147 [81.6%]) with a male–female ratio of 4.5:1. Road traffic accidents (RTA) were the common cause of injury (n = 122 [67.7%]). Unilateral eye involvement was the most common (n = 147 [81.6%]). In the pattern of injury, most of the patients sustained closed globe injuries (CGIs) (n = 158 [87.7%]). Among the CGIs, injury to the ocular adnexa and conjunctiva (n = 141 and 127, respectively) was the most common. Injury to the retina and choroids occurred in 20 (11%) patients. The vision was not affected in most of the cases (n = 125 [69.4%]) with a visual acuity of > 6/18. The majority (n = 120 [67%]) of the patients had an OTS of grade-4, followed by grade-2 (n = 22 [12%]). Most of the patients required only medical management (n = 100 [56%]), whereas 77 (43%) patients required surgical interventions. CONCLUSION: OT was a common presentation in the ED. Male patients with monocular injuries involved in RTAs were mostly affected. The vision was preserved in most of the cases.

AIM:To observe the clinical efficacy of vitrectomy at different times for open ocular trauma and explore the timing of stage Ⅱ vitrectomy.METHODS: Retrospective case series study. A total of 60 cases(60 eyes)with open ocular trauma who visited our ophthalmology department from June 2022 to February 2023 were included. They were divided into treatment group A(interval ≤14 d)and treatment group B(interval >14 d)based on the interval between the stage Ⅰ emergency treatment surgery and the stage Ⅱ vitreoretinal surgery. Among the 32 cases(32 eyes)in the treatment group A, 16 eyes(50%)had eyeball rupture, 13 eyes(41%)had penetrating injury, and 3 eyes(9%)had perforating injury. Among the 28 cases(28 eyes)in the treatment group B, 15 eyes(54%)had eyeball rupture, 12 eyes(43%)had penetrating injury, and one eye(4%)had perforating injury. The two groups of patients were followed-up for 6 mo after surgery, and the treatment effects were compared.RESULTS:There was no statistically significant difference in visual acuity between the two groups of patients before vitrectomy(P>0.05). In the treatment group A, 10 eyes(31%)had significantly improved visual acuity, 21 eyes(66%)had effectively enhanced visual acuity, and 1 eye(3%)had no improvement in visual acuity at 6 mo after surgery. Among the 28 eyes in the treatment group B, 5 eyes(18%)had significantly improved vision, 16 eyes(57%)had effectively enhanced vision, and 7 eyes(25%)had no change in vision, with statistically significant difference between the two groups(U=322.5, P=0.032). There was no significant difference between the treatment group A and the treatment group B in complications such as secondary glaucoma, silicone oil dependence, vitreous hemorrhage, and eyeball atrophy(P>0.05). There was no evidence of traumatic proliferative vitreoretinopathy(TPVR)in the treatment group A during postoperative follow-up, which was significantly lower than that of the treatment group B(P

Background: Ocular trauma is a debilitating condition and one of the most important and leading causes of visual impairments that have high socioeconomic consequences. Objectives: This study aims to investigate the epidemiology of ocular trauma in patients referred to a tertiary center in northern Iran. Materials & Methods: This cross-sectional study was carried out on 476 patients with ocular trauma referred to the eye emergency department of a teaching hospital in Guilan Province, north of Iran, in 2020-21. Personal and trauma-related information was extracted from the patient’s medical records using a checklist. Results: Most patients were in the 31-40 age group (28.8%), with a mean age of 41.5±17.4 years. Most of the injuries occurred at home (57.1%). Few of the patients had used eye safety glasses (5.3%). Most of the patients were living in the city. Closed globe injuries were the common types of traumas (96%), and the prevalence of open globe injuries was at a very low level (4%). Conclusion: Closed globe injuries are the most common types of ocular traumas in northern Iran. Most of the ocular traumas are preventable using eye protection equipment.

Purpose: With the growing popularity of badminton worldwide, the incidence of badminton-related ocular injuries is expected to rise. The high velocity of shuttlecocks renders ocular traumas particularly devastating, especially with the possibility of permanent vision loss. This study investigated the mechanism behind ocular complications through simulation analyses of mechanical stresses and pressures upon shuttlecock impact. Design: Computational simulation study. Participants: None. Methods: A 3-dimensional human eye model was reconstructed based on the physiological and biomechanical properties of various ocular tissues. Finite element analysis simulations involved a frontal collision with a shuttlecock projectile at 128.7 km/hour (80 mph). Intraocular pressure (IOP) changes and tissue stress were mapped and quantified in the following ocular structures: the limbus, ciliary body, zonular fibers, ora serrata, retina, and optic nerve head. Main Outcome Measures: Intraocular pressure and tissue stress. Results: Upon shuttlecock impact, compressive force was transferred to the anterior pole of the cornea, propagating posteriorly to the optic nerve head. Deflection of forces anteriorly contributed to refractory oscillations of compressive and tensile stress of ocular tissue. Initial impact led to a momentary (

Objective Animal Studied Procedure Conclusion To describe the removal of an adherent, presumed plant‐based, anterior chamber foreign body (ACFB) from the inferior iridocorneal angle in a dog using hydropulsion and ophthalmic viscoelastic device (OVD) capture.A 6‐year‐old female spayed pit bull terrier who was referred for further evaluation of a corneal opacity after being observed running into a thorned succulent plant 1 month earlier. On ophthalmic examination, no corneal foreign body was noted, though mild uveitis was present. Gonioscopy revealed a suspected plant foreign body (thorn tip) in the inferior iridocorneal angle.Under general anesthesia, the ACFB was dislodged from the inferior iridocorneal angle using hydropulsion with balanced salt solution. The superior half of the anterior chamber had been filled with 2% hydroxypropyl methylcellulose OVD to trap the foreign object. One month later, the uveitis had resolved and repeat gonioscopy confirmed the absence of any ACFB in the iridocorneal angle.In the absence of an intraoperative goniolens or endoscopy, hydropulsion and OVD capture of adherent ACFBs may be a feasible option for removal. [ABSTRACT FROM AUTHOR]

Objective: In this study we investigated the efficacy of short-term intravitreal injections of anti-vascular endothelial growth factors (anti-VEGF) in treating traumatic submacular hemorrhage. Methods: A total of 115 patients were diagnosed with submacular hemorrhage between 2018 and 2022 at Shenzhen Eye Hospital. In a retrospective analysis, we examined 13 of these patients who presented with submacular hemorrhage and choroidal rupture due to ocular trauma. Eight patients were treated with intravitreal anti-VEGF injection and 5 with oral drugs. We systematically analyzed changes in their ocular conditions pre and post-treatment. The evaluations encompassed best-corrected visual acuity (BCVA), optical coherence tomography, fundus fluorescein angiography, and retinal imaging. Results: The 13 patients diagnosed with submacular hemorrhage comprised of 10 males and 3 female, with their age ranging between 27 and 64 years, with an average age of 38.1 years (standard deviation [SD]: 11.27). A statistically significant reduction in central foveal thickness (CFT) was observed following intravitreal injections of anti-VEGF drugs (P = 0.03). In control group, the CFT was reduced without statistical significance (P = 0.10). The BCVA of the patients in treatment group improved significantly from 1.15 (SD: 0.62. Range: 0.4–2) to 0.63 (SD: 0.59. Range: 0.1–1.6), indicating an average increase of 4.13 lines (SD: 3.36. Range: 0–9) as measured by the visual acuity test using an eye chart (P = 0.01). The difference between baseline visual acuity and final visual acuity was not statistically significant in control group (P = 0.51). Conclusion: Short-term administration of anti-VEGF drugs exhibited significant efficacy in reducing submacular hemorrhage following ocular trauma and enhancing visual acuity. [ABSTRACT FROM AUTHOR]

To examine the association between area-level socioeconomic deprivation and orbital trauma among emergency ophthalmology consults. We conducted a cross-sectional study using 5-year Epic data for all hospital-based ophthalmology consults at the University of Maryland Medical System, and the Distressed Communities Index (DCI) data for area-level socioeconomic deprivation. We ran multivariable logistic regression models adjusting for age to compute odds ratios (OR) and 95% confidence intervals (CI) for the association between the DCI quintile 5 distressed score and orbital trauma. A total of 3,811 cases of acute emergency consults were identified, of whom 750 (19.7%) had orbital trauma and 2,386 (62.6%) had other traumatic ocular emergencies. The odds of orbital trauma among people living in a distressed community were 0.59 (95% CI 0.46–0.76) times the odds for those living in a prosperous community. Among White subjects, the odds of orbital trauma for people living in a distressed community were 1.71 (95% CI 1.12–2.62) times the odds for those living in a prosperous community; among Black subjects, the OR was 0.47 (95% CI 0.30–0.75; p-interaction = 0.0001). Among women, the OR for orbital trauma among those living in a distressed community was 0.46 (95% CI 0.29–0.71); among men, the OR was 0.70 (95% CI 0.52–0.97; p-interaction = 0.03). Overall, we found an inverse association between higher area-level socioeconomic deprivation and orbital trauma among both men and women. The association varied by race, such that there was an inverse association with higher deprivation among Black subjects in contrast to a positive association among White subjects. [ABSTRACT FROM AUTHOR]

To characterize the clinical features of ocular trauma resulting from lawn mower, identify determinants of unfavorable final visual acuity (FVA), and assess the spectrum of microbial in posttraumatic endophthalmitis. This retrospective study enrolled patients who experienced ocular trauma due to lawn mower at Zhongshan Ophthalmic Center from January 2013 to August 2021. Demographics, clinical features, isolated microorganisms, risk factors influencing reduced visual acuity, treatment regimens, and utilization of eyewear were collected. The study included 140 participants (140 eyes) (49.47 ± 12.03 years, 95% male). The predominant injury manifestations were penetrating globe injuries (75.7%) and intraocular foreign bodies (51.4%). Endophthalmitis occurred in 35 cases (25%) and Bacillus cereus (23.5%) was the primary pathogen, followed by Staphylococcus epidermidis (11.8%) and Streptococcus species (11.8%). Following the initial assessment, where 77.9% of patients had initial visual acuity (IVA) at grade IV (ranging from light perception to 4/200) and only 0.7% attained grade I (better than 20/40), post-treatment results revealed that 5.7% achieved FVA at grade I, with a concurrent decrease in patients with grade IV vision to 64.3%. Multivariate logistic regression revealed that injury protection (p < 0.001, OR = 0.237, 95% CI = 0.126–0.446), IVA (p = 0.001, OR = 4.102, 95% CI = 1.730–9.729), and retinal detachment (p = 0.042, OR = 8.105, 95% CI = 1.075–61.111) were significant independent risk factors impacting FVA. Lawn mower often cause severe ocular injuries, with high-velocity metal foreign bodies that can lead to infections, most commonly caused by Bacillus cereus. Correct use of protective gear, initial vision assessment, and detecting retinal detachment are crucial for visual prognosis. • WHAT IS ALREADY KNOW ON THIS TOPIC • Systemic injuries resulting from lawnmower accidents were reported. However, little was known about incidence of ocular trauma from lawn mower, especially in the large study sample. • WHAT THIS STUDY ADDS • We reported on the risk factors for visual prognosis, the incidence of traumatic endophthalmitis and intraocular foreign bodies in lawnmower-related ocular trauma in China. • HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY • This completed information on ocular trauma would be beneficial for clinicians in their management and prescribing decisions in patients. • Main finding • Metallic foreign body retention and Bacillus cereus endophthalmitis are prevalent manifestations in lawnmower-related ocular trauma. Appropriate protective measures can significantly improve visual prognosis. [ABSTRACT FROM AUTHOR]

Introduction: Preservation of life, preservation of limb, and preservation of eyesight are the priorities for military medical personnel when attending to casualties. The incidences of eye injuries in modern warfare have increased significantly, despite personal eye equipment for service members. Serious eye injuries are often overlooked or discovered in a delayed fashion because they accompany other life- and limb-threatening injuries, which are assigned a higher priority. Prehospital military ocular trauma care is to shield the eye and evacuate the casualty to definitive ophthalmic care as soon as possible, with exceptions for treatment of ocular chemical injury and orbital compartment syndrome. Retrospective analysis of eye injuries in recent conflicts identified gaps in clinical capabilities with up to 96% of ocular injuries being suboptimally managed. Ocular compartment syndrome (OCS) is a complication associated with orbital hemorrhage, where significant morbidity occurs as a result of increasing intracompartment pressure. The ischemic tolerance of the retina and optic nerve is approximately 90 minutes, so OCS must be rapidly diagnosed and aggressively treated through lateral canthotomy/cantholysis (LC/C) to prevent permanent vision loss. LC/C procedures consist of using hemostats to crush the lateral canthal fold and cutting the lateral canthal tendon from the inferior crus to relieve increasing intracompartment pressure. The purpose of this study was to examine the baseline capabilities of military physicians and surgeons to accurately and independently perform the LC/C procedures and identify performance gaps that could be closed through focused professional development activities.Materials and Methods: This study received institutional review board approval at our institution. A total of 60 subjects voluntarily participated in the study from emergency medicine (15), general surgery (28), and ophthalmology (17). All procedural assessments were performed 1:1 by expert faculty ocular trauma specialists using a high-reliability eye trauma simulator (Sonalysts, Inc.). The competency standard was set at independent and accurate completion of all procedural components and all critical procedural components. Analyses were performed using descriptive statistics and analysis of variance to examine between-group differences (P < 0.05).Results: There was a significant difference between the total score performance and the critical score performance for the three groups (P < 0.001). Outcomes indicate a significant linear relationship between the expertise level of the clinical provider and the procedural performance of LC/C. Outcomes demonstrate the baseline surgical capabilities of the general surgeons transferred to LC/C performance; however, they were unfamiliar with the anatomy and the procedural techniques and requirements. The group of emergency medicine participants demonstrated performance gaps not only in the same areas as the general surgeons but also in their baseline surgical abilities. This suggests that different professional development activities are necessary for surgeons and physicians tasked with performing LC/V procedures.Conclusions: We identified significant performance gaps among emergency medicine physicians, general surgeons, and ophthalmologists in their abilities to recognize and treat OCS through LC/C procedures. These sight-saving procedures are a critical competency for forward-situated clinicians in expeditionary contexts. We identified the need for targeted approaches to professional development for closing the performance gaps for both emergency medicine physicians and general surgeons. [ABSTRACT FROM AUTHOR]

Background: Ocular trauma is a debilitating condition and one of the most important and leading causes of visual impairments that have high socioeconomic consequences. Objectives: This study aims to investigate the epidemiology of ocular trauma in patients referred to a tertiary center in northern Iran. Materials & Methods: This cross-sectional study was carried out on 476 patients with ocular trauma referred to the eye emergency department of a teaching hospital in Guilan Province, north of Iran, in 2020-21. Personal and trauma-related information was extracted from the patient's medical records using a checklist. Results: Most patients were in the 31-40 age group (28.8%), with a mean age of 41.5±17.4 years. Most of the injuries occurred at home (57.1%). Few of the patients had used eye safety glasses (5.3%). Most of the patients were living in the city. Closed globe injuries were the common types of traumas (96%), and the prevalence of open globe injuries was at a very low level (4%). Conclusion: Closed globe injuries are the most common types of ocular traumas in northern Iran. Most of the ocular traumas are preventable using eye protection equipment. [ABSTRACT FROM AUTHOR]

OBJECTIVES: One major contributor to avoidable ocular morbidity is ocular trauma (OT). The study aimed to document the epidemiological factors, pattern of injury, and outcome among patients with OT presenting to the emergency department (ED). METHODS: This was a prospective observational study conducted in the ED of a tertiary care teaching hospital in Eastern India after due approval from the institutional ethics committee. The data were collected during the period from March 2021 to February 2022. Data pertaining to age, sex, type of injury, mechanism of injury, time and place of injury, details of tissue involvement, visual acuity, any prior history of injury, initial diagnosis, and management were noted. To estimate the severity of the injury and the probable visual outcome, we calculated through OT score (OTS), including one raw score and OTS. Statistical analysis was performed using the R, version 4.6.1. RESULTS: A total of 180 patient's data were included for final analysis. The median (interquartile range) age of the patients was 32 (24-45) years. The majority were males (n = 147 [81.6%]) with a male--female ratio of 4.5:1. Road traffic accidents (RTA) were the common cause of injury (n = 122 [67.7%]). Unilateral eye involvement was the most common (n = 147 [81.6%]). In the pattern of injury, most of the patients sustained closed globe injuries (CGIs) (n = 158 [87.7%]). Among the CGIs, injury to the ocular adnexa and conjunctiva (n = 141 and 127, respectively) was the most common. Injury to the retina and choroids occurred in 20 (11%) patients. The vision was not affected in most of the cases (n = 125 [69.4%]) with a visual acuity of > 6/18. The majority (n = 120 [67%]) of the patients had an OTS of grade-4, followed by grade-2 (n = 22 [12%]). Most of the patients required only medical management (n = 100 [56%]), whereas 77 (43%) patients required surgical interventions. CONCLUSION: OT was a common presentation in the ED. Male patients with monocular injuries involved in RTAs were mostly affected. The vision was preserved in most of the cases. [ABSTRACT FROM AUTHOR]

Introduction: Due to the vulnerable position of the eye, eye injuries are very common in horses. Lack of effective and prompt treatment of eye injuries leads to blindness. Most of the trauma to the horse's eye is the blunt type and usually causes more severe injuries than sharp blows. However, in all these cases, at first, acute uveitis with different severities occurred, which requires quick treatment and can have different consequences. Case report: A two-year-old male Arabian horse with a history of ocular trauma for 4 days to the right eye was referred to the large animal clinic of the School of Veterinary Medicine, Shiraz University, Iran. All other clinical signs, including temperature, respiratory rate, appetite, and mental state were normal. Ocular examination revealed extensive corneal edema, elevated intraocular pressure (IOP) detected by palpation of the globe, blepharospasm, conjunctival hyperemia, miosis, and epiphora. Eye disorder was diagnosed as acute corneal edema and traumatic uveitis. Treatment included administration of flunixin meglumine for three days, atropine eye drops once a day, latanoprost eye drops once a day, gentamicin, and ciprofloxacin eye drops three times daily, and eye wash with saline 0.9% solution twice a day. The treatment continued for 2 weeks and resulted in complete healing which confirmed the diagnosis. The treated horse had a positive response to the therapy and fully recovered within 20 days. No relapse or complications were observed during the final check-up. Conclusion: Acute uveitis is a common complication following blunt trauma to the eye and is diagnosed by clinical symptoms. Since this situation could have a devastating consequence on vision, immediate diagnosis and treatment are essential to achieve the desired result. The treatment of these patients is symptomatic treatment based on anti-inflammatory, mydriatic, and antibiotics. Depending on the patient's condition, the use of other drugs, such as intraocular pressure reducers may be helpful and essential to prevent or treat complications, including glaucoma. [ABSTRACT FROM AUTHOR]

Abstract Background and Aims Ocular trauma (OT) is a a major cause of ocular morbidity and blindness. This study was systematically conducted to determine the factors contributing to OT in Iran. Methods In this study, a systematic review of all published articles in Persian and English languages from 2000 to 2023 was conducted to investigate the factors affecting OT in Iran. The included studies encompassed cross‐sectional, cohort, and case‐control designs. Articles were selected from internationally recognized databases, including PubMed, Web of Science, Scopus, and Google Scholar, as well as Persian databases such as SID and Magiran. The search strategy involved using keywords aligned with the (MeSH) terms, such as “oculars,” “trauma,” and “Iran.” Initially, 403 articles were identified, and ultimately, 14 articles met the inclusion criteria. To ensure the prevention of bias and assess the quality of the selected articles, the Newcastle‐Ottawa Scale was utilized. Result In the present study, the majority of individuals in the reviewed articles were categorized as having mild eye injuries (13.8%). A higher percentage of injuries was observed in males compared to females, and a higher prevalence of injuries was also observed in the age group of over 30 years compared to other age groups. Among the mechanical causes, sharp trauma had the highest prevalence rate (72.5%), while falls had the lowest prevalence rate (14%), followed by sport‐related injuries (29%). Non‐mechanical injuries were mentioned in only one article and had a prevalence rate of 1.5% Conclusion The results of the current research have shown that among the mechanical injuries, accidents involving motorcycles and sharp objects are the leading causes of OT in Iranians. Therefore, the use of protective equipment such as goggles and adherence to traffic laws play a particularly important role, especially in men higher the age of 30. These findings highlight the necessity for targeted educational and preventive measures to reduce OT in Iran.

Intraocular foreign bodies (IOFBs) remain a severe complication of ocular trauma commonly encountered worldwide. This literature review aimed to discuss current practice patterns, areas of controversy, and advances in the management of IOFBs. Injuries involving IOFBs carry significant ocular morbidity and management can be extremely challenging. A systematic approach to preoperative evaluation and IOFB surgical management is detailed in this article and should be applied in each case. The location and composition of an IOFB have important implications on surgical approach and timing, especially in cases of toxic metals and vegetable matter. The advantages, disadvantages, and previous literature regarding immediate versus delayed foreign body removal are presented. Surgical approaches are described, with an emphasis on posterior chamber IOFB management and removal via pars plana vitrectomy. Final visual acuity is variable, but approaches have been used to prognosticate outcomes including the Ocular Trauma Score. By synthesizing current IOFB literature, the goal is to provide practitioners with guidance that will maximize the chances of surgical success and patient outcomes.

Firework-related injuries, particularly ocular trauma, pose a significant public health concern during cultural celebrations. We explore the case of a 20-year-old male who sustained firework-induced ocular trauma at the age of seven, subsequently developing traumatic cataract and glaucomatous optic atrophy. The patient presented with decreased vision and pain in the left eye (LE), 13 years post-injury. He underwent cataract surgery nine years after the incident, with subsequent development of glaucomatous optic atrophy. Examination revealed visual acuity impairment, exotropia, and pupil abnormalities in the LE, along with scleral thinning and corneal opacity. Posterior segment evaluation showed optic nerve cupping and hemorrhages. Gonioscopy indicated angle recession and synechiae in the LE. Optical coherence tomography revealed retinal nerve fiber layer defects. Elevated intraocular pressure in the LE was successfully managed with anti-glaucoma medication. Firework-related ocular trauma can lead to long-term complications, including traumatic cataract and glaucomatous optic atrophy. Timely cataract surgery and vigilant follow-up are essential for early detection and management of secondary glaucoma. Regulatory measures to mitigate firework-related injuries are imperative to prevent such incidents and preserve visual health.

Abstract Background Few ocular trauma studies have addressed mortality outcomes. We sought to determine characteristics of mortality-related ocular trauma admissions and compared them with non-fatal injuries. Methods A retrospective study was conducted using de-identified data of patients admitted with major trauma from the National Trauma Data Bank (2008–2014). Patients with ocular injury were identified using ICD- 9CM codes. Demographics, intention and mechanism, types of ocular and head injuries, and injury severity were documented. Mortality was determined using post-admission disposition. Statistical analysis using student t-test, chi-square, and odds ratios (OR) calculations were performed with STATA-17 software. Significance was set at P 24) (OR = 19.19; P

Abdelhalim A Awidi,1 Jiawei Zhao,2 Ximin Li,1 Fatemeh Rajaii,1 Meleha Ahmad,3 Adrianna Jensen,4 Fasika A Woreta1 1Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, MD, USA; 2Plastic Surgery Department, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; 3Ophthalmic Plastic and Reconstructive Surgery Department, University of California, San Francisco, CA, USA; 4Ophthalmic Plastic and Reconstructive Surgery Department, Pacific Center for Oculofacial and Aesthetic Plastic Surgery, San Francisco, CA, USACorrespondence: Fasika A Woreta, Ophthalmology Department, Wilmer Eye Institute, Baltimore, MD, USA, Tel +1 410 955 5650, Email fworeta1@jhmi.eduPurpose: To investigate the etiology and demographic associations of patients presenting with eyelid lacerations to a US level 1 trauma center emergency department (ED).Patient and Methods: A retrospective chart review of all patients with eyelid lacerations presenting to the ED at a single level 1 trauma center was performed. Eyelid lacerations were categorized as simple eyelid lacerations, eyelid lacerations with eyelid margin involvement, and eyelid lacerations with nasolacrimal system involvement. Data on demographics and clinical characteristics were analyzed.Results: A total of 303 eyelid laceration cases were identified, 56% were simple eyelid lacerations, followed by 24% with nasolacrimal involvement and 20% involving the eyelid margin. Sixty percent of animal bites/scratches resulted in a nasolacrimal system involving laceration, most commonly affecting children. Falls were the most common etiology in children and patients over the age of 60. Black patients, patients presenting with concomitant ophthalmic injuries, and those with Medicaid insurance were more likely to have an assault etiology (p < 0.05 for all).Conclusion: Falls were the most common etiology for eyelid lacerations in children and the elderly, while assault was the most common in adults. Identifying the most common etiology by demographic factors can help raise awareness regarding targeted prevention strategies for high-risk populations.Keywords: eyelid lacerations, ocular trauma, eye injury, emergency department

Tomohiro Ueno, Hideaki Fujita, Aya Ikeda, Kazuhiro Harada, Tomoko Tsukahara-Kawamura, Hiroaki Ozaki, Eiichi Uchio Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, JapanCorrespondence: Eiichi Uchio, Department of Ophthalmology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan, Tel +81 92 801 1011, Fax +81 92 865 4445, Email euchio@fukuoka-u.ac.jpBackground: We studied the kinetic phenomenon of an airbag impact on eyes with different axial lengths using finite element analysis (FEA) to sequentially determine the physical and mechanical responses of intraocular segments at various airbag deployment velocities.Methods: The human eye model we created was used in simulations with the FEA program PAM-GENERISTM. The airbag was set to impact eyes with axial lengths of 21.85 mm (hyperopia), 23.85 mm (emmetropia) and 25.85 mm (myopia), at initial velocities of 20, 30, 40, 50 and 60 m/s. The deformation rate was calculated as the ratio of the length of three segments, anterior chamber, lens and vitreous, to that at the baseline from 0.2 ms to 2.0 ms after the airbag impact.Results: Deformation rate of the anterior chamber was greater than that of other segments, especially in the early phase, 0.2– 0.4 ms after the impact (P < 0.001), and it reached its peak, 80%, at 0.8 ms. A higher deformation rate in the anterior chamber was found in hyperopia compared with other axial length eyes in the first half period, 0.2– 0.8 ms, followed by the rate in emmetropia (P < 0.001). The lens deformation rate was low, its peak ranging from 40% to 75%, and exceeded that of the anterior chamber at 1.4 ms and 1.6 ms after the impact (P < 0.01). The vitreous deformation rate was lower throughout the simulation period than that of the other segments and ranged from a negative value (elongation) in the later phase.Conclusion: Airbag impact on the eyeball causes evident deformation, especially in the anterior chamber. The results obtained in this study, such as the time lag of the peak deformation between the anterior chamber and lens, suggest a clue to the pathophysiological mechanism of airbag ocular injury.Keywords: airbag, ocular trauma, computer simulation, lens, anterior chamber, vitreous body, finite element analysis, deformation

PURPOSE: The purpose of this study was to evaluate and estimate the knowledge, attitude, and practices of Indian fresh medical graduates with respect to ophthalmic emergencies. MATERIALS AND METHODS: This cross-sectional study was conducted on 1300 participants who had completed compulsory rotatory residential internship with the help of a questionnaire distributed through social platforms. The Chi-square and Pearson's coefficient relation tests were used. Statistical analysis was done using IBM SPSS. P

Prevalence of ocular trauma is debatable in India due to the inconsistent findings of different studies from diverse regions. Moreover, few cross-sectional studies on this topic are available. We searched for relevant published Indian studies in PubMed and screened for duplicates. We selected 28 studies and analyzed information regarding study participants and demographics. The mean prevalence derived from all cross-sectional studies were utilized for the entire Indian population. Out Of 10997 articles, we found 2134 studies after the removal of duplicates. Of the 121 eligible studies, we selected 28 studies. The prevalence was 3.75% when we applied the data to the Indian population, and 37,33,333 individuals sustained ocular injury, which resulted in blindness or visual impairment. Ocular injuries mainly contribute to impaired vision and blindness. Preventive strategies should be developed to lower ocular injury occurrence.

Penetrating ocular injuries from pencils and pencil lead are frequently seen in children and may cause an intraocular infection or serious intraocular sterile inflammatory reaction. However, it has been noted that the carbon particles from pencil lead may remain inert in the eye without inciting inflammation for long duration. We report a case of a 21-year-old male with an intracorneal graphite foreign bodies following penetrating ocular injury.

Objective: The aim is to evaluate the anatomical and functional outcomes of retinal detachment (RD) surgery in the pediatric population in a tertiary eye hospital in Nepal. Methods: This study is a hospital-based, retrospective cross-sectional study, including patients under 18 years of age, diagnosed with rhegmatogenous RD (RRD) for 5 years from January 2015 to December 2019, who underwent RD surgery. Results: Twenty patients were included in the study (mean age of 10.75 ± 2.63). Male patients were 19 (95%). A history of trauma was seen in 13 (65%) patients. Phakic RRD was observed in 18 (90%) patients and the rest 2 (10%) patients were pseudophakic. Type B proliferative vitreoretinopathy changes were observed in 3 (15%) patients, type C was observed in single patient (5%). Scleral buckling was performed in 7 (35%) patients, while 12 (60%) patients underwent three-port pars plana vitrectomy (PPV) and silicon oil instillation and the remaining single patient (5%) underwent PPV with gas exchange. Lensectomy was performed in 8 (40%) patients. Retinal attachment with a single surgical procedure was seen in 8 (40%) patients, while 12 (60%) patients required multiple surgeries. The mean duration of silicon oil removal was 5 ± 2.78 months (1-11 months). At the end of 6 months, 11 (55%) patients had improved visual acuity of 6/60. Six months postoperatively, 18 (90%) patients had attached retina. Conclusion: Visual improvement and retinal reattachment could be achieved with early diagnosis and intervention in pediatric RRD. [ABSTRACT FROM AUTHOR]