Search

Retrobulbar haemorrhage can be related to blunt eye trauma which is a rare ophthalmic emergency situation Orbital compartman syndrome (OCS) may be due to a traumatic excessive retrobulbar hemorrhage. Early diagnosis and immediate lateral canthotomy/cantholysis must be performed to save the vision of the affected eye. We wanted to present a patient with orbital compartman syndrome and its management in this case report. [ABSTRACT FROM AUTHOR]

Four patients with traumatic mydriasis and aphakia following blunt injury of the eye globe were evaluated. Patients with severe glare and photophobia due to wide pupil diameter from 6.0 to 9.0 mm were managed by combined iris cerclage pupilloplasty and retropupillar iris-claw lens implantation. The postoperative anatomic results, visual acuity, subjective degree of glare, photophobia, as well as intraoperative and postoperative complications were evaluated. The mean follow-up time was 32.6 months. Best-corrected visual acuity improved in all patients from preoperative 20/60, 20/30, 20/25, 20/22 to postoperative 20/20, 20/22, 20/20, and 20/20 (Snellen charts). All eyes achieved satisfactory anatomic result with round pupil diameter 3.5–4.5 mm. Glare and photophobia disappeared in all patients. There were no intraoperative or postoperative complications. During the follow-up period, pupils remained round and iris-claw lenses well positioned, without tilting. Combined iris cerclage pupilloplasty with retropupillar iris claw lens implantation appears to be a safe and effective surgical technique in reducing pupil size and improving visual outcomes. It is also a cost- and time-effective procedure, providing great results with a single surgery.

Four patients with traumatic mydriasis and aphakia following blunt injury of the eye globe were evaluated. Patients with severe glare and photophobia due to wide pupil diameter from 6.0 to 9.0 mm were managed by combined iris cerclage pupilloplasty and retropupillar iris-claw lens implantation. The postoperative anatomic results, visual acuity, subjective degree of glare, photophobia, as well as intraoperative and postoperative complications were evaluated. The mean follow-up time was 32.6 months. Best-corrected visual acuity improved in all patients from preoperative 20/60, 20/30, 20/25, 20/22 to postoperative 20/20, 20/22, 20/20, and 20/20 (Snellen charts). All eyes achieved satisfactory anatomic result with round pupil diameter 3.5-4.5 mm. Glare and photophobia disappeared in all patients. There were no intraoperative or postoperative complications. During the follow-up period, pupils remained round and iris-claw lenses well positioned, without tilting. Combined iris cerclage pupilloplasty with retropupillar iris claw lens implantation appears to be a safe and effective surgical technique in reducing pupil size and improving visual outcomes. It is also a cost- and time-effective procedure, providing great results with a single surgery. [ABSTRACT FROM AUTHOR]

To assess the damaged regional blood flow and functional activity of the retina and the optic nerve, 96 patients (96 eyes) with a blunt eye trauma (BET) were observed, of which 62 patients (62 eyes) had mild BET (group I), and 34 patients (34 eyes) had moderate BET (group II). Using Ultrasound Doppler techniques, we revealed a statistically significant increase (p < 0.05) of the peak systolic velocity (Vsyst) in the ophthalmic artery (OA), and a decrease of Vsyst and the final diastolic velocity (Vdiast) in the central retinal artery (CRA) (p < 0.05) during the first three days after the trauma in both groups. The recorded photopic negative response (PhNR) in the cone ERG and visual evoked potentials (VEP) showed an inhibited electrical activity of the inner retinal neurons and the visual cortex and a delayed VEP latency. The degree of these changes depended on the severity of post-contusion effects. In patients of group II, a greater inhibition of VEP into small patterns, and a smaller PhNR amplitude in ERG in response to low and high stimulus intensities was observed. All patients displayed changes in the vascular and neuronal systems of the retina in the early post-contusion period, which almost fully disappeared after one month following a 1st degree trauma but remained in the 2nd degree trauma // Russian Ophthalmological Journal, 2016; 1: 32-38.

In order to identify the characteristics of ocular trauma in children for design of data analysis based, accurate and targeted preventive measures, we have studied 29 patients who suffered blunt eye trauma, age 18 and below. The following parameters where taken into account: environment, gender, traumatized eye, type of trauma, zone, circumstances, visual acuity and intraocular pressure. Results: Contusions were the most common type of injuries, the most frequent circumstance was contact with a blunt object undetermined intent, and in more than 50% of cases zone II was the most affected. 50% of patients were between 12-15 years, eye trauma caused by aggression was found to be more frequent between 14-15 years, while injuries produced by a blunt object, undetermined intent where found at a younger age, approximately 12 years old. Ocular hypertension or hypotension was found more often in the rural environment. Visual acuity over 0.5 on admission was found in 38% of patients, and on discharge there number went up to 86% of cases. The patients spent on average 7 days in the hospital.

Purpose: To describe the in-vivo pathology of indirect choroidal rupture (ICR) in patients with recent ocular trauma using swept-source optical coherence tomography (SSOCT).Methods: Retrospective observational study of the presenting and follow-up OCT images of four consecutive Asian patients with blunt trauma presenting over a period of 6 months and review of OCT descriptions in the literature.Results: The three patients who presented within 2 weeks of injury showed a gap in the Bruch's membrane (BM)/retinal pigment epithelial complex at the site of the ICR. The distance of the gap ranged from 103 to 465 μm. Blood from associated tear in the choriocapillary layer dissected under the photoreceptor layer to lift it off the retinal pigment epithelium (RPE) layer. The Sattler's and Haller's layers of the choroid were not affected. Fibro-vascular proliferation occurring in the reparative phase bridges the gap in the BM, RPE complex. Late fibrous tissue proliferation extends into the Sattler's layer in the choroid and goes up to the outer nuclear layer in the retina disrupting its architecture.Conclusion: SSOCT is a useful tool to study the pathology of recent onset ICR as it is capable of imaging through blood. The primary injury in ICR seems to be a break in the Bruch's membrane. The RPE layer and choriocapillaries get disrupted secondary to the break in the BM as their basement membranes are part of the BM. Scarring during the reparative phase disrupts the adjacent layers of the choroid and retina. [ABSTRACT FROM AUTHOR]

The injury resulting from eye trauma cause significant social and economic loss on the basis of individual and community. A significant part of these injuries is caused by blunt eye trauma. The Guidelines for the Medico-legal evaluation of wounding crimes defined in Turkish Criminal Law states under the title of eye lesions that traumatic lesions (edema, laceration, dislocation, bleeding) of retinae cannot be treated by simple medical intervention. Our study aims to discuss traumatic lesions resulting from blunt eye injuries in medicolegal perspective, with the findings determined in a case who admitted our clinic with the request of the judicial report. In the medical documents of a 10 years old girl about whom is requested a judicial report because of her left eye injury resulting from blunt trauma, indicated following: During her examination in the first health care institution she admitted, abrasions around left eye and conjunctival hyperemia were detected, thereafter in the eye policlinic the commotio retinae was identified. If the initial examination findings are taken into consideration, one can conclude that injury is mild; therefore, it can be treated with basic medical interventions, however, commotio retinae diagnosis in subsequent examinations result in the inability of treatment of the injury with basic medical interventions. We think that making retinal assessment with fundus examination for the complete revelation of injury occurring in blunt eye trauma and accurate determination of resultant damage is important regarding contribution to legal procedure.

Purpose: To report concomitant macular hole and central serous chorioretinopathy after blunt trauma. Methods: Case presentation. A 31-year-old man presented with a complaint of a reduction in visual acuity and blurred vision in the right eye after blunt eye trauma. The patient did not have a history of any systemic disorders and drug administration. Results: On ocular examination, best corrected visual acuity was 2/20 in the right eye and 20/20 in the left eye. His intraocular pressures were 14 mmHg right eye and 13 mmHg left eye by applanation tonometry. Dilated fundus examination of the right eye showed macular hole and serous macular detachment, whereas the left eye was completely normal. Optical coherence tomography confirmed the full-thickness macular hole and subretinal fluid in the right eye, and ink-blot leakage pattern was determined in fundus fluorescein angiography. The patient was followed up without systemic therapy. Three months later, the vision was 10/20 in the right eye with completely closed macular hole and complete resolution of subretinal fluid. Conclusion: This is the first case which describes concomitant macular hole and central serous chorioretinopathy after blunt eye trauma. This presentation demonstrates that macular hole and central serous chorioretinopathy can be developed after blunt trauma. Both pathology may result with spontaneous closure of macular hole and spontaneous resolution of subretinal fluid within 3 months. [ABSTRACT FROM AUTHOR]

In order to identify the characteristics of ocular trauma in children for design of data analysis based, accurate and targeted preventive measures, we have studied 29 patients who suffered blunt eye trauma, age 18 and below. The following parameters where taken into account: environment, gender, traumatized eye, type of trauma, zone, circumstances, visual acuity and intraocular pressure. Results: Contusions were the most common type of injuries, the most frequent circumstance was contact with a blunt object undetermined intent, and in more than 50% of cases zone II was the most affected. 50% of patients were between 12-15 years, eye trauma caused by aggression was found to be more frequent between 14-15 years, while injuries produced by a blunt object, undetermined intent where found at a younger age, approximately 12 years old. Ocular hypertension or hypotension was found more often in the rural environment. Visual acuity over 0.5 on admission was found in 38% of patients, and on discharge there number went up to 86% of cases. The patients spent on average 7 days in the hospital. [ABSTRACT FROM AUTHOR]

A 25-year-old man suffered an isolated lens anterior capsular tear and mature cataract formation following blunt injury to his right eye. One week after the trauma, best-corrected visual acuity (BCVA) in the right eye was hand motion. B-scan ultrasonography showed that the lens posterior capsule was intact; no vitreous foreign body or retinal pathology were observed. Orbital computed tomography revealed narrowed anterior chamber and increased lens material volume and lens reflectivity in the injured right eye. The globe was intact and no bone fractures were observed. The cataractous lens material was removed by phacoemulsification and a foldable, acrylic, posterior chamber intraocular lens was implanted in the bag. Postoperative BCVA in the right eye was 20/20.

Cyclodialysis is the result of the separation of the longitudinal ciliary muscle fibers from the scleral spur, which creates an abnormal pathway for aqueous humor drainage that may lead to ocular hypotony. For many years cyclodialysis was considered a treatment option for glaucoma. However, today it usually occurs as a complication of blunt trauma or more rarely as a complication of anterior segment ocular surgery. Ocular hypotony can lead to cataract development, optic disk swelling, refractive changes, and several retinal complications, making accurate identification and timely intervention of the cleft mandatory. Traditionally gonioscopy was the only available technique to diagnose and localize the cleft. However, other tests such as optical coherence tomography, magnetic resonance imaging, transillumination, and specially ultrasound biomicroscopy are now available for the diagnosis of cyclodialysis. Multiple treatment options are also available for this condition. Although medical treatment can be effective to close small clefts, surgery is needed in most patients to restore ocular pressure. [ABSTRACT FROM AUTHOR]

Objective: To analyze the frequency and visual outcome of anterior segment involvement in accidental ocular trauma in children. Methodology: This descriptive case series was conducted in the Department of Ophthalmology Lady Reading Hospital, Peshawar from 15th June 2007 to 15th October 2008 on 200 cases of anterior segment involvement in children during accidental ocular trauma. Patients were admitted through casualty or Outpatient Department. After detailed history, systemic examination and complete ocular examination was done including visual acuity, slit lamp examination and examination under anesthesia when necessary. Results: In this study, male children constituted 74.5% (149) and females 25.5% (51) of the total. Children between ages of 6-10 years are more vulnerable (42 %). Injury caused by blunt object was seen in 64.05% (129) of children and mostly it was due to stone in 21.50 % (71). The commonest place of injury was indoors in 38.50% (77), followed by playgrounds in 28.00% (56) and on streets and roads in 21.5% (43). The visual acuity on arrival was PL + ve in (35.5%) and open globe injury was observed in 36.0%. At the end of two months 13.5% eyes were phthisical. Conclusion: Blunt ocular trauma is a common ocular trauma in children with males more vulnerable. School going children are more at risk. Blunt trauma especially because of stone is the main culprit with devastating visual results. [ABSTRACT FROM AUTHOR]

A 25-year-old man suffered an isolated lens anterior capsular tear and mature cataract formation following blunt injury to his right eye. One week after the trauma, best-corrected visual acuity (BCVA) in the right eye was hand motion. B-scan ultrasonography showed that the lens posterior capsule was intact; no vitreous foreign body or retinal pathology were observed. Orbital computed tomography revealed narrowed anterior chamber and increased lens material volume and lens reflectivity in the injured right eye. The globe was intact and no bone fractures were observed. The cataractous lens material was removed by phacoemulsification and a foldable, acrylic, posterior chamber intraocular lens was implanted in the bag. Postoperative BCVA in the right eye was 20/20. [ABSTRACT FROM AUTHOR]

Copyright of Der Ophthalmologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Ophthalmologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We report a case of a 14-year-old otherwise healthy patient who developed acute retinal periphlebitis mimicking frosted branch angiitis inferotemporally and associated exudative retinal detachment in the left eye following blunt trauma. Fluorescein angiography revealed delayed filling of inferotemporal branch retinal vein and late leakage of sheathed retinal venules, and late pooling in the area of exudative retinal detachment. Indocyanine green angiography showed a crescent-shaped hypofluorescent streak concentric to the optic disk inferiorly highly suggestive of choroidal rupture. The patient was treated with oral prednisone, with gradual tapering over a period of 15 days. One month after presentation, retinal vein sheathing and exudative retinal detachment had resolved, with the development of peripapillary subretinal fibrosis, macular atrophy, pseudomacular hole, and epiretinal membrane. The acute perivenular sheathing in our patient might be related to autoimmune-mediated reaction induced by retinal vascular damage caused by severe ocular trauma. Fluorescein angiography and indocyanine green angiography findings might suggest that the retinal detachment could be caused by leakage from choroid through Bruch's membrane and retinal pigment epithelium rupture or by transient dysfunction of the outer or inner blood-retinal barrier. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 30-year-old male patient who has decreased his vision after blunt trauma in his left eye. Topics discussed examination included Anterior segment, Dilated fundus, and Fundus autofluorescence imaging; mentions the continuous hyper-reflective line at the level of the ellipsoid zone that represented as the bacillary layer; and information on the hypo-autofluorescence areas that corresponded to intraretinal haemorrhages and hyper-autofluorescence areas.

The purpose of this study was to evaluate the utility of ultrasound biomicroscopy in imaging eyes with blunt eye trauma. A retrospective review of 23 patients referred to the Department of Ophthalmology of Gulhane Military Medical Faculty, between August 2009 and April 2010 was performed. All patients underwent detailed ophthalmic and ultrasound biomicroscopic examination. Twenty three eyes of 23 patients were included in the study. Mean age was 32.18±9.66 (range: 20-63) years. The mean intraocular pressure in the affected eye was 20.36±3.54 mmHg. Etiological factors were as follows; playing accident (45.45%), work accident (36.36%), assault (9.09%) and traffic accident (9.09%). The most common findings detected on ultrasound biomicroscopy were hyphema (8 eyes, 34.7%), angle recession (8 eyes, 34.7%), zonular deficiency (4 eyes, 17.3%), iridodialysis (4 eyes, 17.3%), crystalline lens subluxation (2 eyes, 8.6%), peripheral anterior synechiae (2 eyes, 8.6%) and intraocular lens dislocation (1 eye, 4.3%). Of the 23 patients, 4 (17.3%) underwent one of the ophthalmic surgeries including cataract surgery, filtration surgery, iris repair and intraocular lens reposition. We conclude that besides its benefits in surgical planning, ultrasound biomicroscopy may have a special role in detecting anterior segment pathologies, which may not be identified on clinical examination. [ABSTRACT FROM AUTHOR]

Acute retrobulbar haemorrhage is a rare complication of blunt eye trauma. It can be sight-threatening but is reversible when recognized and treated promptly. We presented a case of acute retrobulbar haemorrhage with profound reduction of vision. Emergency surgical decompression was performed to preserve the vision. Clinical features and management are discussed. [ABSTRACT FROM AUTHOR]