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Purpose: Pseudoxanthoma elasticum-like lesions have been described in association with an increased risk for stroke in β-thalassemia. We describe a patient with thalassemia intermedia and angioid streaks who developed a central retinal artery occlusion and subsequent portal vein thrombosis., Method and Patient: Case report of a 47-year-old woman with thalassemia intermedia, angioid streaks, central retinal artery occlusion, and portal vein thrombosis., Results: Our patient presented with a cilioretinal artery-sparing central retinal artery occlusion in the left eye and evidence of angioid streaks in both eyes. One month later, she developed neovascularization of the angle in the left eye and underwent panretinal photocoagulation. Neovascularization of the angle resolved, and final vision was 20/30. She later developed portal vein thrombosis, and anticoagulation was started., Conclusion: The finding of angioid streaks in the setting of thalassemia may suggest the presence of a systemically defective elastin layer. This can be a procoagulative factor and may warrant further assessment of the coagulation and cardiovascular system to take prophylactic measures. The occurrence of a thromboembolic event, however, is multifactorial and the end result of interaction of procoagulant and anticoagulant factors.

Roth spots seen on fundoscopic examination (white-centered hemorrhages) were classically described as septic emboli in patients with subacute bacterial endocarditis (SBE). Many physicians have considered them pathognomonic for this entity. More recent evidence suggests, however, that they are nonspecific and may be found in other disease states. A review of the pathogenesis of these white-centered hemorrhages will be provided, along with some diseases other than SBE in which they may occur.

The authors conducted a retrospective review of 32 patients with posterior retinal folds following retinal reattachment surgery. Twenty-eight of these patients underwent combined pars plana vitrectomy, fluid-air exchange with either internal drainage through a preexisting retinal break or external drainage of subretinal fluid, and scleral buckle. We believe these drainage techniques resulted in incomplete elimination of subretinal fluid, with resultant sequestration of fluid at the dependent border between attached and detached retina. Metamorphopsia and decreased visual acuity were noted in patients with folds involving the macula. The likelihood of fold formation may be greatly reduced by internal drainage through a posterior retinotomy combined with more complete removal of slowly gravitating fluid as it flows dependently to the drainage site.

We analyzed the records of 132 patients hospitalized between July 1986 and February 1989 for management of traumatic hyphema. The incidence of secondary hemorrhage was compared between patients treated with or without systemic administration of aminocaproic acid in addition to an otherwise identical protocol. Results among patients who were examined within one day of injury disclosed a 4.8% secondary hemorrhage rate in aminocaproic acid-treated patients (three of 63 patients) compared with a 5.4% rate in the patients not treated with aminocaproic acid (three of 56 patients, P = .31). All six patients sustaining secondary hemorrhage recovered visual acuities of 20/40 or better, with five of six patients achieving 20/20 visual acuities. A separate group of 13 patients who were examined more than one day after injury were found to have a secondary hemorrhage rate of 38.5% (five of 13 patients). Macular injury, not secondary hemorrhage, was most often responsible among those patients suffering permanent visual loss. In this study of a predominantly white population, patients had a relatively low incidence of secondary hemorrhage and did not demonstrate detectable benefit from aminocaproic acid administration. Because of the recognized side effects and cost of treatment, further analysis to determine which patients will benefit from treatment with aminocaproic acid is indicated.

A prospective evaluation of all patients presenting with a sports-related ocular injury during a 1-year (4-season) period was conducted. Of the 202 patients evaluated, 28 (13.8%) required hospitalization and 11 (5.6%) required intraocular surgery. Twenty-six patients (12.8%) sustained permanent ocular sequelae including seven (3.5%) who suffered visual loss. Basketball accounted for 28.7%, baseball/softball 19.8%, and racquetball 11.4% of all injuries. At the time of injury, 5.1% of patients had worn protective eye wear, whereas on follow-up only 31% had used eye protection. These results indicate that sports trauma remains a significant cause of ocular morbidity.

Ocular injuries due to Hymenoptera venom are uncommon and most injuries occur on the ocular surface. We reported two rare cases of corneal endothelial damage caused by hornet venom that was sprayed, not injected, through stinging in the eye. Case 1: A 57-year-old male patient was injured when a hornet sprayed venom into his left eye. He was referred to our hospital because the edoema and epithelial erosion of the cornea persisted. The patient presented with bullous keratopathy, asymmetrical iris atrophy, irreversible mydriasis, and glaucoma. His cataract progressed, and his best-corrected visual acuity was 0.03. Cataract surgery was performed after anti-inflammatory treatment with steroids, and Descemet-stripping automated endothelial keratoplasty was performed 6 months later. The patient recovered well postoperatively: his best-corrected visual acuity improved to 1.0 and he continued his glaucoma treatment. Case 2: A 75-year-old male patient had damage to his corneal epithelium, severe conjunctivitis, and conjunctival edoema when sprayed hornet venom entered his left eye. At initial presentation, the corneal endothelial cell density had decreased to 1042 cells/mm2. The conjunctival sac was washed, and steroid and topical antibacterial instillations were administered. His best-corrected visual acuity improved from 0.07 at the initial visit to 0.5. However, the corneal opacification and glaucoma persisted, and 3 months later the corneal endothelial cell density decreased to 846 cells/mm2. Corneal injuries caused by sprayed hornet venom are rare; however, they can cause intense anterior chamber inflammation and severe, irreversible corneal endothelial damage. In such cases, prompt initial treatment, the administration of adequate anti-inflammatory medication, and careful evaluation of the corneal endothelium are required. [ABSTRACT FROM AUTHOR]

We treated five patients receiving epsilon-aminocaproic acid who demonstrated sudden and accelerated clot dissolution with accompanying increases in intraocular pressure 24 to 96 hours after discontinuing treatment. All of these patients required additional ocular hypotensive medications and one patient required anterior chamber washout for persistently increased intraocular pressure. These findings suggest that certain patients with hyphema may be at risk for significant intraocular pressure increases following cessation of epsilon-aminocaproic acid therapy.

To report an atypical case of MOG antibody-associated optic neuritis with Roth spots and widespread retinal hemorrhages. A 49-year-old woman complained of 1 week history painful visual loss in the left eye. Funduscopy exam showed a severe optic disc edema associated with multiple peripapillar hemorrhages, peripheral retinal hemorrhages and Roth spots in the left eye. Orbit MRI revealed an hyperintensity in the left optic nerve, enhanced with gadolinium. The serum Myelin Oligodendrocyte (MOG) antibodies was found positive. Early intravenous high dose of steroids rapidly improved visual acuity and fundus abnormalities rapidly resolved. Retinal hemorrhages can also be detected in case of optic disc edema associated with an optic neuritis, as seen in MOGAD. [ABSTRACT FROM AUTHOR]

Objective: To describe the demographics and outcomes of sports‐related ocular injuries in an Australian tertiary eye hospital setting. Methods: Retrospective descriptive study from the Royal Victorian Eye and Ear Hospital from 2015 to 2020. Patient demographics, diagnosis and injury causation were recorded from baseline and follow‐up. Outcomes included visual acuity (VA), intraocular pressure (IOP), ocular injury diagnosis, investigations and management performed. Results: A total of 1793 individuals (mean age 28.67 ± 15.65 years; 80.42% males and 19.58% females) presented with sports‐related ocular trauma. The top three injury‐causing sports were soccer (n = 327, 18.24%), Australian rules football (AFL) (n = 306, 17.07%) and basketball (n = 215, 11.99%). The top injury mechanisms were projectile (n = 976, 54.43%) and incidental body contact (n = 506, 28.22%). The most frequent diagnosis was traumatic hyphaema (n = 725). Best documented VA was ≥6/12 at baseline in 84.8% and at follow‐up in 95.0% of cases. The greatest risk of globe rupture/penetration was associated with martial arts (odds ratio [OR] 16.22); orbital blow‐out fracture with skiing (OR 14.42); and hyphaema with squash (OR 4.18): P < 0.05 for all. Topical steroids were the most common treatment (n = 693, 38.7%). Computed tomography orbits/facial bones were the most common investigation (n = 184, 10.3%). The mean IOP was 16.1 mmHg; 103 (5.7%) cases required topical anti‐ocular hypertensives. Twenty‐six individuals (1.45%) required surgery with AFL contributing the most surgical cases (n = 5, 19.23%). Conclusion: The top three ocular injury causing sports were soccer, AFL and basketball. The most frequent injury was traumatic hyphaema. Projectiles posed the greatest risk. [ABSTRACT FROM AUTHOR]

Objective: To describe the clinical features, management, and outcome of dogs presenting with sports ball projectile ocular injuries. Animals Studied: Eighteen dogs. Procedures: A retrospective study reviewing cases of ocular injury due to a sports ball projectile that presented to the Cornell University ophthalmology service between 2004 and 2021. Dog age, type of sports ball, initial ocular lesions, eye affected, clinical management, and visual outcome were recorded. Results: Sports ball projectile ocular injuries were identified in 18 eyes of 18 dogs. The median age of the dogs was 1.0 years old, ranging from 0.3‐ to 9‐years‐ old. Nine dogs were male, and 9 were female. Ocular injuries were caused by small, dense balls (e.g., golf balls, baseballs) in 11 dogs; small, light balls (e.g., tennis balls, toy balls) in 5 dogs; and large, soft balls (e.g., soccer ball, football) in 2 dogs. Closed‐globe injuries (12 of 18 eyes) presented with traumatic uveitis (91%), hyphema (45%), and subconjunctival hemorrhage (18%). All 12 closed‐globe injury cases were medically managed, eight dogs remained visual. Open‐globe injuries (6 of 18 dogs) presented with three corneal lacerations and three scleral ruptures. Five open‐globe injuries required enucleation, and one was medically managed and maintained vision. Conclusion: Sports ball projectile ocular injuries in dogs can result in substantial ocular morbidity and in loss of vision. Small, dense balls were associated with injuries that carried the most guarded prognosis and required more aggressive management. Small and large lighter projectiles were associated with less serious ocular injuries and visual outcomes. [ABSTRACT FROM AUTHOR]

Purpose: To describe clinical and imaging characteristics of the outer retinal folds (ORF) in cases of retinitis, retinochoroiditis, and chorioretinitis.Methods: Retrospective review of retinitis cases with presence of ORFs either at presentation or during follow up.Results: ORFs were seen adjacent to retinitis lesions in 16 eyes of 14 cases (retinitis post-febrile illness n = 10, toxoplasma retinochoroiditis n = 2, fungal chorioretinitis n = 2) either at presentation (n = 2) or during follow up (n = 14). Optical coherence tomography (OCT) appearance was outer retinal vertical stout lesions involving ellipsoid, external limiting membrane, and outer nuclear layer. All the cases had a presence of past or concurrent subretinal fluid and/or subretinal hyperreflective material when ORF was seen. ORF resolved with variable outer retinal atrophy over a mean period of 2.86 months.Conclusion: ORF is observed in cases of retinitis with subretinal fluid either at presentation or during resolution. It is not specific to any etiological disease. Differentiation of this sign from vertical outer retinal stripes in viral retinitis on OCT is important to avoid misinterpretation. [ABSTRACT FROM AUTHOR]

To analyze the incidence of baseball-related ocular injuries, mechanisms commonly associated with precipitating trauma, and secondary visual sequelae, and explore the age and sex-specific variations in the distributions of these variables. Baseball-related ocular injuries presenting to the emergency department (ED) were identified using the National Electronic Injury Surveillance System for 2011 through 2020. Age, sex, diagnosis, mechanism of injury, visual sequela, and patient disposition were analyzed. Statistical comparisons were performed using the chi-square test and Fisher exact test. 558 ED presentations were captured, translating to an average national incidence of 1,492 events. The incidence of trauma declined notably. Most encounters involved pediatric (≤18) and male patients (82.6% and 87.6%, respectively). Patients commonly presented with contusions or abrasions (41.4%). Contact with the baseball was the most frequently mentioned mechanism of injury (87.6%). There was a significant age-related (P = 0.009) difference in the distributions of diagnoses. 7.3% of patients had a visual sequela. There was a declining incidence of baseball-related ocular injuries presenting to the ED. However, the long-term complications of injuries could not be explored. Further efforts are required to understand the implications of ocular injuries to ensure patients receive appropriate protections. [ABSTRACT FROM AUTHOR]

Purpose: To characterize the epidemiology and outcomes of hyphema. Methods: Retrospective case series. Medical records from patients with traumatic and spontaneous hyphema seen at the Wilmer Eye Institute, Johns Hopkins, from 2011 through 2017 were evaluated. Aetiology, demographics, clinical characteristics, complications, management and outcomes were ascertained. Multivariable logistic regression was used to identify factors associated with elevated intraocular pressure (IOP), rebleeding and poor outcome (final visual acuity ≤ 20/40) in traumatic hyphema. A safe frequency of follow‐up was retrospectively determined. Results: Traumatic hyphema (n = 152) was more common in males (78%) and adults (55%), with sports/recreational activities being the most frequent cause (40%). Elevated IOP was the most common complication (39%). Rebleeding occurred in seven patients (5%) and was more likely with a higher IOP on presentation (OR:1.1; p = 0.004). Thirty‐seven patients (24%) had a poor outcome, mostly due to traumatic sequelae such as cataract (32%) or posterior segment involvement (30%). A poor outcome was more likely with worse presenting visual acuity (OR: 9.1; p = 0.001), rebleeding (OR: 37.5; p = 0.035) and age > 60 years (OR: 16.0; p = 0.041). Spontaneous hyphema (n = 28) did not have a gender predominance and was more common in adults > 60 years (71%). The most common cause was iris neovascularization (61%). Complications and visual outcomes were worse compared with traumatic hyphema. Conclusions: Traumatic hyphema continues to be common in young males engaging in sports, necessitating increased awareness for preventive eyewear. Older age and rebleeding can lead to poor outcomes. Elevated IOP at presentation predisposes to rebleeding and warrants frequent follow‐up. Otherwise, routine follow‐up at days 1, 3, 5, 7 and 14 is sufficient for uncomplicated cases. [ABSTRACT FROM AUTHOR]

Purpose: To identify age groups or activities at risk for ocular injuries to provide parents, sports teams, schools, and hospitals with the appropriate tools for prevention strategies. Methods: A retrospective chart review was conducted of all trauma-related cases from 2013 to 2015 and data were obtained with the use of an electronic medical record. All patients younger than 18 years who presented to the ophthalmology clinic with traumatic ocular injuries were included. Results: A total of 409 patients met the inclusion criteria and all were included in this study. The mean age was 7.74 years. Boys were injured more frequently than girls (60.4%). Most ocular injuries occurred between the ages of 2 and 9 years (51.8%). The most common sport was soccer, followed by ball/ice hockey, which differs from previous study findings. This may highlight the increasing popularity of soccer and the risk it may entail. Injuries occurred at home in 23.2% of cases. Final visual acuity was 20/40 or better in 77% of patients. Conclusions: These findings are comparable to the authors' previous data and to those of the only other Canadian study done on this subject, with the exception of an increased incidence of soccer-related injuries in the current cohort, highlighting an area important to future prevention strategies. [[J Pediatr Ophthalmol Strabismus. 2020;57(3):185–189.] [ABSTRACT FROM AUTHOR]

Copyright of Der Onkologe 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.)

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.)

Purpose: To report a case developing a severe retinal fold (RF), resembling a roll cake on optical coherence tomography (OCT), after retinal detachment (RD) surgery.Case report: A 61-year-old man underwent vitrectomy for a limited macula-on-superior rhegmatogenous RD and gas tamponade at another hospital. Despite remaining prone for 4 days, RF was noted after gas disappearance and he was referred to us. OCT showed a roll cake-like RF, which resolved after vitrectomy with internal limiting membrane (ILM) peeling, creation of a new detachment, perfluorocarbon liquid injection, air-fluid exchange, silicone oil tamponade and prone positioning.Conclusion: ILM peeling including the area of the retinal fold, followed by new detachment creation and finally perfluorocarbon liquid injection, effectively flattened the severe RF. To our knowledge, this is the most severe case of RF to be documented by OCT and illustrates that broad ILM peeling, including the RF, is effective for treating RF. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To compare the postoperative anatomic success rates and the frequency of complications between prone or supine postoperative positioning after transconjunctival sutureless vitrectomy (TSV) for rhegmatogenous retinal detachment (RRD). Methods: All patients underwent primary 27‐gauge TSV for the treatment of primary RRD. Patients were divided into two groups as follows: group A was patients instructed to keep strict postoperative prone positioning for a minimum of 8 days. Group B was patients instructed to keep the prone positioning on the day of the surgery followed by supine positioning for minimum of 7 days from the day after surgery. Result: Sixty‐two eyes were enrolled (group A: 32, group B: 30). There was no significant difference in baseline data between two groups. The initial and final anatomical success rates were 93.8% and 100% in group A and 93.3% and 100% in group B, respectively (p = 1, p = 1, respectively). Posterior synechia of the iris occurred in one eye in group A and in two eyes in group B (p = 0.61). Macular pucker and retinal fold did not occur in either group. Preoperative intraocular pressure (IOP; mmHg) was 14.5 ± 2.9 in group A and 14.5 ± 2.6 in group B (p = 0.92). Intraocular pressure (IOP) was not statistically different between the groups during the follow‐up period (p = 0.36, p = 0.07, respectively). Conclusion: Supine positioning may be an option as a postoperative positioning after TSV and gas tamponade for the treatment of RRD. [ABSTRACT FROM AUTHOR]

Background: Formation of retinal folds is a serious and possibly underreported complication of vitrectomy with intraocular gas for retinal detachment. Certain risk factors are associated with this complication.Materials and methods: Presentation of our own cases with retinal folds after retinal detachment surgery and review of the relevant literature.Results: Spontaneous resolution of a retinal fold without surgical intervention with excellent visual outcome was observed in a patient operated with vitrectomy and intraocular gas for retinal detachment. In another case surgical intervention with repeat vitrectomy and macular detachment followed by intraocular gas resulted in complete resolution of a retinal fold with excellent visual outcome.Conclusion: Retinal fold formation after vitrectomy for superior bullous retinal detachments running through the fovea can be managed both conservatively and surgically. Treatment decision is made on an individual basis depending on patient symptoms. Knowledge of the risk factors for fold formation and postoperative posturing after retinal detachment surgery is very important in order to avoid this complication. [ABSTRACT FROM AUTHOR]

The current study reports a case of a patient with a chronic myelocytic leukemic fundus lesion, initially diagnosed in the Department of Ophthalmology, Rizhao People's Hospital (Rizhao, China). A male, 23-years-of-age, presented with a dark shadow in the front of the right eye, accompanied with blurred vision for 3 days (visual acuity of right eye, 0.4; visual acuity of left eye, 0.6). In addition, the patient had experienced gingival bleeding for 2 years, and recurrent upper respiratory infections for 1 year. A fundus examination revealed mild binocular papillary edema, dilated and tortuous veins, and the retina exhibited large quantities of scattered and dark red bleeding spots. The bleeding spots had white spots in the center, which exhibited typical Roth spots, whilst routine blood examination, abdominal ultrasound, marrow biopsy and other laboratory tests confirmed the diagnosis of chronic myelogenous leukemia. Patients with leukemia typically present with initial symptoms that include fever, fatigue, anemia and hepatosplenomegaly, and a diagnosis as a result of eye-related symptoms is rare, rendering the present case unique. [ABSTRACT FROM AUTHOR]

Purpose: To review the occurrence of macular retinal folds following retinal detachment surgery. Method: Review of the literature. Results: Macular folds have been reported in up to 3% of cases postoperatively. Risk factors are tamponading gas bubble, large exoplants, detachments with bullous configuration or running through the fovea, and incomplete drainage of subretinal fluid. Preventive measures include correct posturing and avoidance of modifiable risk factors. The natural history is variable. Complete resolution as well as persisting folds with permanent structural damage have been reported. Treatment indications and techniques remain controversial. Very few successful reports of surgical correction have been published to date. Conclusions: Macular folds are a serious but underreported complication of retinal detachment surgery that can be avoided in the majority of cases. Macular folds can be prevented by correct posture and avoiding large exoplants, large tamponade bubbles and incomplete drainage of subretinal fluid. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the occurrence of eye injuries and orofacial traumas in floorball. In addition, the athletes' habits of wearing protective goggles and mouthguards was surveyed, and an assessment was made of the general level of knowledge amongst athletes and coaches about preventive and first aid measures after a dental trauma and the resulting consequences. The study was conducted by the same interviewer in Switzerland and Sweden during the 2009/2010 season using a standardized questionnaire. A total of 608 individuals (565 athletes and 43 coaches) belonging to the amateur and semi-professional leagues in the two countries were individually interviewed. Although 72.7% of all athletes had observed and 27.7% of field players had sustained an injury to the eye or its vicinity, only 25 athletes (4.9%) wore protective eyewear. Similarly, despite 31.7% of all players having observed a dental or jaw injury and 11.3% of interviewed field players having suffered one, only one athlete wore a mouthguard on a regular basis. Participants from Switzerland were significantly better informed than participants from Sweden with regard to first aid measures. The results of this study show that floorball has an equally high risk for dental trauma as handball. Further investigations of dental injuries in floorball would be valuable in order to provide players, coaches, parents and sporting federations with the necessary information to make decisions regarding the use of mouthguards. It is strongly recommended that protective eyewear should be made mandatory. [ABSTRACT FROM AUTHOR]

A previous instalment to this review focused on the sport science for rodeo, the history behind the sport and what is currently known about the physical and physiological status, coronary risk profile, strength and power levels, event-specific kinesiological and biomechanical aspects, nutritional habits and psychological indices associated with the rodeo athlete. In regards to injury, rodeo is well known for its high-velocity, high-impact atmosphere where athletes compete against the clock and uncooperative livestock. Considered by many to be a dangerous sport with high vulnerability towards trauma and frequent injuries, animal/human contact events comprise ∼80% of reported injuries. Severe trauma includes fractures, dislocations, subluxations, concussions, ligament ruptures, pneumothorax and various neurapraxias. Head and neck trauma account for 10-29% of total trauma and up to 63% of upper body injuries, with concussion incidence rates of 3.4 per 1000 competitive exposures. The incidence of thoracic, back and abdominal injuries comprise 11-84% of trauma, while shoulder injuries, involving anterior/posterior arthralgia, inflammation, instability and increasing weakness, account for 8-15% of upper extremity cases. Lower extremity trauma accounts for 26-34% of cases, with the majority involving the knee. Many believe that the incidence of trauma is underestimated, with studies hampered by numerous limitations such as a lack of injury awareness, missing data, poor injury recall, an array of reporting sources, delays in subject response and treatment, no uniform definition of injury or reporting system and predisposing factors prior to injury. Primary mechanisms of injuries are attributed to physical immaturity, fatigue, age and experience, behaviour, the violent nature of the sport and lack of adequate medical intervention. Although there is limited adherence to organized conditioning programmes, when properly planned, sport-specific conditioning may enhance athletic potential, minimize predisposition to injury and enhance recovery. Education in care and rehabilitation should be spearheaded by the medical community to reduce injury, as several studies have linked trauma to poor technique, inexperience and poor judgement. Medical services should encompass emergency medical oversight for trauma at all levels and press toward preventive care. Competitors should also be cognizant of the signs and symptoms of overtraining, a condition exacerbated by overuse and minimal recovery. The use of helmets, taping, bracing, protective vests, cervical collars and mouth-pieces is gaining popularity but has not been thoroughly studied. Guidelines requiring padding of chutes, gates or equipment essential for performance may also avert trauma. Whether increases in knowledge, education and technology are able to reduce predisposition to injury among this population, remains to be seen. As with all high-risk sports, the answer may lie in increased wisdom and responsibility of coaches and athletes to ensure an adequate level of ability, self-control and common sense as they compete in this sport. [ABSTRACT FROM AUTHOR]

AIMS: To determine the severity and long term sequelae of eye injuries caused by modern sports that could be responsible for significant ocular trauma in the future. METHODS: Prospective observational study of 24 (25 eyes) athletes with sports related ocular injuries from health clubs, war games, adventure, radical and new types of soccer, presenting to an eye emergency department between 1992 and 2002 (10 years). RESULTS: Modern sports were responsible for 8.3% of the 288 total sports eye injuries reported. Squash (29.2%) was the most common cause, followed by paintball (20.8%) and motocross (16.6%). The most common diagnosis during the follow up period was retinal breaks (20%). 18 (75%) patients sustained a severe injury. The final visual acuity remained <20/100 in two paintball players. CONCLUSIONS: Ocular injuries resulting from modern sports are often severe. Adequate instruction of the participants in the games, proper use of eye protectors, and a routine complete ophthalmological examination after an eye trauma should be mandatory. [ABSTRACT FROM AUTHOR]

Reports on the commonality of visual impairment in the world. Statistics on the number of people with low vision; Refractive error as the leading cause of impairment; Cataracts blamed as the leading cause of blindness in the world; Infectious causes of blindness; Nutritional and metabolic causes of blindness; Trauma; Aims and goals of Global Vision 2020 and the Challenge of World Blindness.

Objective: To outline the severity and long-term sequelae of eye injuries in soccer. Design: Prospective observational study of 163 patients who sustained soccer-related ocular injuries between April 1, 1992, and March 31, 2000 (8 years). Methods: Patients were observed at a sports ophthalmology unit located in the largest university hospital of the northern region of the country and central to all major soccer fields in town. The data were recorded using the United States Eye Injury Registry report forms for initial and follow-up observation. Main Outcome Measures: (1) Self-reported history surrounding the ocular trauma, initial visual acuity, diagnosis, and operations and (2) final visual acuity, late diagnosis, and additional operations. Results: Injuries occurred predominantly in young men (mean ± SD age, 23.2 ± 8.8 years) practicing indoor soccer (50.9%) or outdoor soccer (47.2%), and most resulted from a kicked ball (79.1%) near the goalpost (60.1%). Angle recession and peripheral vitreoretinal lesions were more likely to occur in the superotemporal quadrant (54.7%; 95% confidence interval, 44.2%-65.0%; and 57.6%; 95% confidence interval, 48.4%-66.4%; respectively). Vitreoretinal lesions were present in 42.2% (95% confidence interval, 33.1%-51.8%) of patients with "normal" visual acuity (≥20/40) and in 50.0% (95% confidence interval, 38.1%-61.8%) of patients without hyphema. No significant association was found between severity of injury and age, sex, type of soccer, level of athletic expertise, or player position. Conclusions: Severe ocular lesions can occur in soccer players without symptoms and at all skill levels. The development of laboratory models will be essential to explain the tendency for lesions to be in the superotemporal quadrant. The data support the need for protective eyewear designed specifically for soccer. [ABSTRACT FROM AUTHOR]

Provides information on the prevention and treatment of common eye injuries in sport. Risk of eye injuries in sports; Common mechanisms of eye injuries; Aspects of the ocular examination; Signs and symptoms of eye injuries that require immediate medical referral.

Objective: To identify risk factors associated with higher rates of ocular complications in children with traumatic hyphema. Methods: Consecutive inpatient records from July 1990 through December 1997 were retrospectively reviewed for all children (aged ≤ 18 years) who were admitted to the Wilmer Ophthalmological Institute, Baltimore, Md, within 48 hours of a closed-globe injury leading to hyphema. Data obtained included age, sex, race, sickle cell status, initial and final visual acuities, hyphema size and intraocular pressure at presentation, the occurrence of a secondary hemorrhage, subsequent intraocular pressure elevations, and therapeutic interventions. Results: Forty children fulfilled the inclusion criteria: 20 African American, 1 Asian American, and 19 white. Five of the 20 African American children had sickle cell trait, and 1 had sickle cell anemia. The rate of secondary hemorrhage was statistically higher in the African American population (P = .05), but no statistical difference existed between the rate of secondary hemorrhage in patients with and without sickle cell hemoglobinopathy. Sickle cell hemoglobinopathy was associated with a higher intraocular pressure at presentation (P = .03) and during inpatient follow-up (P = .02). Conclusions: In the setting of traumatic hyphema, African American children appear to be at greater risk for developing a secondary hemorrhage. In our patients, sickle cell hemoglobinopathy increased the risk of intraocular pressure elevation, but did not seem to increase the risk of rebleeding beyond that associated with race. Larger studies are needed to validate these observations. [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.)

In a retrospective study from 1988 to 1998, eye injuries were found in 553 patients. Seventy-six (13.7%) of these injuries were associated with sport. The mechanism of trauma was for the most part a ball (71.1%) or a club (13.2%). Most eye injuries occurred in soccer (35.5%), which is, by far, the most widespread sport in this region of Norway. A disproportionately high number of the injuries occurred in floorball (17.1%), bandy (13.2%), and squash (10.5%). The rules in these sports may, in theory, be strict enough to prevent eye injuries i most cases. However, these rules are often neglected in informal activities. Strategies for educating the general public about the potentially serious effect of eye injuries in sports exposed to such risk are of great importance. [ABSTRACT FROM AUTHOR]

Aim: We sought to characterise the morphological and functional effects of drainage retinotomy on the vascular, neural, subretinal and epiretinal components of the affected retina. Patients and methods: Following successful retinal reattachment surgery involving drainage retinotomy in 15 cases (retinotomy group) and no retinotomy in 14 cases (control group), the existence, nature and quadrantic area of visual field loss to a white III4e target was determined using kinetic Goldmann perimetry. Vascular alterations were characterised using fluorescein angiography with peripheral sequences. Results: Visual field defects within 30° of fixation were present in 12 of 14 (86%) of the retinotomy group (including all eyes in which the retinotomy was sited within five disc diameters of fixation) and none of the control group (Fisher exact test, P=0.00005). Following superonasal retinotomy, inferotemporal field area (median area 82 units, range 44 to 128) was approximately half that following superotemporal retinotomy (median area 167 units, range 119 to 192) (Wilcoxon's ranksum P=0.003). No vascular abnormalities distal to the retinotomy were identified, although subretinal neovascularisation (two eyes) and epiretinal membrane formation (one eye) occurred at the retinotomy site. Conclusion: We recommend that where possible subretinal fluid be drained via existing breaks, and if retinotomy is necessary, that it should be sited more than five disc diameters from fixation in the superotemporal quadrant to minimise visual field loss. [ABSTRACT FROM AUTHOR]

Using data compiled from the ophthalmic literature and WHO's Blindness Data Bank, the available information on eye injuries from an epidemiological and public health perspective has been extensively reviewed. This collection of data has allowed an analysis of risk factors, incidence, prevalence, and impact of eye injuries in terms of visual outcome. However, most of the estimates are based on information from More Developed Countries (MDCs). The severity of eye injuries can be assessed through proxy indicators such as: (i) potentially blinding bilateral injuries; (ii) open-globe injuries; (iii) endophthalmitis; (iv) enucleation or (v) defined visual impairment. Major risk factors for ocular injuries include age, gender, socioeconomic status and lifestyle. The site where the injury occurs is also related to a risk situation. Available information indicates a very significant impact of eye injuries in terms of medical care, needs for vocational rehabilitation and great socioeconomic costs. The global pattern of eye injuries and their consequences emerging from the present review, undertaken for planning purposes in the WHO Programme for the Prevention of Blindness, suggests that: – some 55 million eye injuries restricting activities more than one day occur each year; – 750,000 cases will require hospitalization each year, including some 200,000 open-globe injuries; – there are approximately 1.6 million blind from injuries, an additional 2.3 million people with bilateral low vision from this cause, and almost 19 million with unilateral blindness or low vision. Further epidemiological studies are needed to permit more accurate planning of prevention and management measures; a standardized international template for reporting on eye injuries might be useful to this effect, along the lines of the reporting occurring through the US Eye Injury Registry. [ABSTRACT FROM AUTHOR]

Background: Retinal folds (RF) following retinal detachment (RD) surgery are infrequent complications and their management is controversial. Spontaneous resolution of RF has been reported. Methods: An observational case report of a surgical complication of RD surgery was done. The progressive migration of a postoperative macular fold away from the center of the fovea was documented by optical coherence tomography (OCT) and retinography. Results: A macular fold was detected following 23G vitrectomy with liquid perfluorocarbon injection, photocoagulation, and SF6 injection to treat a bullous rhegmatogenous retinal detachment. In the following year, visual acuity remained stable at 20/25 while the macular fold migrated 1 mm away from the center of the fovea. Conclusions: A conservative approach may be appropriate in cases of macular fold following retinal detachment surgery, provided that good visual acuity is present and OCT shows a trend towards migration of the macular fold. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 43-year-old woman with a superotemporal bullous retinal detachment (RD) sparing the macula. She underwent uncomplicated scleral buckling (SB) procedure. After the surgery, the woman complained for disturbing metamorphopsia and visual acuity (VA) could not improve more than 20/80.

Background: To describe the surgical technique used in the management of two cases of dry retinal folds which occurred following retinal detachment surgery. Methods: Two patients with persistent dry retinal folds. Results: Patients underwent complete vitrectomy and membrane peeling, followed by injection of perfluorocarbon liquid. The retina was prodded and massaged flat with a silicone-tipped cannula under the perfluorocarbon liquid. The folds disappeared and the retina remained flat. Conclusion: The use of gentle manipulation under heavy perfluorocarbon liquids is an effective strategy for managing longstanding dry posterior retinal folds. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 17-year-old African-American young man with sudden, painless loss of vision in his right eye while playing basketball. Result of his eye examination was revealed. The man was diagnosed with retinal artery occlusion (RAO) secondary to patent foramen ovale (PFO).

Here the management of a macular fold complicating retinal reattachment surgery is discussed. The macular fold was repaired by a technique similar to that used in retinal translocation surgery. Direct injection into the macular fold was performed, which caused a linear, rather than the intended concentric, detachment of the retina. Permanent flattening of the macula fold was achieved and the best-corrected Snellen visual acuity was 6/12 at 6 months. The importance of intervention, advantages and disadvantages of this technique and alternative methods of managing such cases are discussed. It may be prudent to consider peripheral, rather than direct, injection into the macular fold to detach the macula in such cases. [ABSTRACT FROM AUTHOR]