眼睑外伤的美容修复

目的遵循整形外科学原则和技术修复眼睑外伤。方法采用分层对位缝合和“Z”或“W”成形术缝合，皮肤用皮内连续缝合法。结果71例(93眼)的手术效果良好，瘢痕细小。结论眼睑皮肤伤口按整形外科原则及技术处理，美容效果良好。     

外伤致眼球异位1例

患者男38岁因重物砸伤头面部致左耳鼻流血,左眼肿胀、失明3d余,于2005年7月1日来我科就诊。查体:神志清楚,前额正中及左上眼睑有一长约10.0cm不规则皮肤裂伤,深及皮下,创面干燥,无渗血。左眼眶塌陷约1.0cm,眼睑后未见眼球,睑结膜充血水肿,无流液及眼内容物流出。右眼肿胀,眼裂变窄,结膜充血,水肿(),角膜透明,眼球活动自如,眼压正常,瞳孔直径约2.5mm,直接对光反射迟钝。右眼视力为眼前数指,眼底检查见视盘界清,黄斑部轻度水肿,视网膜无出血渗出。左鼻流少量血性液体,似有少量玻璃体样物从左鼻流出,左鼻腔内见脂肪组织,未见色素膜及其它球壁组…     

眼面部火药枪子弹击伤14例

火药枪子弹为圆形有磁性的铁砂，击伤后伤面广泛子弹存留，本文子弹存留最多１例为７９颗，最少１例为２３颗，利用磁铁根据Ｘ线照片定位有顺序取出子弹，大量抗生素、皮质类固醇等治疗，有眼球穿通伤者，虽然取出子弹，但多数最后失明。     

53例儿童眼球开放性外伤的手术治疗

目的 探讨儿童开放性眼外伤手术治疗的方法及临床疗效.方法 53例儿童复杂性眼外伤Ⅰ期均行角巩膜创口清创缝合,同时Ⅰ期或Ⅱ期联合白内障摘除、眼内异物摘除、玻璃体手术及视网膜复位.结果 术后矫正视力提高者45眼（84.9%）,视力无提高者8眼（15.1%）.其中术中视网膜脱离复位率100%,眼内异物摘除成功率100%.结论 儿童严重开放性眼外伤治疗中,Ⅰ期手术修复是提高伤眼视力和决定后续治疗的关键,Ⅱ期手术治疗是提高临床疗效的有效手段.     

角膜移植术治疗角膜外伤5例报告

在眼外伤中角膜外伤较为常见,常因无移植手术条件而造成失明,特别在大别山苏区县,农民无条件到大城市就医。面对这种情况,我院于1983年开展了角膜移植术。由于取供体角膜有困难,有时采用引产死胎角膜作供体材料。对5例角膜外伤进行治疗,取得了一定的效果。现报告如下。     

黏弹剂在角膜外伤缝合术中的应用14例观察

角膜裂伤术后常发生虹膜组织前后粘连,可引起一系列并发症.我们在缝合角膜后前房内注入并保存黏弹剂,有效控制了虹膜组织前后粘连,取得满意效果,报告如下. 1 资料与方法 1.1 一般资料 1996年11月至1998年11月由于眼外伤所致角膜裂伤14例(特别重的外伤涉及晶状体后囊、玻璃体的未入选).钝挫伤7例,锐器伤7例.其中晶状体损伤3例,均为男性,年龄12～45岁,平均33.4岁.伤后24 h内就诊者8例,2～4天就诊者5例,1例5天就诊.均有眼红、眼痛、流泪和视物不清等症状.创口4～11 mm不等,大部分有不同程度虹膜组织脱出,房闪明显.     

外伤致眼球脱位治疗一例

患者男 ,18岁。因右眼不慎被打谷机脱谷齿牙扎伤致剧烈头痛、眼痛、视物不清且眼球外突 2ｈ ,于 1990年 7月 14日来我院就诊。体检 :患者精神紧张 ,其他无异常。眼部检查 :矫正视力右眼为眼前指数 ,左眼为 5 1;右眼球突出眼眶外呈轻度内转位 ,且嵌顿固定不动 ,上、下眼睑内翻紧贴眼球壁 ,右上睑近外眦部皮肤可见挫伤淤血 ,外眦结膜和筋膜自角膜缘 6～ 12点钟方位呈轮状撕裂 ;角膜中央区上皮浅层剥离 ;前房深 ,瞳孔圆 ,直径约 4ｍｍ ,直接和间接对光反应存在 ;视乳头颜色略淡 ,视网膜静脉轻度充盈扩张。左眼正常。诊断 :右眼球外伤性脱位。…     

视神经外伤的治疗进展

视神经外伤是头部外伤的严重伴发症，本综述了其诊断标准，主要治疗手段和视神经减压术，鼻外眶筛蝶窦进路手术视野好，进路直接，损伤小，易于接受，疗效高。     

颌面中部外伤并发间接性视神经损伤治疗体会

目的 探讨颌面部外伤并发间接性视神经损伤的特征及治疗。方法 15例患者在进行颌面外伤处理后均应用皮质类固醇和脱水剂等治疗,对其中3例视神经受压的患者进行视神经管减压术。结果 15例患者治疗前无光感5眼（29．41％）,治疗后减少至2眼（11．76％）,光感－0．04治疗前7眼（41．18％）降至3眼（17．65％）,视力0．05－0．3治疗前5眼（29．41％）,治疗后提高至12眼（70．59％）。结论 颌面中部外伤患者在治疗外伤时应早发现并发间接性视神经损伤。预后与早期发现及治疗的关系极为密切。     

眼外伤评分在眼后节机械性眼外伤手术中的应用价值

目的：评估眼外伤评分（ OTS）在后节机械性眼外伤手术中的临床应用价值。方法回顾性、非对照、连续病例研究。研究对象为2010年1月～2011年1月在本科接受玻璃体手术治疗的严重后节机械性眼外伤患者,研究其预后视力与OTS系统预测视力的关系。结果研究期间共81例患者在本科接受眼后段手术治疗,OTS评分为2～47分,其中OTS-1级60例、OTS-2级21例。平均随访时间为（15．6±3．3）个月。本院治疗的OTS评分分级为1～2级的眼外伤患者,最终视力预后显著优于OTS预后。结论 OTS评分可以提供机械性眼外伤手术的预后参考,但对于OTS评分在1～2级的机械性眼外伤患者并不能直接使用OTS预后信息。（中国眼耳鼻喉科杂志,2015,15：16-19）     

眼外伤患者情绪障碍的研究

目的　调查眼外伤患者的抑郁、焦虑状况 ,为眼外伤患者心理治疗提供依据。方法　用Zung抑郁自评量表和焦虑自评量表调查眼外伤患者和正常对照组各 87例 ,用 χ2 和t检验进行统计学分析。结果　眼外伤组的抑郁及焦虑评分与对照组比较均有显著性差异 (χ2 =6.99,P <0 .0 1;χ2 =2 5 .95 ,P <0 .0 1。结论　眼外伤患者抑郁、焦虑状态发生率较高 ,应加强眼外伤患者的心理治疗。     

洛阳市眼外伤流行病学研究

目的研究本地区眼外伤的流行病学特征。方法连续入选2007年2月至2009年3月住院的眼外伤296例（325眼）,对性别、年龄、文化程度、职业、受伤地点等人口学特征及受伤类型、病因进行回顾性分析,了解眼外伤的流行病学状况。结果眼外伤常见于男性,受伤年龄趋势集中在31～64岁,文化程度以初中以下文化为多,主要是工人和农民,受伤地点高发于工业场所,其次为公共场所。最常见的眼外伤是眼球挫伤（41.54%）,致伤病因多为钝器伤（29.85%）和肢体打击伤（20.00%）。此外非机动车祸伤多于机动车祸伤。结论初中文化程度以下的一线工人和农民为眼外伤的高危人群,有必要对此类人群强化岗前教育并在作业中进行必要的安全防护措施。     

Psychological distress in people with disfigurement from facial palsy

Aims

Psychological distress is well documented in people with facial disfigurement. However, the prevalence of psychological distress in patients with facial palsy has not been studied. This study aims to establish the prevalence of psychological distress and the extent of anxiety and depression in a sample of facial palsy patients from the Northwest of England.

Method

A total of 103 participants with facial palsy completed a questionnaire pack comprising the Illness Perception Questionnaire-Revised (IPQ-R), a demographic questionnaire, and the Hospital Anxiety and Depression Scale (HADS). The severity of participants'' facial palsy was measured by the House–Brackmann scale.

Results

In all, 32.7 and 31.3% of the sample had significant levels of anxiety and depression, respectively. The mean age of participants was 59, and 35.9% had grade 6 facial palsy. Significant associations were found between participants'' perception of consequences, duration, timeline, and the level of distress. No significant associations were found between clinical severity of facial palsy and levels of distress. Females had significantly higher levels of anxiety compared with males.

Conclusions

There was a significant level of distress in this study group. The levels of psychological distress were higher than the levels found in other outpatient attenders. There were significant associations between participants'' illness perceptions and their level of distress.     

Fundus autofluorescence in patients with blunt ocular trauma

Acta Ophthalmol. 2011: 89: e89–e94

Abstract.

Purpose: To report fundus autofluorescence and optical coherence tomography (OCT) findings in patients with blunt ocular trauma. Methods: Six eyes of six consecutive patients with blunt ocular trauma were evaluated in an observational case series using colour fundus photography, the Heidelberg Retina Angiograph 2 (HRA2) system for fundus autofluorescence (FAF) and OCT (Stratus OCT). Results: Three patients presented with secondary retinal pigment epitheliopathy that was identified as a reduced FAF plaque with interposed increased FAF granular smaller lesions. These findings were not as evident in fundus examination and colour photography in two patients. Visual field in one patient showed a decreased area of sensitivity that correlated to the reduced/increased autofluorescent lesion. The other three patients had subretinal haemorrhage and choroidal rupture, which appeared with a reduced FAF with an increased FAF rim after resolution. OCT demonstrated a choriocapillaris/ retinal pigment epithelium (RPE) complex disruption and its resolution over time in all patients with choroidal rupture. Conclusion: Damaged RPE area was more evident and better delineated by FAF imaging compared with fundus examination and fundus photography alone. Autofluorescence imaging might be a useful exam to show the length and severity of post‐traumatic retinal lesions and it may add relevant information in the global evaluation of blunt ocular trauma complications. Moreover, OCT added valuable information to the diagnosis and progression of choroidal rupture. Further studies to determine the predictive value of FAF in ocular blunt trauma are warranted.     

Entropion in children with isolated peripheral facial nerve paresis

Purpose

Adults with facial nerve paresis (FNP) generally develop ectropion, but a recent report of children with syndromatic FNPs implies that entropion may be more common in this setting than ectropion. This study evaluates eyelid position and other periorbital changes in children with isolated, non-syndromatic FNP.

Methods

Charts were reviewed of 10 sequential children who presented to a major national eye referral centre with isolated FNP of variable aetiology. Severity of FNP was assessed according to the House-Brackmann scale.

Results

All 10 patients (4 males and 6 females; mean age at presentation, 4 years) had unilateral, isolated FNP. Mild lower-eyelid entropion was present in four patients, and severe lower-eyelid entropion required surgical correction in three patients. All patients had lower eyelid retraction (mean 2.3 mm) and lagophthalmos (mean 2.9 mm). None had enophthalmos, lower eyelid ectropion, or brow ptosis.

Conclusion

Unlike adults, children with isolated FNP seem prone to develop entropion rather than ectropion. Entropion reported previously in five syndromic children with FNP seems more likely related to patients'' age than to their congenital syndromes.     

Diagnostic yield for neuroimaging in patients with unilateral eye or facial pain

BACKGROUND: The neuroimaging evaluation of isolated pain in or around the eye has not been studied previously. We report the low diagnostic yield of neuroimaging in patients who have a normal ocular examination and unilateral eye pain or facial pain predominantly affecting the eye. METHODS: Retrospective review of patients referred to 3 neuro-ophthalmology practices for unexplained pain in or around the eye. Inclusion criteria were adults with isolated unilateral eye/facial pain, neuroimaging, and a normal eye exam. Ex-clusion criteria were symptoms typical of a defined pain syndrome (e.g., trigeminal neuralgia or giant cell arteritis), and exam findings that would account for the pain. RESULTS: One hundred and twenty-seven (127) of the 760 reviewed patients met study criteria, and underwent MRI (75) or CT (34) scans, or both (18). Imaging was normal in 106 (83%). Abnormalities (n = 21) on imaging (17%) included nonspecific T2-weighted hyperintensities (10), sinusitis (5), superior ophthalmic vein enlargement (1), pontine lacunar infarct (1), Chiari malformation (1), thalamic mass (1), old occipital stroke (1), and focal enlargement of the third cranial nerve (1). INTERPRETATION: Although imaging showed abnormalities in 17% of cases of isolated pain in or around the eye, only 2 abnormalities were believed to be possibly related to the pain and only 1 case was probably related. The diagnostic yield of neuroimaging in patients with a normal examination and isolated, unilateral eye/facial pain referred to a neuro-ophthalmologist is low.     

眼外伤患者的健康教育

目的 探讨做好眼外伤患者健康教育的意义。方法 对56例眼外伤患者，入院时做好心理护理和常规指导；住院期间从疾病知识、用药知识、休息饮食等方面进行反复的宣教；出院给以正确的健康指导。结果 通过科学的健康教育，使患者能够主动配合，治疗和护理效果更令人满意，使其早日康复。结论 眼外伤患者的健康教育有非常重要的意义，护士有责任为不同人群提供健康教育。     

开放性眼球损伤109例的临床流行病学分析

目的对开放性眼球损伤的眼外伤患者进行临床流行病学探讨。方法选取1990/2000间我院住院眼外伤患者1087例(1233眼),其中开放性眼球损伤109例(109眼),记录患者年龄、性别、职业、受伤原因、时间与就诊时间、视力、眼球被伤部位、大小、有无虹膜嵌顿、有无白内障、前房积血、玻璃体脱出及治疗情况。结果开放性眼球损伤发生率8.92%,16～45岁年龄层占59.62%,0～7岁年龄组发生率也占13.76%,男女比例为8.08∶1,受伤职业上工人(包括建筑工地的临时工,乡镇企业工人)明显多于其他行业。治疗后视力恢复与受伤原因、部位、就诊时间、及时处理预防并发症关系密切。结论近年来,开放性眼外伤有增加趋势,应加强防护。要培训基层医务人员掌握现场抢救知识,如医疗条件不够,迅速转院,努力降低开放性眼球损伤的发生率,有效减少受伤后的致盲率。