Ocular contusion caused by elastic cords: a retrospective analysis using the Erlangen Ocular Contusion Registry

Purpose: Elastic cords are common tools to secure luggage to the roof of motor vehicles or the carrier of bicycles. In comparison with other variants of ocular contusion, patients with elastic cord injuries appear to suffer more severe ocular damage. Methods: The charts of 398 consecutive patients of the Erlangen Ocular Contusion Registry who had been hospitalized for ocular contusion over a 10‐year period were retrospectively reviewed. The acute clinical findings of 23 patients with elastic cord injury were compared with 375 patients with other contusions. Open globe injuries were excluded. Results: A total of 5.8% of the patients were injured by elastic cords; their mean age was 36.6 ± 17.0 years (range 8?66; median 34 years). The following morphological changes were documented in elastic cord injuries versus other ocular contusions: hyphema 100% versus 75%; angle recession 92% versus 72%; iridodialysis 17% versus 9%; traumatic cataract 14% versus 10%; lens dislocation 38% versus 13%; choroidal rupture 19% versus 6%; peripheral Berlin's oedema 57% versus 35%; and central Berlin's oedema 29% versus 12%. The difference of the incidence was significant for lens dislocation (P < 0.01), choroidal rupture (P = 0.024), and central (P = 0.029) and peripheral Berlin's oedema (P = 0.043). The final visual outcome was lower in patients with elastic cords injuries (P = 0.008). Conclusion: Elastic cord injuries induce more severe ocular damage than most other contusions. The elastic cords producing industry is called on to develop safer luggage fixation systems and warn against the potential harmful consequences of injury to the eye.     

Ocular prosthesis incorporating IPS e-max press scleral veneer and a literature review on non-integrated ocular prosthesis

The article highlights a new method for the fabrication of an ocular prosthesis by the incorporation of a ceramic scleral veneer. The steps of fabrication include impression making, wax try-in, performing a “cut-back” on a selected stock eye, insertion of the IPS e-max press scleral veneer, finishing and insertion. It also includes a detailed review on non-integrated ocular prostheses.     

Clinical profile of medicolegal cases presenting to the eye casualty in a tertiary care center in India

Purpose:The purpose of this study was to analyze the clinical profile of medicolegal cases (MLCs) presenting to the eye casualty in a tertiary care hospital.Results:Out of 188 MLCs, 164 (87.2%) were male. Mean age (±standard deviation) was 31.6 (±12.7) years. Age ranged from 7 to 75 years. Twenty-six (13.8%) patients had bilateral involvement. The fist was the most common mode of injury, which was seen in 109 (58%) cases. A total of 27 (14.3%) patients had associated extraocular injury. No evidence of ocular or orbital trauma (malingering) could be found in 13 (7%) patients. Mechanical trauma was present in 169 (90%) patients with injury to globe in 129 (69%) patients and injury to lid or orbit without damage to the globe in 40 (21%) patients. Chemical injury was observed in 6 (3%) patients. Closed globe injury (CGI) was seen in 116 eyes and open globe injury (OGI) was noted in 29 eyes. The most common type of injury, zone, pupil, and grade of injury in CGI were Type A or contusion (79%), Zone I (72%), Pupil B (absence of relative afferent pupillary defect) in 95%, and Grade A [visual acuity (VA) ≥20/40] in 68% of the eyes, respectively. The most common type of injury, zone, pupil, and grade of injury in OGI were Type B or penetrating (48%), Zone II (38%), Pupil B (59%), and Grade D (VA 4/200-light perception) (42%), respectively.Conclusions:The most common form and mode of ocular injury in MLC were closed globe injury and fist, respectively. The most common type of injury in CGI and OGI was contusion and penetrating injury, respectively.     

马来西亚西部小儿眼外伤研究

目的：调查5a 期间就诊于马来西亚西部三级转诊中心的小儿眼外伤患者的视力结果。
　　方法：回顾性研究。对所有2009-01/2013-12就诊于急诊创伤科的连续患者进行筛检,选取年龄在15岁以下的眼外伤患者纳入研究对象。排除随访患者。收集患者人口统计学数据、既往治疗和眼部病史资料。详细记录眼外伤情况,治疗和疾病发展情况。
　　结果：小儿眼外伤的患病率为每年17.6/100000。其中男性患者占69.5%(296/426例)。患者的平均年龄为6.08依2.24岁。家用工具(19.7%)和摔伤(19.7%)是致眼外伤最常见的原因。多数患者(79.9%)救诊时的视力≥6/12。眼前节(93.9%)最容易受伤,22.8%的患者需要手术治疗。相对性瞳孔传入障碍与闭合性眼球损伤程度(P =0.001)及不良视力预后( P =0.001)相关。大多数患者(92.7%)的最终视力≥6/12。
　　结论：须提高对小儿眼外伤的预防意识并及时进行治疗,以确保患者视力的最大程度恢复。     

Eye injuries in twentieth century warfare: A historical perspective

With successive wars in the twentieth century, there has been a relative increase in injuries to the eye compared to injuries of other parts of the body. The main causes of eye injury have changed with advances in techniques and weaponry of warfare, with blast fragmentation injuries accounting for 50–80% of cases. Penetrating and perforating injuries are most common, and injuries associated with intraocular foreign bodies pose special diagnostic and management problems. Injuries are bilateral in 15–25% of cases. Injuries associated with chemical, nuclear, and laser weapons have distinct characteristics and epidemiology. Enucleation was commonly performed at the turn of the century, but incidence has declined with better understanding of the pathophysiology of ocular trauma, improved surgical techniques and sepsis control with antibiotics. Sympathetic ophthalmia appears to be uncommon and earlier fears of this complication seem to have been exaggerated. Timely evacuation to a surgical facility is important for a good visual prognosis and preservation of the globe. However, prevention of injuries with eye armor is ultimately the best management, and the need for a comprehensive eye protection program in the military cannot be overemphasized, especially since eye injuries pose important socioeconomic, as well as medical, problems.     

中国城市人口需住院治疗的眼外伤病例回顾性分析

目的:阐明流行病学,眼外伤成因,严重眼外伤造成的视觉状况,在中国具有代表性的城市治疗7a后最终的视觉灵敏度。方法:大坪医院根据其2000-01/2006-12接收的眼外伤住院患者档案资料,开展了一项眼外伤临床案例回顾性分析活动。结果:开放性眼球损伤268例,其他294例为眼钝挫伤病例。眼外伤最常见的成因是金属(29.4%)、爆炸(14.6%)以及石头(13.9%)。在此次研究中,大多数的眼外伤患者最终的治疗结果并不乐观,他们当中,受过外伤的眼睛的最终视力治疗结果不及0.1。结论:眼外伤治疗方法在近几年中取得了很大的进展,但治疗结果不尽人意。     

Concerns of anophthalmic patients wearing artificial eyes

Background: To identify the concerns of experienced artificial eye wearers and investigate whether these had changed since they lost their eye. Design: A retrospective study of private practice patients. Participants: Sixty‐three experienced artificial eye wearers. Methods: An anonymous questionnaire was posted to participants. Paired Wilcoxon tests were used to investigate changes to concern levels over time. Ordinal logistic regression was used to investigate associations of demographic variables with concern levels. Main Outcome Measures: Changes in level of concern over time. Results: At the time of initial eye loss, participants were mainly concerned about the health of their remaining eye, coping with monocularity and receiving good advice. Between initial eye loss and the present, reductions in concern occurred with judging distance, peripheral vision, appearance, receiving good advice, comfort, retention, colour and movement of the artificial eye, fullness of orbit, loss of balance and postoperative pain. Patients whose jobs involved the public were more concerned about appearance and reduced visual range than those in other occupations. Participants' chief present‐day concerns were health of the remaining eye and watering, crusting and discharge. All results above had a probability <0.05. Conclusions: The study emphasized patients' concerns about the health of their remaining eye and their need for good advice at time of eye loss. Knowledge that their initial concerns about judging distance, reduced peripheral vision and appearance all decrease over time may help clinicians in counselling these patients. Watering, crusting and discharge was the chief present‐day concern after health of the remaining eye.     

Ocular Genetics Program: multidisciplinary care of patients with ocular genetic eye disease

BACKGROUND: Patients who suffer from ocular genetic diseases have special needs in terms of diagnosis and management of rare entities, low-vision needs, genetic counselling, and psychosocial adjustments that are usually not addressed by an ophthalmologist alone. The Ocular Genetics Program (OGP) at the Hospital for Sick Children, Toronto, was established in 1994 to provide comprehensive, multidisciplinary care of patients with inherited eye disorders. We now assess the benefits of such a program and of integrating research into the care of patients. METHODS: We report our experience in developing a multidisciplinary ocular genetics program and the results of a pilot patient satisfaction survey that involved 61 patients. RESULTS: The OGP multidisciplinary aspects are described. Of the 61 patients surveyed, 98% stated that they were satisfied with the OGP; 93%-96% of patients were content with "one day of appointments", "understanding of eye problem", and "coordination of ancillary tests such as visual fields test, electrophysiology, and others"; and for 70%-86% of respondents "waiting time to get an appointment", "information received on current research", and "primary health care provider adequately informed" were satisfactory. INTERPRETATION: The OGP is a unique service in Canada, which strives to provide the comprehensive care needed by ocular genetic patients. High patient satisfaction is an indicator of the success of this approach. Long waiting times for appointments and application of laboratory research in clinical care remain challenging.     

Hospitalized eye injury in a Chinese urban population:a 7-year retrospective analysis

AIM:To present the epidemiology,cause of injury,ocular status and final visual acuity after management of severe ocular trauma required hospitalization during 7 years in a representative urban Chinese population. METHODS:A retrospective analysis of the hospital admission files of ocular trauma patients admitted to the Daping hospital from January 2000 to December 2006 was carried out. RESULTS:A total of 268 patients were open-globe injury and the remaining 294 patients were closed-globe types.The most common causes of ocular injuries were metal(29.4%), explosive(14.6%)and stone(13.9%).And the visual outcomes of most of eye injury patients in this study were poor;half of injured eyes ended with visual acuity worse than 0.1. CONCLUSION:Therapeutic methods to ocular trauma make a great progress in recent years,but the visual outcomes are poor.     

CASE REPORT Sympathetic Ophthalmia after a Hyphema due to Nonpenetrating Trauma

Purpose: To report a case of sympathetic ophthalmia occurring after nonpenetrating ocular trauma. Methods: Interventional case report. Results: An 18-year-old white male presented with sympathetic ophthalmia four weeks after a hyphema from a nonpenetrating bungee cord injury. Vision was 20/20; there were keratic precipitates, anterior chamber cells, vitritis, and discrete yellow deep choroidal lesions consistent with Dalen-Fuch's nodules OU. The uveitis was treated with topical, oral, and periocular corticosteroids and the oral immunosuppressives cyclosporine and mycophenolate mofetil. Vision remained 20/20 OU for the first year of follow-up; vision OD then deteriorated to 20/50 over the next year with the formation of a posterior subcapsular cataract OD. Conclusion: Sympathetic ophthalmia may result from nonpenetrating ocular trauma. Ophthalmologists should be aware of this as prompt intervention is warranted.     

Hospitalized eye injury in a Chinese urban population: a 7-year retrospective analysis

AIM: To present the epidemiology, cause of injury, ocular status and final visual acuity after management of severe ocular trauma required hospitalization during 7 years in a representative urban Chinese population. METHODS: A retrospective analysis of the hospital admission files of ocular trauma patients admitted to the Daping hospital from January 2000 to December 2006 was carried out. RESULTS: A total of 268 patients were open-globe injury and the remaining 294 patients were closed-globe types. The most common causes of ocular injuries were metal (29.4%), explosive (14.6%) and stone (13.9%). And the visual outcomes of most of eye injury patients in this study were poor; half of injured eyes ended with visual acuity worse than 0.1. CONCLUSION: Therapeutic methods to ocular trauma make a great progress in recent years, but the visual outcomes are poor.     

Ocular surface in patients with different degrees of myopia

AIM: To investigate the clinical features of the ocular surface in patients with different degrees of myopia. METHODS: A cross-sectional study was conducted involving 122 participants with myopia in Beijing Tongren Hospital from February to June, 2023. After completing the Ocular Surface Disease Index (OSDI) score scale, measurements were taken for refraction, biometric parameters and ocular surface parameters. The prevalence, severity and related parameters of the dry eye among different groups based on axial length (AL) were compared. Correlation analysis was performed between ocular surface parameters and refraction/biometric measurement parameters. RESULTS: Statistically significant differences were observed in refractive error, corneal thickness, anterior chamber depth, and subfoveal choroidal thickness among the groups (all P<0.05). With the increase in AL, the incidence and severity of dry eye increased significantly (P<0.05). Moreover, the tear film break-up time (BUT) shortened (P<0.05), and the corneal fluorescein staining (CFS) points increased significantly (P<0.05). OSDI scores were positively correlated with AL and spherical equivalent (SE; both P<0.05); BUT was negatively correlated with AL, SE, and corneal astigmatism (AST; all P<0.05); Schirmer I test (SIT) results were negatively correlated with AL and SE (both P<0.05). CONCLUSION: AL elongation is a risk factor for dry eye onset in myopic participants. The longer the AL, the more severe the dry eye is, with the increased CFS spots and tear film instability. Additionally, SE and AST exhibit negative correlations with dry eye symptom scores and ocular surface parameters.     

The epidemiology and etiology of pediatric ocular trauma

Eighteen million people worldwide have uniocular blindness from traumatic injury. Injuries occur disproportionally commonly in childhood. Every year a quarter of a million children present with serious ocular trauma. For the vast majority the injury is preventable. We review the international literature that identifies high-risk circumstances.     

Progression rate to primary angle closure following laser peripheral iridotomy in primary angle-closure suspects: a randomised study

AIM: To report the progression rate (PR) to primary angle closure (PAC) following laser peripheral iridotomy (LPI) in PAC suspects (PACS). METHODS: Prospective, randomized controlled interventional clinical trial conducted at the Handan Eye Hospital, China. Totally 134 bilateral PACS, defined as non-visibility of the posterior trabecular meshwork for ≥180 degrees on gonioscopy were randomly assigned to undergo LPI in one eye. Gonioscopy and Goldmann applanation tonometry were performed prior to, on day 7 and 12mo post LPI. RESULTS: Eighty of 134 patients (59.7%) could be followed up at one year. The mean intraocular pressure (IOP) in treated eyes was 15.9±2.6 mm Hg at baseline, 15.4±3.0 mm Hg on day 7; 16.5±2.9 mm Hg at one month, and 15.5±2.9 mm Hg at 12mo; the IOP in untreated eyes was similar (P=0.834). One or more quadrants of the angle opened in 93.7% of the LPI treated eyes, but 67.0% (53/79) remained closed in two or more quadrants. The PR to PAC in untreated eyes was 3.75% and one developed acute angle-closure glaucoma (AACG); the PR to PAC in treated eyes was 2.5% and none had developed peripheral anterior synechia (PAS) or AACG. CONCLUSION: LPI can open some of the occludable angle in the majority of eyes with PACS, but 67% continue to have non-visibility of the trabecular meshwork for over 180 degrees.     

65岁及以上老年人眼部肿瘤784例病理学诊断构成分析

目的分析65岁及以上老年人眼部肿瘤的临床病理诊断构成情况。设计回顾性病例系列。研究对象2002年1月至2015年12月天津市眼科医院存档并经手术治疗后病理检查确诊的65岁及以上老年人眼部肿瘤患者784例(795眼)的临床资料。方法回顾分析肿瘤的发生部位、病理诊断及构成情况。主要指标病理诊断及构成比。结果784例眼部肿瘤中,男性375例(47.8%)381眼(47.9%)。眼睑肿瘤564例(71.9%),其中良性肿瘤407例(72.2%),恶性肿瘤152例(27.0%)。泪囊区肿瘤9例(1.2%)。眼表肿瘤117例(14.92%),其中良性肿瘤94例(80.3%),恶性肿瘤13例(11.1%)。泪腺肿瘤18例(2.3%)。眼眶肿瘤66例(8.4%),其中良性肿瘤34例(51.5%),恶性肿瘤30例(45.5%)。眼内肿瘤10例(1.3%)。结论2002-2015年天津市眼科医院65岁及以上老年人眼部肿瘤以眼睑和眼表肿瘤多见。眼部恶性肿瘤发生部位以眼睑和眼眶多见。恶性肿瘤病理类型主要为基底细胞癌、皮脂腺癌和淋巴瘤等。     

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）     

Evaluation of the Northern Ireland National Artificial Eye Service: A Regional Audit of Patient and Prosthetic Characteristics

Purpose: The purpose of this study is to establish an up-to-date baseline of the profile of patients using the National Artificial Eye Service in Northern Ireland and to understand key areas of service provision, to contribute to patient and health-care provider education, and thus to improve patient outcomes for future researchers.

Methods: A prospective audit of artificial eye wearers attending the Northern Ireland National Artificial Eye Service between May 18, 2015 and June 26, 2015 was conducted.

Results: A total of 131 patients, who attended consecutively for appointments over the 6-week period, were included: males 68%; females 32%. The majority of eyes were lost secondary to trauma (54%). In recent decades, medical causes have now taken over as the primary referral cause for prosthetic eyes. Approximately, one-third of patients attending the service required further education on how to maintain the hygiene of their ocular prosthesis.

Conclusion: Patients attending artificial eye services should be further educated about using lubricants to maintain the hygiene of their prosthesis. Primary care health professionals (General Medical Practitioners and Primary Care Optometrists) should be informed about artificial eye services and of how to contact the service for advice if required. Trauma remains the most common cause for referral; however, in recent decades more patients are attending secondary to a medical cause of eye loss. Health service providers should be aware of the changing profile of patients attending artificial eye services and of the medical and traumatic causes of eye loss.     

Clinical Application of X-ray, B-scan, and CT in the Diagnosis of Ocular Foreign Bodies

 PURPOSE:To analyze the sensitivity and specificity of X-ray, B-ultrasound, and CT scan in diagnosing ocular foreign bodies, and to compare the accuracy of  these three imaging tools in locating these foreign bodies. METHODS:A retrospective review was conducted of radiographic and clinical eye examination data from 62 patients (66 eyes), suspected of having ocular foreign bodies at time of first presentation to the Zhongshan Ophthalmic Center (Guangzhou, China) between August 2007 and October 2011. The sensitivity and specificity of X-ray, B-ultrasound and CT scan in the diagnosis of ocular foreign bodies were investigated and their accuracy in locating these foreign bodies was compared. RESULTS:A total of 75.8% (n = 47) subjects had ocular foreign bodies; 66% of these were metallic. Patients with intraocular, eye wall, and extraocular foreign bodies accounted for 46, 28, and 26% of the total, respectively. The sensitivities ofX-ray, CT scan, and B-ultrasound in the diagnosis of ocular foreign bodies were 58.3%, 61.7%, and 75%, the specificityies were 63.3%, 100%, and 87.5%, and the accuracy in locating foreign bodies was 73.4%, 94.7%, and 86.5%, respectively. The properties of foreign bodies affected the diagnosistic accuracy of X-ray, but exerted little impact upon B-ultrasound and CT scan.  CONCLUSION:A fairly high incidence of ocular foreign bodies was noted in patients suspected with ocular foreign bodies at their first presentations. X-ray combined with CT scan or X-ray in combination with B ultrasound showed a relatively high sensitivity and specificity in diagnosing ocular foreign bodies. CT scan had the highest accuracy in locating ocular foreign bodies.     

开放性眼外伤中导致视力受损的并发症

目的探讨开放性眼外伤与伤口位置及外伤类型相关的眼部并发症和导致视力下降的原因。方法回顾性分析开放性眼外伤172例(172眼)。按外伤区带(zone)统计分析并发症及伤后视力情况。结果区带Ⅰ眼外伤(84例)及眼球穿孔伤(114例)的并发症主要是外伤性白内障和角膜瘢痕;而区带Ⅱ、Ⅲ(88例)及眼球破裂伤(58例)主要并发症为外伤性白内障和视网膜脱离。伤后视力恢复情况:区带Ⅰ伤优于区带Ⅱ和Ⅲ伤(70.23%vs44.32%P<0.05);眼穿孔伤优于眼破裂伤(66.67%vs37.93%,P<0.05)。结论外伤性白内障是开放性眼外伤中最常见影响视力的并发症。区带Ⅱ和Ⅲ级伤及眼破裂伤由于视网膜脱离发生率较高,视力愈后较差。