1/11. Traumatic anterior lens dislocation: a case report.A 45-year-old man presented to the emergency department complaining of decreased vision and pain in the left eye after blunt trauma to the eye. On evaluation, the vision was limited to detecting hand motions, and the intraocular pressure was 37 mmHg. Secondary acute angle-closure glaucoma, with pupillary block due to anterior dislocation of the lens, was diagnosed. The intraocular pressure remained elevated after medical therapy, and the patient underwent intracapsular cataract extraction and anterior vitrectomy. The possibility of elevated intraocular pressure due to lens dislocation or other types of secondary glaucoma should be considered after blunt ocular trauma.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/11. Tear in the trabecular meshwork caused by an airsoft gun.PURPOSE: To report a case of a tear in the trabecular meshwork caused by an airsoft gun, a toy that propels a plastic bullet. methods: Case report. RESULTS: A 7-year-old Japanese boy sustained an ocular injury to the right eye from an airsoft gun. Ophthalmic examination 1 hour after the injury showed a best-corrected visual acuity in the injured eye of hand motion, corneal abrasion and edema, hyphema, and commotio retinae. gonioscopy 6 days after the injury revealed a tear in the trabecular meshwork as well as an angle recession. Ultrasound biomicroscopy (UBM) strongly suggested that the tear extended into Schlemm's canal. Corneal abrasion and edema, hyphema, and commotio retinae resolved over 10 days, and best-corrected visual acuity improved to 20/15. Two months after the injury, the trabecular meshwork had not healed. CONCLUSION: Airsoft guns can cause a full-thickness tear in the trabecular meshwork, which may contribute to development of late-onset glaucoma. UBM is useful to evaluate the tomographic features of the disrupted trabecular meshwork. The potential force of airsoft guns to cause substantial ocular injuries should be recognized. Wearing ocular protection should be mandatory while playing with airsoft guns.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
3/11. Bottle-cork injury to the eye: a review of 13 cases.PURPOSE: To analyze the anatomic and functional consequences of wine-cork injury to the eye in relation to the patient's age and the type of cork and wine. methods: We retrospectively studied 13 patients, six women and seven men, presenting to our department with bottle-cork injury to the eye between January 1999 and June 2001. RESULTS: All patients presented with closed-globe injury according to Kuhn et al's classification. All the cases were injured by bottle corks from sparkling wine: white in ten cases and red in three. Mean visual acuity at admission was 20/100 (range, hand motion to 20/20). The most frequent early injury was anterior chamber hyphema (84.6%), followed by corneal injury (62.2%), ocular hypertension (46.1%), lens subluxation (30.8%), traumatic cataract (23.1%), and post-traumatic retinal edema (23.1%). Mean final visual acuity was 20/25; the follow-up ranged from 3 to 29 months, averaging 16.1 months. Late complications were as follows: pupil motility anomalies (38.5%), traumatic cataract (30.8%), iridodialysis (15.4%), traumatic optic neuropathy (7.7%), post-traumatic glaucoma (7.7%), and traumatic maculopathy (15.4%). Surgical treatment was necessary in two cases (15.4%). CONCLUSIONS: Bottle-cork eye injuries account for 10.8% of post-traumatic hospital admissions to our department. Most of them are due to sparkling white wine served at room temperature. There is no correlation between ocular injury and the eye-bottle distance or the type of cork.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
4/11. Laser eye injuries in military occupations.INTRODUCTION: lasers (light amplification by stimulated emission of radiation) play an important role in our world and their use is increasing. They are powerful tools for good, but can also cause tragedy, especially in an aviation environment. Information about injuries associated with lasers is limited. This study highlights several laser eye injuries in the U.S. military and discusses issues pertaining to them. methods: We gathered data from the U.S. Army safety Center, the U.S. Army Center for health promotion and preventive medicine, and the Walter Reed Army Institute of research. This paper describes ten representative cases of laser eye injury that occurred in the U.S. military between 1984 and 2000. RESULTS: patients suffered retinal damage, though no corneal injury occurred. Most were caused by accidental exposure to a Q-switched, Neodynium:YAG (Nd:YAG) laser at 1064 nm wavelength. The incidents occurred both on and off duty, indoors and outdoors, and from close and long ranges. None of the victims were wearing eye protection. Inadequate training and poor equipment design were major factors in at least six of the nine unintentional cases. The tenth occurred during military operations in the Persian Gulf. All of the victims needed several months medical care and follow up. Two received medical discharges as a result of their injuries. DISCUSSION: As illustrated by these cases, human and societal costs from unintentional laser eye injuries can be reduced by improving operator training, safety procedure compliance, and equipment design. In addition, intentional laser eye injuries are a growing concern and further research is needed to design appropriate protection, treatment and countermeasures.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
5/11. air bag associated posterior segment ocular trauma.Airbags indeed reduce the risk of injury and death in motor vehicle accidents, however, ocular injury induced by airbag deployment has been reported. From 1999 to 2001, medical records were retrospectively reviewed for patients with severe ocular injury related to airbag inflation at Taipei veterans General Hospital. The ocular presentation, clinical course, management and visual outcome were recorded and studied in detail. Three cases of ocular posterior segment injury associated with airbag inflation were identified. Mean age was 37.3 years old (range 34-39 years). None of the patients was wearing a seat belt. All patients had periocular contusion, corneal edema, and hyphema. vitreous hemorrhage was found in 3 cases, and there were 2 cases with severe macular injury, including traumatic maculopathy and hypotony maculopathy. retinal detachment developed in 1 case. One patient presented with traumatic macular hole 6 weeks after injury. The initial visual acuity was hand motion only in all patients, the final visual outcomes recovered to 6/20, 1/60 and 2/60, respectively. The airbag-associated posterior segment ocular trauma was induced by impact with fully deployed airbag. Severe ocular posterior segment trauma with devastating visual sequelae might occur in drivers and passengers who have not fastened their seat belt.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
6/11. Treatment of post-traumatic trabecular mashwork thrombosis and secondary glaucoma with intracameral tissue plasminogen activator in previously unrecognized sickle cell anemia.Intracameral tissue plasminogen activator (t-PA) application in a child with previously unrecognized sickle cell anemia, post-traumatic hyphema, thrombosis in trabecular mashwork and consecutive acute glaucoma showed positive results. Thirteen year-old boy, son of African father and Caucasian mother, was admitted to hospital, with symptoms of acute glaucoma and partial hyphema after right eye trauma. visual acuity of affected eye was 0.5 and intraocular pressure (IOP) 46 mm Hg. Despite a common therapy three days later clinical condition of patient's right eye was getting worst. visual acuity was only hand motion (HM) and IOP 53 mmHg. At this point rose suspicion of sickle cell disease (SCD) and decision about injecting t-PA (20 microg) into anterior chamber was made. Cytological examination of aqueous humor revealed 10% sickled erythrocytes. Hemoglobin electrophoresis discovered hemoglobin S so that diagnosis of SCD was confirmed. Intraocular application of t-PA showed excellent results in post-traumatic hyphema with trabecular mashwork thrombosis in the patient with sickle cell anemia. Two-years follow up confirmed permanent normalisation of IOP and visual acuity. Successful outcome with anterior chamber paracentesis and intracameral injection of t-PA is promising novel approach, which we recommend in treatment of post-traumatic hyphema in SCD.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
7/11. epikeratophakia in children with traumatic cataracts.epikeratophakia provides a permanent optical correction for aphakia in children with congenital or traumatic cataracts; suturing the epikeratophakia graft onto the cornea eliminates the problems of contact lens or spectacle non-compliance in these young and generally uncooperative patients and provides tectonic support to scarred and irregular corneas. Eighteen children under the age of six years underwent epikeratophakia for the correction of aphakia after the removal of trauma-induced cataracts. Graft success rate was 88%; the average change in keratometry in the patients with successful grafts was 14.82 /- 2.0 diopters. In the 13 patients eligible for visual acuity tabulation, preoperative acuities ranged from light perception to 20/200, and postoperative acuities ranged from hand motions to 20/30. Ten (77%) had acuities of 20/80 or better. Poor results in three patients with less than 20/200 acuities were likely the results of non-compliance with amblyopia therapy. Present work indicates that in cases of traumatic cataract, the epikeratophakia procedure facilitates amblyopia therapy and decreases the astigmatism in scarred and irregular corneas.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
8/11. Corneoscleral laceration caused by air-bag trauma.PURPOSE: To report a case of a corneoscleral laceration sustained as a direct result of inflation of a driver-side air bag. methods: A patient who sustained a severe ocular injury in a low-speed motor vehicle accident underwent clinical and radiologic examination and subsequent treatment. RESULTS: The left eye underwent primary repair of a complex corneoscleral laceration. Two weeks postoperatively, visual acuity in the left eye remained at bare hand motion. CONCLUSION: Although air-bag-related eye trauma may be relatively infrequent, the severity of the injuries incurred warrant research efforts to explore new air-bag designs that minimize the risk of ocular injury.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
9/11. Severe penetrating eye trauma caused by fish pick accidents.PURPOSE AND methods: The authors describe three cases in which commercial fishermen presented with penetrating ocular injuries from fish picks, which are hand-held, fish-sorting tools with relatively blunt tips designed to partially penetrate fish and expedite handling. Ocular injuries from this tool have not been reported previously. RESULTS: Presenting visual acuity was light perception in two cases and hand motions in one case. Corneal laceration and vitreous hemorrhage were seen in all cases. Initial ultrasound showed no retinal detachment, and all patients underwent primary repair of the corneal laceration. However, within the first 2 months, follow-up ultrasound was suggestive of retinal detachment in all cases, and pars plana vitrectomy was performed. One patient who was found to have a retinal hole but no retinal detachment did well, with a visual acuity of 20/80. Two patients with retinal detachment did poorly, one with a dense epiretinal membrane and the other with a chronic irreparable retinal detachment and extensive subretinal fibrosis. CONCLUSIONS: These injuries differ from fish hook injuries because the instrument is much larger and is blunt in nature, imparting significant energy into the eye. Consequently, patients with these injuries have a much less favorable outcome.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
10/11. Post-traumatic corneal mucormycosis caused by absidia corymbifera.OBJECTIVE: The purpose of the study was to report a case of mycotic keratitis caused by the organism absidia corymbifera (class Zygomycetes, order mucorales, family Mucoraceae). DESIGN: Case report. PARTICIPANT: A healthy 37-year-old farmer scratched his left cornea on a galvanized nail while working in his barn. Within 24 hours, an infiltrate in the interior cornea developed that advanced superiorly, reducing the vision to hand motion by the following day. He was treated with topical and systemic antibiotics and antifungal medications, but the infiltrate spread to the adjacent nasal limbus. INTERVENTION: An 11-mm penetrating keratoplasty was performed with an adjacent nasal 7-mm superficial lamellar sclerectomy. MAIN OUTCOME MEASURES: Pathologic examination of the keratoplasty specimen. RESULTS: Corneal cultures grew A. corymbifera. The organisms were identified in tissue sections by light, fluorescent, electron, and immunoelectron microscopy. CONCLUSIONS: The authors believe that this is the first reported case of keratitis caused by an absidia species and, as such, represents an unusual form of mucormycosis in an otherwise healthy individual.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
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