1/132. siderosis bulbi resulting from an intralenticular foreign body.PURPOSE: To report a case of siderosis bulbi that resulted from a small intralenticular foreign body. METHOD: Case report. RESULTS: A 36-year-old man with normal visual acuity and a peripheral intralenticular iron foreign body in the left eye was treated conservatively. Nine weeks after the injury, he had ocular signs of siderosis bulbi, with changes in the electroretinogram. A clear lens aspiration with removal of the foreign body was performed. After removal of the iron foreign body, no progression or regression of the ocular signs of siderosis bulbi has occurred, and the electroretinogram has not changed over a 2-year period. CONCLUSIONS: Even in the presence of good vision, a patient with an intralenticular ferrous foreign body should be followed closely, and the foreign body should be removed before irreversible siderosis bulbi occurs.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
2/132. "A little reminder does no harm": case report.A case of falsified non-accidental ocular injury of a 29 year old male is presented. The importance of an accurate history and appropriate investigations in the management of ocular injuries is highlighted to promote a high standard of health care delivery in zimbabwe.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
3/132. Orbitocranial injury caused by wood.A rare case of a patient with orbitocranial injury by a wooden foreign body is reported. Penetrating periorbital wound by a wooden stick with entry site at the right upper eyelid was related to the invasion into the temporal lobe. Fortunately, the anterior and posterior segments of eye were unharmed, but right ocular motility was markedly restricted mechanically in all directions. Forced duction test was strong positive, especially the dextroversion of the right eye. Computed tomography scan showed a well-delineated low density from the orbital wall into the temporal lobe. The wooden foreign body was subsequently removed from the orbit and the temporal lobe, through the neurosurgical frontotemporal approach. After the wooden foreign body was removed, the ocular movement of the right eye fully recovered without any intracranial or ocular complications.- - - - - - - - - - ranking = 5keywords = injury (Clic here for more details about this article) |
4/132. hyphema caused by a metallic intraocular foreign body during magnetic resonance imaging.PURPOSE: To report a 63-year-old man with a retained intraocular foreign body who developed a hyphema during magnetic resonance imaging (MRI) of the brain. methods: Case report and review of the current literature on ocular injury caused by intraocular foreign bodies when subjected to an electromagnetic field. RESULTS: Our patient underwent a brain MRI, and the intraocular foreign body caused a hyphema and increased intraocular pressure. The presence and location of the intraocular foreign body were determined by computed tomography (CT). CONCLUSION: magnetic resonance imaging can cause serious ocular injury in patients with ferromagnetic intraocular foreign bodies. This case demonstrates the importance of obtaining an occupational history, and, when indicated, a skull x-ray or CT to rule out intraocular foreign body before an MRI study.- - - - - - - - - - ranking = 2keywords = injury (Clic here for more details about this article) |
5/132. eye injuries in a terrorist bombing: Dhahran, saudi arabia, June 25, 1996.OBJECTIVE: We report the experience of our institution in the evaluation and care of multiple simultaneous ocular trauma patients after a terrorist bomb attack on a united states military base in saudi arabia. DESIGN: Retrospective, noncomparative small case series. PARTICIPANTS: Three patients who received severe ocular injuries after a terrorist bombing. INTERVENTION: All patients underwent surgical repair of the injuries that were inflicted as a result of the terrorist bombing. MAIN OUTCOME MEASURES: Baseline ocular characteristics, intraoperative findings, surgical procedures, and final (3 years after injury) anatomic and visual outcomes were noted. RESULTS: glass fragments caused by the blast were the mechanism of all the ocular injuries in these patients. All patients had primary repair of the injuries done in saudi arabia and were sent to our institution for tertiary care. Three of the four eyes injured had stable or improved visual acuity and one eye was enucleated. Two patients had no serious injury other than the globe trauma. One patient had extensive eyelid trauma and required serial procedures to allow fitting of a prosthesis. CONCLUSIONS: Blast-injury patients are at risk for open globe injury as a result of glass fragments. The types of injury that can occur from terrorist blasts can be extensive and involve all the tissues of the eye, the ocular adnexa, and the orbit.- - - - - - - - - - ranking = 5keywords = injury (Clic here for more details about this article) |
6/132. Recurrent fungal keratitis and endophthalmitis.PURPOSE: To report a case of recurrent fungal sclerokeratitis and endophthalmitis with a very successful outcome due to aggressive combined surgical and medical therapy. To discuss the management of this potentially devastating infection. methods: A 65-year-old man presented with 6 months of left eye redness and irritation after injury from organic matter propelled from an airboat. Initially, he had been treated with foreign body removal, antibiotics, and steroids. He was diagnosed with reactive sclerokeratitis at presentation and was treated with steroids. However, when he did not improve, cultures were obtained and acremonium species filamentous fungi was identified. Despite treatment with appropriate topical and systemic antifungals, his fungal sclerokeratitis progressed to endophthalmitis. Two therapeutic penetrating keratoplasties (PKs) with iridectomy and intraocular amphotericin b were necessary to eradicate the fungal infection. RESULTS: visual acuity was restored to 20/25-3 with correction 9 months after initial presentation. There was no recurrence of fungal infection after the second therapeutic PK. CONCLUSION: The possible reasons for recurrence of fungal infection are discussed. The role of timely and aggressive medical and surgical intervention for fungal sclerokeratitis and endophthalmitis in restoring excellent vision is emphasized.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
7/132. Intracranial penetrating orbital injury.The authors report a case of double-penetrating injury of the globe with intracranial involvement from a pellet gun. A 16-year-old boy had a visual acuity of bare light perception in the left eye after being hit by a pellet. There was an inferior limbal entry site, dense hyphema, and no view of the fundus. Computed tomographic scan showed the pellet intracranially close to the left cavernous sinus. After neurosurgical clearance, the patient underwent primary closure of the corneoscleral entry site followed 3 weeks later by pars plana vitrectomy, lensectomy, and repair of a rhegmatogenous retinal detachment. At 12 months postoperatively, visual acuity was 20/300 and the retina was attached. Our case demonstrates the potential for significant visual recovery in some patients with a penetrating orbital injury and intracranial involvement. Complete radiographic evaluation with neurosurgical consultation is important in the management of these patients prior to ophthalmologic intervention with possible foreign body removal. There is a need for more public awareness regarding the potentially harmful effects of pellet guns.- - - - - - - - - - ranking = 6keywords = injury (Clic here for more details about this article) |
8/132. Two remarkable events in the field of intraocular foreign body: (1) The reversal of siderosis bulbi. (2) The spontaneous extrusion of an intraocular copper foreign body.Two unusual events concerning intraocular foreign bodies are presented. The first patient had an occult or unsuspected intraocular foreign body. He showed iridoplegia with mydriasis, siderosis iridis, and an intraocular piece of iron lying posteriorly near the retina. The foreign body was removed and the patient regained normal iris color and pupillary activity. His vision remains 20/15 six years postoperatively dispite ensuing retinal detachment one year after removal of the foreign body. The second patient was a young boy injured by a blasting cap explosion. He lost one eye from the injury and had a piece of intraocular brass in his left eye. In spite of the development of chalcosis and a mature cataract the lens gradually shrank in the pupillary space permitting a clear aphakic area and 20/25 vision. The brass fragment migrated forward and inferiorly and was finally extruded under the conjunctiva five years later, where it was removed and chemically analyzed by x-ray diffraction.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
9/132. Foreign body orbital cyst.PURPOSE: To present the clinical and histopathological characteristics of a retained orbital foreign body. methods: A 34-year-old male was hit in his left eye by a flower stake. At first examination there was a massive haematoma of the left orbit and eyelids, reduced movement of the left eye and a small conjunctival lesion beneath the upper lid. There were no signs of deeper orbital or ocular lesions. During the subsequent months the haematoma disappeared, but increased proptosis and impaired eye movements with diplopia were noticed. One year after the injury, ultrasound and CT-scan revealed an ovoid cystic tumour behind the globe. During surgery the content of the cyst appeared purulent and from the centre of the cyst a foreign body measuring 25 x 13 x 1 mm was removed. RESULTS: microscopy of the foreign body showed the typical structure of a decidual leaf. The superficial cells were empty, whereas the centrally located cells contained remnants of cytoplasm. Confined to the border between the empty and the filled cells, a band of cells containing groups of gram positive cocci was noted. Staining for immunoglobulins revealed traces of IgG in the superficial empty cells only. CONCLUSION: The high degree of preservation of the leaf and the survival of the cocci may be due to a barrier function of the intact plant cell walls with their high content of cellulose.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
10/132. X-ray turns a blind eye to ferrous metal.The case is reported of a 31-year-old man with a retained metallic intraocular foreign body (IOFB) in the left eye who underwent magnetic resonance imaging (MRI) for investigation of a subsequent unrelated brachial plexus injury Despite the patient providing good history of IOFB, the decision to proceed with MRI was based on screening orbit X-ray which was reported as normal. A review of published reports regarding screening recommendations for MRI for patients with IOFB is provided. A minimum recommendation is for prescreening questionnaire; belief of the patient history is critical. If there is any doubt after history and examination by an ophthalmologist, then computed tomography imaging of the orbits is recommended.Whether screening by plain X-ray imaging is worthwhile is debatable as the sensitivity and specificity of this modality is poor.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
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