1/7. Puncture wounds caused by glass mistaken for with stab wounds with a knife.Three cases are presented where fatal puncture wounds caused by broken glass were very similar to stab wounds inflicted by a knife with a single-edged blade. Thus, all three cases caused a murder investigation to be initiated. It could only be determined that these wounds had been caused by glass after a detailed forensic autopsy. In two of the three cases, the only evidence for this was the identification of glass fragments in the wounds. The importance of X-ray examinations is underlined because modern glass in common use is radiopaque. glass fragments lodged in the wounds can reduce the loss of blood and thus, prolong the capacity to act despite severe injuries.- - - - - - - - - - ranking = 1keywords = puncture (Clic here for more details about this article) |
2/7. Traumatic epithelial flap detachment after laser subepithelial keratomileusis.PURPOSE: To report a case of corneal epithelial flap detachment 20 days after laser subepithelial keratomileusis (LASEK). methods: A 30-year-old man underwent LASEK for correction of myopia. On postoperative day 8, he was comfortable and the corneal epithelium healed completely with uncorrected visual acuity (UCVA) of 20/20. On postoperative day 20, the corneal epithelial flap on the right eye detached and was lost during pressure patching after puncture of the hordeolum. RESULTS: The corneal defect was treated with a bandage contact lens, levofloxacin, and hyaluronic acid eye drops. Ten days after detachment, UCVA had improved to 20/20 and the epithelium had closed completely. CONCLUSIONS: Mild trauma can cause epithelial flap detachment during the early postoperative period of LASEK.- - - - - - - - - - ranking = 1keywords = puncture (Clic here for more details about this article) |
3/7. Successful treatment of recurrent corneal erosion with Nd:YAG anterior stromal puncture.I used a new technique to create anterior corneal stromal punctures for the treatment of traumatic recurrent corneal erosions that had not responded to conventional therapy. Three patients with such erosions within the visual axis were successfully treated by using multiple applications of the Nd: YAG laser set at energy levels between 1.8 and 2.2 mJ. One of these patients had previous stromal puncture with a bent 25-gauge needle. The erosions of all patients healed without complications and have remained symptom-free for four to six months. Compared with needle puncture, the laser punctures were more reproducible, shallow, and translucent.- - - - - - - - - - ranking = 8keywords = puncture (Clic here for more details about this article) |
4/7. Minor trauma, disastrous results.An 81-year-old-woman developed a right facial palsy and orbital cellulitis following an apparently innocuous puncture injury of the right lower eyelid. Generalized tetanus ensued which proved fatal despite aggressive treatment including use of tetanus immune globulin, wound debridement, and neuromuscular blockade with ventilatory assistance. tetanus immunization status should be ascertained in all patients with potentially contaminated wounds in and around the eye. Cephalic tetanus, may be misleading initially because of the presence of cranial nerve palsies and the absence of classic signs such as trismus and risus sardonicus.- - - - - - - - - - ranking = 1keywords = puncture (Clic here for more details about this article) |
5/7. Recurrent erosion. Treatment by anterior stromal puncture.The majority of patients with recurrent corneal erosion respond to conventional forms of therapy such as topical lubricants, patching, debridement, or bandage soft contact lenses. However, there remain a small number who do not. For the small number of patients who do not respond to this type of treatment, this report describes a procedure: multiple anterior stromal punctures are created that presumably stimulate more secure epithelial adhesion to the underlying stroma. Of 21 eyes in 18 patients treated in this manner, three eyes required retreatment of adjacent areas; otherwise, there were no recurrences in follow-up periods ranging from 5 months to 12 years. This procedure is a simple and effective method for safe office treatment of patients with recalcitrant recurrent erosion.- - - - - - - - - - ranking = 5keywords = puncture (Clic here for more details about this article) |
6/7. The danger of intracranial wood.Peri-orbital puncture wounds by sharp wooden objects are not rare, but can be dangerous when there is intracranial penetration by and retention of the wooden foreign body. Days to years after an apparently trivial initial wounding, serious intracranial complications can occur. The authors have reviewed 42 case reports from the literature. morbidity-defined as permanent neurologic sequelae-occurred in 74% of the cases. Intracranial suppuration was the major complication, with brain abscess having occurred in nearly one-half of the cases. mortality occurred in 25% of 28 cases occurring in the post-antibiotic era. The qualities of wood which make it especially hazardous as a wounding agent and foreign body are discussed. The role of orbital anatomy in affording easy access to the cranial contents is described. Surgical exploration in all those cases in which there is a reasonable suspicion of intracranial injury is recommended.- - - - - - - - - - ranking = 1keywords = puncture (Clic here for more details about this article) |
7/7. Unrecognized microscopic hyphema masquerading as a closed head injury.OBJECTIVE: To present a child with an unrecognized microscopic traumatic hyphema and acute glaucoma who was initially treated as a closed head injury patient. DESIGN: Case report and discussion. RESULTS: Symptoms attributable to unrecognized occult ocular injury in a child with sickle cell trait resulted in evaluation and treatment of the child for a closed head injury. Evaluation included a computed tomography scan of the head and lumbar puncture. An ophthalmologic consultation later revealed a microscopic hyphema and acute glaucoma as the etiology of the child's signs and symptoms. CONCLUSIONS: Children who present with neurologic symptoms and a history of ocular trauma should undergo an ophthalmologic examination as soon as possible. hyphema, even if not readily visible on physical examination, can result in the development of acute glaucoma with signs and symptoms that resemble a closed head injury.- - - - - - - - - - ranking = 1keywords = puncture (Clic here for more details about this article) |