Cases reported "Eye Injuries, Penetrating"

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1/10. Ocular injury caused by an air bag for a driver wearing eyeglasses.

    BACKGROUND: Although air bags have been shown to reduce the number of fatalities and serious injuries caused by motor vehicle accidents, there have been many reports of air bag-related ocular injuries. We recently treated air bag-related corneal laceration in a patient wearing eyeglasses at the time of a motor accident. CASE: A 38-year-old Japanese man was driving a car at approximately 40 km per hour when he struck a stopped 2-ton truck. He was wearing a three-point lap-shoulder seat belt. At impact, the driver's-side air bag deployed and struck the man on the left side of his face. He was wearing eyeglasses with glass lenses, and the air bag broke the left lens of his eyeglasses, and glass fragments lacerated his cornea. OBSERVATIONS: External examination showed multiple superficial abrasions of the skin and ecchymosis of the left side of his face. Slit-lamp examination of his left eye showed corneal laceration and hyphema. The lens had opacities and was covered with fibrin membrane. Repair of the corneal laceration and phacoemulsification of the lens were performed. Six months later, his best corrected visual acuity was 20/20 in the left eye. CONCLUSIONS: As cars are increasingly equipped with air bags, reports of air bag-related eye injuries have increased. To our knowledge, this is the first reported case of corneal laceration caused by a shattered lens in an air bag-related injury. Ophthalmologists should caution patients about the danger of eye injuries in air bag-equipped cars, and thought should be given to improving the materials for eyeglasses.
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ranking = 1
keywords = hyphema
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2/10. 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.
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ranking = 2
keywords = hyphema
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3/10. 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.
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ranking = 1
keywords = hyphema
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4/10. Favorable outcome using a black diaphragm intraocular lens for traumatic aniridia with total iridectomy.

    A 25-year-old man had a penetrating injury to the left eye. Ocular examination revealed a full-thickness corneal laceration, total aniridia, anterior capsule rupture, and microscopic hyphema. Ten days after the immediate primary-repair surgery, aspiration of the lens secondary to traumatic cataract was performed. Four months later, a black diaphragm intraocular lens was implanted. Postoperatively, the best corrected visual acuity was 20/20 in both eyes. Multifocal spectacles were prescribed to provide the near and far vision required for the patient's job. Normal intraocular pressure and acceptable photophobia were noted during the 18-month follow-up.
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keywords = hyphema
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5/10. Scleral and corneal laceration with iris prolapse caused by an eagle claw.

    BACKGROUND: To describe the visual rehabilitation after surgical treatment of an ocular injury sustained during an attack by a bird of prey. methods: A 51-year-old woman who was attacked by an eagle in a cage had a laceration of cornea and sclera at 9 o' clock, an iris prolapse that was jammed into the scleral wound, and a flat anterior chamber with hyphema. The uncorrected visual acuity was hand movements. Surgical treatment was performed immediately and included iris repositioning and suturing, scleral and conjunctival suturing, and transscleral cryotherapy to the retina. RESULTS: Eight months later, the best corrected visual acuity was 20/20. The anterior segment showed a posterior synechia in the area of the iris repair and an almost round pupil; the crystalline lens showed only a localized opacification. CONCLUSIONS: A bird of prey, even though caged, can injure an eye in humans. With immediate surgical treatment, good visual rehabilitation was achieved in this case. It should be reiterated that spectacles offer no protection against ocular trauma in these cases.
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keywords = hyphema
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6/10. fluorescence of blood-stained cornea.

    Corneal blood staining represents deposition of hemoglobin and its breakdown products within the cornea. Pathologic examination of these corneas typically reveals degenerating endothelial cells and keratocytes. These degenerative changes have typically been attributed to the blunt trauma itself or to toxicity of the erythrocytic debris (a "localized hemosiderosis"). Another possible mechanism for this injury, however, is porphyrin-induced photosensitivity. Examination of frozen sections of an acutely blood-stained human cornea demonstrated fluorescence within all layers of the cornea, similar to that seen with hematoporphyrin derivative. The production of cytotoxic oxygen species within the blood-stained cornea exposed to light may contribute to endothelial and keratocyte degeneration. Limiting light exposure of blood-stained corneas or eyes with hyphemas might theoretically reduce light-induced and porphyrin-mediated toxicity.
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keywords = hyphema
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7/10. Low-dose intraocular tissue plasminogen activator treatment for traumatic total hyphema, postcataract, and penetrating keratoplasty fibrinous membranes.

    tissue plasminogen activator (tPA) has been used to treat severe postcataract and vitrectomy fibrinous membranes, but intraocular bleeding has occurred with doses of 25 micrograms or higher. We report three patients, one with nonclearing total hyphema and uncontrollable intraocular pressure and two with severe fibrinous membrane formation, who had treatment with low-dose (4 micrograms to 6 micrograms) intraocular tPA. Although the fibrinous membranes or hyphema resolved in all three patients, they recurred and bleeding that required additional treatment occurred in one patient. Intraocular low-dose tPA may minimize the risk of corneal and retinal toxicity and may be considered an alternative treatment in intractable cases. However, secondary intraocular hemorrhage can occur, and the timing between the initial vascular injury, treatment with tPA, and subsequent bleeding may reduce the risk of further hemorrhaging.
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ranking = 6
keywords = hyphema
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8/10. diagnosis of traumatic cyclodialysis by ultrasound biomicroscopy.

    BACKGROUND AND OBJECTIVE: To evaluate the ability of high-frequency ultrasound biomicroscopy to diagnose traumatic cyclodialyses not evident on clinical examination. patients AND methods: Six eyes to six patients with posttraumatic hypotony and/or shallow anterior chamber and suspected cyclodialysis clefts were examined with slit-lamp biomicroscopy, gonioscopy, B-scan ultrasonography, and ultrasound biomicroscopy. Ultrasound biomicroscopy provided high resolution of cross-sectional images of the anterior chamber angle, posterior chamber, and anterior uveal tissue. RESULTS: Ultrasound biomicroscopy confirmed the disinsertion of the ciliary body from the scleral spur and associated ciliary body detachment in all eyes. gonioscopy failed to demonstrate a cyclodialysis cleft in five eyes because of hyphema (two eyes) and abnormal iris architecture (related to trauma) precluding visualization of the angle recess (three eyes). Using information from ultrasound biomicroscopy imagining, one patient underwent a ciliary body reattachment procedure and repair of the cyclodialysis cleft. CONCLUSION: Ultrasound biomicroscopy is a noninvasive method that can accurately diagnose the presence of traumatic cyclodialyses and can aid in surgical management. It is particularly useful in the presence of hazy media, hypotony, and/or abnormal anterior segment anatomy.
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ranking = 1
keywords = hyphema
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9/10. Ultrasound biomicroscopy in anterior ocular trauma.

    BACKGROUND AND OBJECTIVE: The authors investigated the role of ultrasound biomicroscopy after ocular trauma. patients AND methods: Ultrasound biomicroscopy was performed in six eyes of six patients at the new york Eye and ear Infirmary after a variety of traumatic ocular injuries. RESULTS: Eyes with angle recession, iridodialysis, cyclodialysis, hyphema, an intraocular foreign body, scleral laceration, and subluxed crystalline lens were imaged without complication. Ultrasound biomicroscopy aided in the diagnosis when visualization was limited by media opacities or distorted anterior segment anatomy. CONCLUSION: Ultrasound biomicroscopy is a safe and effective adjunctive tool for the clinical assessment and management of ocular trauma, especially when visualization is limited and multiple traumatic injuries are involved.
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ranking = 1
keywords = hyphema
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10/10. Ocular sequelae of BB injuries to the eye and surrounding adnexa.

    BACKGROUND: BB injuries continue to be one of the most common causes of severe ocular injury among adolescent males. Extraocular and nonperforating anterior globe injuries most commonly result in favorable visual outcomes. The appropriate medical management of both perforating and nonperforating anterior globe injuries resulting from BB trauma and their potential ocular sequelae are reviewed. case reports: Three cases illustrating typical as well as atypical anterior globe injuries caused by BBs are presented. Two cases involve nonperforating anterior globe injuries--one with intracranial and one with intraorbital involvement. The third involves a retained intraocular foreign body. The biomicroscopic and ophthalmoscopic features of these injuries are discussed, as are potential complications and management strategies associated with these types of trauma. CONCLUSIONS: Injuries associated with intraocular BBs often result in enucleation if functional vision is not salvageable. Sequelae to such injuries include endophthalmitis, traumatic hyphema, ocular siderosis, and sympathetic ophthalmia. Plain-film radiography and axial computed tomography are critical first steps in determination of the position of any intracranial or intraorbital metallic foreign body. Routine observation for the development of ocular sequelae resulting from retained intraocular, intracranial, and intraorbital BB injuries is recommended.
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keywords = hyphema
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