Cases reported "Eye Injuries, Penetrating"

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1/98. 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.
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2/98. A case of bacterial endophthalmitis following perforating injury caused by a cat claw.

    A case of bacterial endophthalmitis following a perforating ocular injury caused by a cat claw is reported. The scleral wound was sutured immediately following the injury and systemic antibiotics were administered. Despite this treatment, endophthalmitis occurred 3 days after the injury. The endophthalmitis was resolved by pars plana vitrectomy, however preretinal reproliferation and retinal detachment subsequently occurred. After reoperation the retina was reattached and the corrected visual acuity improved from 10 cm/HM to 20/200. pseudomonas aeruginosa was detected in cultured vitreous humor that was collected during surgery. This case illustrates the possibility of endophthalmitis being caused by gram negative bacillus in cases of perforating injuries caused by animal claws. Perforating ocular injuries caused by animal claws are relatively rare. Here we report a case of endophthalmitis due to pseudomonas aeruginosa that occurred after a perforating injury caused by a cat claw. The eye was treated by pars plana vitrectomy.
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keywords = visual
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3/98. Post-traumatic endophthalmitis: causative organisms and visual outcome.

    PURPOSE: Post-traumatic endophthalmitis makes up a distinct subset of intraocular infections. The purpose of the present study was to identify the causative organisms and record the visual outcome after infectious endophthalmitis in eyes with penetrating trauma. methods: We reviewed 18 consecutive cases of culture-positive endophthalmitis that developed after penetrating ocular trauma. All cases were treated with pars plana vitrectomy and intravenous and intraocular antibiotics. RESULTS: The 15 males and 3 females ranged in age from 4 to 43 years (mean 25.1 /- 11 years). Nine (50%) had intraocular foreign bodies. A single species was isolated in 16 cases, and multiple organisms in two. staphylococcus epidermidis and gram-negative organisms were the most frequent and were cultured either alone or in association with other organisms in respectively five (27.7%) and four cases (22.2%). clostridium perfringens was isolated in three cases (16.6%). bacillus was not found as a cause of endophthalmitis. Final visual acuity was better than 20/400 in eight cases (44%). In five cases (27.7%), the eye was saved but visual acuity was counting fingers. Two eyes (11%) had no light perception. The remaining three eyes (16.6%) were enucleated or eviscerated. clostridium perfringens was isolated from two eyes and aspergillus niger from one. Postoperative retinal detachment developed in four eyes, which were successfully operated. CONCLUSIONS: Organisms isolated in this series were similar to those in previous reports of post-traumatic endophthalmitis from other parts of the world, except that the frequency of clostridium perfringens isolation was high and no bacillus species were cultured. In view of its devastating outcome, post-traumatic endophthalmitis must be treated promptly with vitrectomy and intravitreal antibiotics.
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keywords = visual
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4/98. 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 = visual
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5/98. Caterpillar setae in the deep cornea and anterior chamber.

    PURPOSE:To report a case of caterpillar setae embedded in the deep cornea and anterior chamber. methods: A 26-year-old man was struck in his right eye by a caterpillar (Dendrolimus punctatus walker). Severe conjunctival injection, chemosis, and erosion of the cornea developed immediately. Numerous setae fragments were found to be embedded into the palpebral conjunctiva and deep cornea, extending into the anterior chamber near the anterior iris surface. RESULTS: After partial removal of the setae under a microscope, the inflammation subsided and visual acuity improved to RE: 20/20. CONCLUSION: Caterpillar setae are sharp enough to penetrate the cornea and extend into the anterior chamber.
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keywords = visual
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6/98. Anterior segment ischemia and retinal detachment after vertical rectus muscle surgery.

    PURPOSE: The authors describe the clinical course of a woman who developed two complications following vertical strabismus repair: anterior segment ischemia (ASI) and retinal detachment. methods: A 62 year-old woman is described. She presented with new onset proptosis and left hypertropia with significant diplopia in all fields of gaze. This presentation, her 15 year history of thyroid disease, and preoperative computed tomography (CT) of the orbits were consistent with Graves' ophthalmopathy. Vertical strabismus repair was carried out by recessing the left superior rectus muscle and resecting the left inferior rectus muscle. RESULTS: The diplopia was eliminated. The patient developed significant postoperative ASI and iatrogenic rhegmatogenous retinal detachment in the left eye due to unsuspected globe perforation. She was treated with systemic corticosteroids and radial scleral buckling. CONCLUSIONS: Severe ASI following strabismus surgery is a well recognized complication, with age, thyroid ophthalmopathy, and manipulation of the vertical rectus muscles as risk factors. The retinal detachment soon after strabismus surgery was difficult to detect, possibly due to diminished visualization of the posterior segment as a result of ASI.
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ranking = 1
keywords = visual
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7/98. 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.
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ranking = 2
keywords = visual
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8/98. Combined cataract extraction and submacular blood clot evacuation for globe perforation caused by retrobulbar injection.

    A 45-year-old woman, originally scheduled for cataract surgery in the left eye, was referred for management of a globe perforation noticed after the retrobulbar injection of an anesthetic solution. There was a moderate degree of vitreous hemorrhage, and initial visual acuity was hand movement. A submacular blood clot of about 4-disc diameter was detected when the vitreous hemorrhage gradually cleared. One week after the incident, combined phacoemulsification, intraocular lens implantation, pars plana vitrectomy, and submacular clot removal using tissue plasminogen activator (tPA) as an adjunct were performed. Recovery was uneventful. At the last follow-up 6 months after surgery, best corrected visual acuity was 20/30.
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ranking = 2
keywords = visual
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9/98. 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 = 3
keywords = visual
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10/98. Corneal laceration with total but isolated aniridia caused by a pecking injury.

    A 38-year-old man sustained a left eye injury after being attacked by a mynah bird. Ocular examination revealed a beak-shaped, full-thickness corneal laceration with total aniridia in the left eye. No other ocular injury was observed, and the lens and posterior segment remained normal over the subsequent 3 months. A penetrating keratoplasty was planned for visual restoration.
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ranking = 1
keywords = visual
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