Cases reported "Wounds, Nonpenetrating"

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1/22. eye injuries associated with paintball guns.

    AIMS: This study identifies the various types of ocular injuries sustained after blunt trauma with a paintball fired from a paintball gun. methods: We report two patients who sustained injury to an eye after being shot with a paintball and review similar cases presented in the world literature. The type of injury sustained and the final visual acuity obtained after a paintball hit to the eye are examined. RESULTS: The two boys presented were hit in the eye with a paintball resulting in lens subluxation, hyphema formation, and angle recession. cataract extraction was required in both cases. One boy also had an optic neuropathy and a choroidal rupture. A review of the literature reveals a variety of injuries occur after a paintball hit to the eye. In some of the cases, the damage to the eye has led to loss of vision and at times loss of the eye. CONCLUSIONS: Paintball guns can cause devastating ocular injuries. Wearing protective eye and face gear during this game is essential. We recommend that an anti-fog face mask with a one-piece polycarbonate eye shield be worn by those participating in paintball games.
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keywords = hyphema
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2/22. Partial dislocation of laser in situ keratomileusis flap by air bag injury.

    PURPOSE: A patient developed significant corneal complications from air bag deployment, 17 months after laser in situ keratomileusis (LASIK). methods: Case report, slit-lamp microscopy, and review of the medical literature. RESULTS: A 37-year-old woman underwent bilateral LASIK with resultant 20/20 uncorrected visual acuity. Seventeen months later, she sustained facial and ocular injuries from air bag deployment during a motor vehicle accident. Examination revealed bilateral corneal abrasions, partial dislocation of the right corneal LASIK flap, and a hyphema in the right eye. The LASIK flap was realigned, but recovery was complicated by a slowly healing epithelial defect and flap edema. One month following the injury, epithelial ingrowth beneath the LASIK flap was noted. Surgical elevation of the flap and removal of the epithelial ingrowth was performed. Eight months later, epithelial ingrowth was absent and the visual acuity was 20/40. Residual irregular astigmatism necessitated rigid gas permeable contact lens fitting to achieve 20/20 visual acuity. CONCLUSIONS: air bags may cause significant ocular trauma. The wound healing response of LASIK allows corneal flap separation from its stromal bed for an indeterminate time after surgery. Discussion of the possible risk of corneal trauma as part of informed consent prior to LASIK may be appropriate.
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keywords = hyphema
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3/22. A case of isolated posterior capsule rupture and traumatic cataract caused by blunt ocular trauma.

    An isolated rupture of the posterior capsule that is caused by a blunt ocular trauma has been rarely reported and is usually detected incidentally during surgery for a complicated cataract. We found an isolated posterior capsule rupture on the third day after trauma in a 25-year-old man who was admitted for the treatment of traumatic hyphema and we performed a phacoemusification and anterior vitrectomy with PC-IOL, implantation because of the traumatic cataract which had progressed after the injury. The PC-IOL was implanted safely into the capsular bag without severe enlargement of the posterior capsular rupture. The break seems to function as a capsulotomy which provides a clear visual axis. We report this case with a review of the literatures.
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4/22. 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.
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5/22. Traumatic expulsive iridodialysis after small-incision sutureless cataract surgery.

    phacoemulsification with intraocular lens (IOL) implantation was performed in the right eye of an 84-year-old woman using a small clear corneal incision. Ten weeks after surgery, the patient fell, which caused traumatic iridodialysis and hyphema with expulsion of the iris through the surgical corneal incision. Apart from a transient rise in intraocular pressure, no other complication was identified and the visual acuity returned to 20/20 within 2 months. The IOL remained in situ and undisturbed in the capsular bag, and the retina remained flat, suggesting that an IOL in the capsular bag may provide a stable barrier to prevent tissue loss from the posterior segment.
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keywords = hyphema
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6/22. Delayed suprachoroidal hemorrhage and factor viii deficiency.

    PURPOSE: To describe the clinical course of a 52-year-old white man with previously undiagnosed hemophilia who suffered blunt trauma to the right eye with consequent delayed, spontaneous suprachoroidal hemorrhage. DESIGN: Observational case report. methods: The patient's clinical course from the time of trauma to postenucleation is discussed and correlated with B-scan ultrasonography and histopathology. RESULTS: The patient developed recurrent hyphemas, delayed choroidal hemorrhage with detachment and eventually loss of the eye. Hematologic evaluation established a diagnosis of mild factor viii deficiency. CONCLUSION: Despite mild hemophilia, this patient had not experienced any clinically important morbidity until his eye injury. Ophthalmologists should be aware that bleeding disorders such as hemophilia predispose patients to spontaneous intraocular hemorrhage.
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keywords = hyphema
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7/22. Sympathetic ophthalmia after a hyphema due to nonpenetrating trauma.

    PURPOSE: To report a case of sympathetic ophthalmia occurring after nonpenetrating ocular trauma. methods: Interventional case report. RESULTS: An 18-year-old white male presented with sympathetic ophthalmia four weeks after a hyphema from a nonpenetrating bungee cord injury. Vision was 20/20; there were keratic precipitates, anterior chamber cells, vitritis, and discrete yellow deep choroidal lesions consistent with Dalen-Fuch's nodules OU. The uveitis was treated with topical, oral, and periocular corticosteroids and the oral immunosuppressives cyclosporine and mycophenolate mofetil. Vision remained 20/20 OU for the first year of follow-up; vision OD then deteriorated to 20/50 over the next year with the formation of a posterior subcapsular cataract OD. CONCLUSION: Sympathetic ophthalmia may result from nonpenetrating ocular trauma. Ophthalmologists should be aware of this as prompt intervention is warranted.
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keywords = hyphema
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8/22. Magnetic susceptibility artifact in orbital magnetic resonance imaging.

    Case report of a 16-year-old boy presenting with total hyphema due to blunt trauma to the left eye. During a subsequent cinematic MRI scan to identify salvageable lateral rectus muscle, the attachment of the left lateral rectus was obscured by a 20-mm diameter signal void. A subsequent CT scan for a suspected metallic foreign body revealed the muscle attachment after all. The theoretical explanations for this finding are discussed.
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keywords = hyphema
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9/22. Ocular blunt trauma: loss of sight from an ice hockey injury.

    A case of ocular blunt trauma is described in which a 17 year old male ice hockey player collided with an opponent during a game. The opponent's stick travelled under the patient's half face visor and struck his left eye causing hyphema, angle recession, lens subluxation, and choroidal rupture over the macula, permanently reducing his vision to counting fingers. Sequelae of ocular blunt trauma are discussed along with methods of injury prevention by addressing players' behaviour and safety equipment. This injury is unlikely to have occurred with properly used full face protection.
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10/22. Traumatic aniridia in a pseudophakic eye.

    A case is presented that illustrates selective disinsertion and extrusion of iris tissue after blunt trauma without damage to the intraocular lens (IOL). This was an observational case report of a single patient treated as an inpatient using topical steroids and antiglaucoma drugs. Progress was monitored by tonometry and slitlamp examination. Total absence of iris tissue was discovered after resolution of hyphema with restoration of vision. Absence of iris tissue was confirmed on gonioscopy and fundoscopy. The IOL was found undisplaced and intact in the capsular bag, and visual function was restored. The insertion of foldable IOLs through self-sealing small-incision cataract sections confers protection to the globe in the face of blunt trauma in 2 ways. The self-sealing cataract section acts as a release valve during the compressive phase and allows extrusion of the disinserted iris tissue, whereas the flexible IOL absorbs the impact and prevents disruption of surrounding tissues.
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keywords = hyphema
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