RESUMEN
BACKGROUND: The Military Health System recognizes the importance of analyzing "foreign bodies" removed from US service members through several policy documents. This activity focuses on detecting potentially toxic metals. Intra-ocular "foreign bodies" (IOFBs) represent a small, clinically important subset. The development of ocular metallosis with iron and copper fragments is a specific local reaction to IOFBs. The results of the compositional analysis of removed IOFBs can influence clinical management decisions aimed at optimizing the preservation of sight. METHOD: The Joint Pathology Center (JPC) and Vision Center of Excellence (VCE) have established a pathway for the analysis of IOFBs removed from Department of Defense and Veterans Health Administration patients. The analysis of IOFBs uses analytical methods to provide information about the fragments' surface elemental and molecular composition. RESULTS: Metallic specimens analyzed included iron and copper-containing fragments. Non-metallic IOFBs analyzed include glass, plastic (polyurethane), and nitro-cellulose fragments. CONCLUSION: The JPC/VCE approach to analyzing IOFBs promotes uniform handling and shipping of specimens to minimize contamination. The analytical approach allows for the characterization of IOFBs with a wide variety of compositions. The results support clinical management decisions aimed at optimal treatment for the preservation of patients' visual acuity.
Asunto(s)
Cuerpos Extraños en el Ojo/inducido químicamente , Cuerpos Extraños en el Ojo/diagnóstico , Ojo/patología , Adulto , Ojo/fisiopatología , Cuerpos Extraños en el Ojo/fisiopatología , Lesiones Oculares Penetrantes/inducido químicamente , Lesiones Oculares Penetrantes/diagnóstico , Lesiones Oculares Penetrantes/fisiopatología , Femenino , Guías como Asunto/normas , Humanos , Masculino , Triaje/métodos , Triaje/normasAsunto(s)
Antiinflamatorios/efectos adversos , Lesiones Oculares Penetrantes/inducido químicamente , Metilprednisolona/análogos & derivados , Metilprednisolona/efectos adversos , Lesiones por Pinchazo de Aguja/inducido químicamente , Retina/efectos de los fármacos , Degeneración Retiniana/inducido químicamente , Desprendimiento de Retina/inducido químicamente , Esclerótica/lesiones , Adolescente , Lesiones Oculares Penetrantes/diagnóstico , Lesiones Oculares Penetrantes/cirugía , Femenino , Angiografía con Fluoresceína , Humanos , Inyecciones/efectos adversos , Coagulación con Láser , Acetato de Metilprednisolona , Lesiones por Pinchazo de Aguja/diagnóstico , Lesiones por Pinchazo de Aguja/cirugía , Retina/lesiones , Retina/cirugía , Degeneración Retiniana/diagnóstico , Degeneración Retiniana/cirugía , Desprendimiento de Retina/diagnóstico , Desprendimiento de Retina/cirugía , Esclerótica/cirugía , Agudeza Visual , VitrectomíaRESUMEN
Pepper spray containing oleoresin capsicum is used by law enforcement and the public as a form of nonlethal deterrent. Stimulated by the identification of a case of a corneal abrasion associated with pepper spray exposure, a descriptive retrospective review of a physician-maintained log of patients presenting to a jail ward emergency area over a 3-year period was performed. The objective was to give some quantification to the frequency with which an emergency physician could expect to see corneal abrasions associated with pepper spray exposure. Of 100 cases of pepper spray exposure identified, seven patients had sustained corneal abrasions. We conclude that corneal abrasions are not rare events when patients are exposed to pepper spray and that fluorescein staining and slit lamp or Wood's lamp examination should be performed on all exposed patients in whom corneal abrasions cannot be excluded on clinical grounds.
Asunto(s)
Capsicum/efectos adversos , Lesiones de la Cornea , Tratamiento de Urgencia/métodos , Lesiones Oculares Penetrantes/inducido químicamente , Plantas Medicinales , Adolescente , Adulto , Aerosoles , Medios de Contraste , Servicio de Urgencia en Hospital/estadística & datos numéricos , Lesiones Oculares Penetrantes/diagnóstico , Lesiones Oculares Penetrantes/terapia , Femenino , Fluoresceína , Medicina Legal , Humanos , Masculino , Persona de Mediana Edad , Policia , Guías de Práctica Clínica como Asunto , Prisiones , Estudios Retrospectivos , Agudeza VisualRESUMEN
In this report we present a patient on whom a sub-Tenon injection of steroids was performed, with the intention of treating an active chorio-retinitis threatening the macula. The globe was inadvertently penetrated and part of the steroid solution released into the vitreous cavity. Conservative treatment was decided upon and a spontaneous complete resolution of the complication was observed after a period of 24 days.