ABSTRACT
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.
Subject(s)
Eye Foreign Bodies/chemically induced , Eye Foreign Bodies/diagnosis , Eye/pathology , Adult , Eye/physiopathology , Eye Foreign Bodies/physiopathology , Eye Injuries, Penetrating/chemically induced , Eye Injuries, Penetrating/diagnosis , Eye Injuries, Penetrating/physiopathology , Female , Guidelines as Topic/standards , Humans , Male , Triage/methods , Triage/standardsSubject(s)
Anti-Inflammatory Agents/adverse effects , Eye Injuries, Penetrating/chemically induced , Methylprednisolone/analogs & derivatives , Methylprednisolone/adverse effects , Needlestick Injuries/chemically induced , Retina/drug effects , Retinal Degeneration/chemically induced , Retinal Detachment/chemically induced , Sclera/injuries , Adolescent , Eye Injuries, Penetrating/diagnosis , Eye Injuries, Penetrating/surgery , Female , Fluorescein Angiography , Humans , Injections/adverse effects , Laser Coagulation , Methylprednisolone Acetate , Needlestick Injuries/diagnosis , Needlestick Injuries/surgery , Retina/injuries , Retina/surgery , Retinal Degeneration/diagnosis , Retinal Degeneration/surgery , Retinal Detachment/diagnosis , Retinal Detachment/surgery , Sclera/surgery , Visual Acuity , VitrectomyABSTRACT
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.
Subject(s)
Capsicum/adverse effects , Corneal Injuries , Emergency Treatment/methods , Eye Injuries, Penetrating/chemically induced , Plants, Medicinal , Adolescent , Adult , Aerosols , Contrast Media , Emergency Service, Hospital/statistics & numerical data , Eye Injuries, Penetrating/diagnosis , Eye Injuries, Penetrating/therapy , Female , Fluorescein , Forensic Medicine , Humans , Male , Middle Aged , Police , Practice Guidelines as Topic , Prisons , Retrospective Studies , Visual AcuityABSTRACT
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.