Clinical evaluation of ophthalmic findings in active, amateur, adult, competitive male boxers in India.

Background: In the popular fighting sport of boxing, opponents strike each other above the belt line in the face, chest, and belly. The physical parts most exposed are therefore the nose and eyes. In amateur boxing, fights go only three rounds - three minutes for men and one minute for women - with a one-minute break in between. They wear gloves, but the head protection used in the men's game has been removed by AIBA due to the high likelihood of concussion when using head protection. Because chronic ocular changes may take longer than the expected short-term effects, this study included at least 3 years of competitive sports participation. Study design and setting: Institutional-based cross-sectional study. Materials and methods: To evaluate ophthalmic outcomes, 200 eyes of 100 active amateur, adult, and competitive male boxers were studied. Results: Of the 100 boxers, 51 had ophthalmic changes in at least one eye, and 49 had normal eyes. The average age of boxers was 24.98 years. The average duration of boxing training was 7.04 years. Healed eyelid scars, subconjunctival hemorrhages, conjunctival papillae, traumatic mydriasis, posterior synechiae, angulation abnormalities, traumatic cataracts, lens subluxation, increased intraocular pressure, and peripapillary atrophy were observed on the ocular side. None of these could be attributed to boxing. Conclusion: Boxing-related eye injuries are common in India and the most common vision-threatening eye abnormalities include traumatic cataracts, lens subluxation, and angle abnormalities. Surprisingly, no macular lesions were found on physical examination and OCT. Additional studies with a larger number of boxers will be needed to evaluate and prevent clinical symptoms. All boxers should have a complete eye exam regularly. Abbreviations: AIBA = Association Internationale de Boxe Amateur, OCT = Optical Coherence Tomography.

Patterns of concomitant traumatic brain injury and ocular trauma in US service members.

Background: Concomitant traumatic brain injury (TBI) and ocular trauma (OT) are caused by the same physical mechanisms, which may complicate therapeutic intervention if screening and evaluation of each condition are not promptly initiated. The aim of this study is to identify concomitant TBI in OT patients and characterize the pattern of those injured service members (SMs) in non-combat environments to assist in the early detection and treatment of both TBI and OT. Methods: Encounters matching the case definitions of TBI and OT for injured SMs were extracted from the Military Health System. Concomitant TBI and OT was identified as patients who were diagnosed with both medical conditions within 30 days. Incidence rates of concomitance were analyzed using a Poisson regression model. The odds of mechanisms and types of OT with concomitant TBI were analyzed using logistic regression models. Results: From 2017 to 2021, there were 71 689 SMs diagnosed with TBI, and 69 358 patients diagnosed with OT. There were 3251 concomitant cases identified. The overall concomitance rate in OT patients was 4.7%. Clinical presentations of concomitant OT had a higher rate of complications. Blast, transport accidents, assaults, alcohol, falls, and sports-related injuries (in decreasing order) were significantly associated with concomitance rates. Compared with closed globe injuries, OT with orbital fractures, rupture, laceration, adnexal periocular injury, and penetrating injury had higher risks of concomitant TBI. For patients with orbital fractures, nearly half (44.1%) sustained a concomitant TBI. Conclusions: A practical approach using temporal proximity of diagnostic data was developed to identify concomitant cases of TBI and OT which presented with more severe injury types than non-concomitant cases. These results indicate OT patients with orbital or open globe injuries sustained from high-impact mechanisms warrant further TBI screening to prompt early detection and treatment. Level of evidence: IV.

Orchard Sports Injury and Illness Classification System (OSIICS) Version 15.

BACKGROUND: Sports medicine (injury and illnesses) requires distinct coding systems because the International Classification of Diseases is insufficient for sports medicine coding. The Orchard Sports Injury and Illness Classification System (OSIICS) is one of two sports medicine coding systems recommended by the International Olympic Committee. Regular updates of coding systems are required. METHODS: For Version 15, updates for mental health conditions in athletes, sports cardiology, concussion sub-types, infectious diseases, and skin and eye conditions were considered particularly important. RESULTS: Recommended codes were added from a recent International Olympic Committee consensus statement on mental health conditions in athletes. Two landmark sports cardiology papers were used to update a more comprehensive list of sports cardiology codes. Rugby union protocols on head injury assessment were used to create additional concussion codes. CONCLUSION: It is planned that OSIICS Version 15 will be translated into multiple new languages in a timely fashion to facilitate international accessibility. The large number of recently published sport-specific and discipline-specific consensus statements on athlete surveillance warrant regular updating of OSIICS.

Ocular Chemical Burns: Epidemiological Trends in a Colombian Medical Center.

Ocular chemical burns are a significant cause of visual impairment. This study aims to characterize ocular chemical burns in a southwestern Colombia referral center and identify associated factors with low vision. A cross-sectional study was carried out based on the review of medical records of patients diagnosed with chemical eye burns who consulted the emergency ophthalmology service between January 2016 and December 2019. Descriptive statistics were performed. Associations with low vision (Best Corrected Visual Acuity, BCVA, ≥20/70 in Snellen chart) in the last follow-up appointment were identified using a multivariate logistic regression with odds ratios (OR) and 95% confidence intervals (95% CI). 219 eyes affected by chemical burns were identified from 174 patients with a mean age of 39 years (SD±20), out of which 57.5% (n=100) were men. We ran a multivariate model adjusted by sex, eye wash, type of chemical, and Dua's classification. We found that the odds of low vision for patients without eyewash before the consult were three times the odds of those who had it (Adjusted OR [aOR]=3.5, 95%CI=1.3-9.4) and almost five times for those with Dua's classification greater than 1 (aOR=4.7, 95%CI=1.7-12.9). The ocular chemical burns reported in this study occurred more in young people of productive age. Acids were the principal causal agent. The association between lack of early management and the severity of the chemical burn with low vision has been highlighted. Ocular burns remain a relevant cause of consultation on the ophthalmology service in Cali, and prevention strategies are required.

A Systematic Review on the Effectiveness of Eyewear in Reducing the Incidence and Severity of Eye Injuries in Racket Sports.

PURPOSE: To assess what eyewear (if any) reduces eye injury incidence and severity in squash, racketball, tennis and badminton. DESIGN: Systematic review following the 'Preferred Reporting Items for Systematic Reviews and Meta-Analyses' (PRISMA) and the 'implementing Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science' (PERSiST) guidelines. METHODS: PubMed, SportDiscus and Web of Science were searched on 22nd February 2023. All study types except reviews were eligible. Studies had to report the type of eyewear worn (if any) with a form of eye injury incidence and severity. RESULTS: 364 papers were initially retrieved and after the screening process 29 remained. A subgroup analysis was carried out on studies that had a sample size of five or above, were not only looking at a particular type of eye injury and that had sufficient data to allow the percentage of eye injuries that occurred when no eyewear was worn to be calculated. From this analysis, the median percentage of eye injuries that occurred when no eyewear was worn was found to be 93%. Some of these injuries were serious and required complex treatment. Prescription lenses, contact lenses and industrial eyewear made some injuries more severe. In squash and racketball, lensless eye guards were ineffective as the ball could deform on impact, still making contact with the eye. Only eyewear compliant with updated ASTM (or similar) standards was associated with no eye injuries and so provided adequate protection in all four sports. CONCLUSIONS: Although this systematic review only summarizes evidence on injuries requiring hospital treatment, it is recommended that national governing bodies and key decision makers within squash, racketball, tennis and badminton examine the evidence presented and consider extending existing rules or implementing new recommendations and policies on protective eyewear use to reduce eye injury incidence and severity in their sport.

Epidemiology of ophthalmic trauma in the United States from 2009-2018: A Nationwide Emergency Department Sample Analysis.

PURPOSE: To determine the incidence, characteristics, disposition, and economic burden of emergency department (ED) visits for ophthalmic trauma in the United States (US). DESIGN: Retrospective study. METHODS: The Nationwide Emergency Department Sample was used to calculate and characterize ED visits for ophthalmic trauma in the US from 2009 to 2018. Linear regression was used to estimate trends in annual incidence and mean inflation-adjusted ED charges. Logistic regression was used to assess variables associated with inpatient admission. RESULTS: There were over 7.3 million ED visits for ophthalmic trauma in the US over the 10 years, with an annual incidence of 233 per 100,000 population. Patients were predominantly male (65 %), 21-44 years old (39 %), and from low-income households (56 %). Only 1 % of patients were hospitalized. Older age, male sex, metropolitan teaching hospitals, and trauma centers were associated with significantly higher odds of inpatient admission. The mean inflation-adjusted ED charge per visit more than doubled over the decade ($1,333 to $3,187) with total charges exceeding $14 billion. Superficial injuries (44 %) and eyelid/orbit wounds (20 %) accounted for the majority of visits. Orbital floor fractures (4 %) and open globe injuries (2 %) accounted for a minority of visits but were responsible for most admissions (49 % and 29 %, respectively) and the highest mean ED charge ($7,157 and $6,808, respectively). CONCLUSIONS: Ophthalmic trauma represents an increasingly significant burden to EDs in the US. Preventive efforts should target young males from low socioeconomic backgrounds. Strategies to improve outpatient access and redirect non-urgent injuries may help alleviate costs.

An emergency room influx and trauma cases prediction in a Brazilian ophthalmological hospital by an ophthalmologist without code experience / Predição do influxo de atendimentos e casos de trauma em um serviço de urgência oftalmológico brasileiro realizado por um oftalmologista sem experiência em programação

ABSTRACT Purpose: The emergency medical service is a fundamental part of healthcare, albeit crowded emergency rooms lead to delayed and low-quality assistance in actual urgent cases. Machine-learning algorithms can provide a smart and effective estimation of emergency patients' volume, which was previously restricted to artificial intelligence (AI) experts in coding and computer science but is now feasible by anyone without any coding experience through auto machine learning. This study aimed to create a machine-learning model designed by an ophthalmologist without any coding experience using AutoML to predict the influx in the emergency department and trauma cases. Methods: A dataset of 356,611 visits at Hospital da Universidade Federal de São Paulo from January 01, 2014 to December 31, 2019 was included in the model training, which included visits/day and the international classification disease code. The training and prediction were made with the Amazon Forecast by 2 ophthalmologists with no prior coding experience. Results: The forecast period predicted a mean emergency patient volume of 216.27/day in p90, 180.75/day in p50, and 140.35/day in p10, and a mean of 7.42 trauma cases/ day in p90, 3.99/day in p50, and 0.56/day in p10. In January of 2020, there were a total of 6,604 patient visits and a mean of 206.37 patients/day, which is 13.5% less than the p50 prediction. This period involved a total of 199 trauma cases and a mean of 6.21 cases/day, which is 55.77% more traumas than that by the p50 prediction. Conclusions: The development of models was previously restricted to data scientists' experts in coding and computer science, but transfer learning autoML has enabled AI development by any person with no code experience mandatory. This study model showed a close value to the actual 2020 January visits, and the only factors that may have influenced the results between the two approaches are holidays and dataset size. This is the first study to apply AutoML in hospital visits forecast, showing a close prediction of the actual hospital influx.

RESUMO Objetivo: Esse estudo tem como objetivo criar um modelo de Machine Learning por um oftalmologista sem experiência em programação utilizando auto Machine Learning predizendo influxo de pacientes em serviço de emergência e casos de trauma. Métodos: Um dataset de 366,610 visitas em Hospital Universitário da Universidade Federal de São Paulo de 01 de janeiro de 2014 até 31 de dezembro de 2019 foi incluído no treinamento do modelo, incluindo visitas/dia e código internacional de doenças. O treinamento e predição foram realizados com o Amazon Forecast por dois oftalmologistas sem experiência com programação. Resultados: O período de previsão estimou um volume de 206,37 pacientes/dia em p90, 180,75 em p50, 140,35 em p10 e média de 7,42 casos de trauma/dia em p90, 3,99 em p50 e 0,56 em p10. Janeiro de 2020 teve um total de 6.604 pacientes e média de 206,37 pacientes/dia, 13,5% menos do que a predição em p50. O período teve um total de 199 casos de trauma e média de 6,21 casos/dia, 55,77% mais casos do que a predição em p50. Conclusão: O desenvolvimento de modelos era restrito a cientistas de dados com experiencia em programação, porém a transferência de ensino com a tecnologia de auto Machine Learning permite o desenvolvimento de algoritmos por qualquer pessoa sem experiencia em programação. Esse estudo mostra um modelo com valores preditos próximos ao que ocorreram em janeiro de 2020. Fatores que podem ter influenciados no resultado foram feriados e tamanho do banco de dados. Esse é o primeiro estudo que aplicada auto Machine Learning em predição de visitas hospitalares com resultados próximos aos que ocorreram.

Missed games, financial losses, and characteristics of eye injuries in the National Basketball Association during the 2010-2011 to 2017-2018 seasons.

PURPOSE: The purpose is to report financial loss, demographic metrics, and mechanisms of injury associated with eye injuries in the National Basketball Association (NBA) from the 2010-2011 to 2017-2018 seasons. METHODS: We performed a retrospective review of eye injuries in the NBA from the 2010-2011 to 2017-2018 seasons using publicly available information from Basketball Reference and the Pro Sports Transactions websites. Only injuries of the eye and adnexa that caused players to miss games in the regular season and playoffs were included in the study. Financial loss was calculated based on the regular season salary of the players and normalized for inflation with 2018 as the base year. RESULTS: There were 30 eye injuries causing a total of 106 missed games and $7,486,770 in financial losses across eight seasons. Linear regressions showed a moderately positive increase in eye injuries (Pearson's r = 0.68, P = 0.07, and 0.79 injuries per year/1000 game-days increase) and financial losses (Pearson's r = 0.67, P = 0.07, and $185.75 increase per year/1000 game-days) over time. There were significantly more games missed due to orbital fractures than games missed due to contusions/lacerations (11.5 vs. 2.8 missed games, P = 0.01). CONCLUSION: We demonstrate an increasing trend of eye injuries in the NBA, resulting in increased financial loss. Injuries may be varied in type and affect the number of games missed.

Community-Level Awareness of Proper Immediate Steps Regarding Ocular Chemical Injury in Qassim Region, Saudi Arabia.

Background An ocular chemical injury is a critical medical condition that results in harm to many components within the orbit, including the epithelium, cornea, and anterior segment. Most accidents tend to transpire among individuals in younger age groups, primarily as a result of their exposure to hazardous conditions either within their domestic environment or in occupational settings. Objective The objective of this study is to evaluate the extent of community awareness of chemical eye injuries and the appropriate measures for urgent care, focusing on different age groups within the Al-Qassim region. Methods A cross-sectional study was utilized in this research, employing data from a sample of 384 individuals residing in Qassim. The participants completed a self-administered questionnaire, which was administered online and ensured anonymity. The questionnaire used in this study had been previously validated. Results The study included a total of 384 participants who were not affiliated with the medical field, selected from the Al-Qassim region. Most of the respondents demonstrated fairly good level of awareness regarding ocular chemical injury (69%). There was a statistically significant relationship between age and the level of awareness (p-value=0.00001<0.05). Most participants believed that ocular chemical injury could cause ocular complications (93.8%) and identified chloride and detergents (92.2%) as the main materials that cause ocular injuries. Conclusion Overall summary, this study's findings suggest that there exists a moderate degree of knowledge among the public regarding chemical injuries to the eye and the appropriate rapid response to such injuries. Majority of the community members were aware that ocular chemical injury can cause ocular complications, blindness, perforation, scarring, and cataracts. Additionally, chloride and detergents were found to be the most common causes of ocular injuries among the population. The study found the most common immediate action when exposed to ocular chemical injury was to irrigate the eye with large amount of water. The study established a statistically significant association between the age and awareness about ocular chemical injury; thus, age appears to be a key factor influencing the amount of awareness seen.

Complete transection of the inferior rectus following blunt trauma: a case report.

This report describes a rare case of complete transection of the inferior rectus resulting from blunt trauma to the orbit. Only eight other cases were identified in the literature. Computed tomography scans should be examined carefully for potential extraocular muscle injury.

Bilateral Angle Recession and Chronic Post-Traumatic Glaucoma: A Review of the Literature and a Case Report.

Ocular trauma affects millions of people worldwide and is a leading cause of secondary glaucoma. Angle recession is the main cause of post-traumatic glaucoma after blunt eye trauma, and it is usually unilateral. The aim of this paper is to investigate the possible causes of angle recession with a bilateral presentation. Airbag activation during traffic accidents is a likely cause to be ruled out, along with repeated head or eye trauma, due to contact sports or a history of physical abuse. These aspects can aid in early detection, appropriate management, and improved outcomes for patients with ocular trauma. Finally, we report the case of a 75-year-old Caucasian man who developed a bilateral angle recession after an airbag impact, with advanced glaucoma in the right eye and ocular hypertension in the left eye. To our knowledge, this is the first case in the literature of chronic post-traumatic glaucoma probably caused by an airbag.

Ocular Trauma Trends during COVID-19 Pandemic.

Background: The article aims to study the demographics and clinical characteristics of ocular trauma patients presenting to the Eye Casualty Clinic between COVID-19 and non-COVID-19 era in Ampang Hospital, Malaysia. Methods: In this cross-sectional study, data of patients presented with ocular trauma injury to the Ampang Hospital during the COVID-19 era from 18 March 2020 to 17 September 2020 were retrieved and compared with the similar period of the previous non-COVID-19 era year. Results: Among the total number of 453 patients, 76.82% (n = 348) were predominantly males. The commonest age group was between 21 years old-40 years old (49.45%, n = 224), and the commonest location of ocular trauma injury occurred at the workplace (38.19%, n = 173); welding was the commonest work-related injury (13.83% in 2019; 12.50% in 2020). Injury-to-treatment time was significantly longer during the COVID-19 era, where patients who sought treatment within a day of injury were 27.27% (n = 69) in 2019 and 18.50% (n = 37) in 2020 (P = 0.030). During the COVID-19 pandemic, patients with vision worse than 6/60 on presentation were higher at 8% compared with 3.56% before the COVID-19 pandemic (OR = 2.35; 95% CI: 1.01, 5.48; P = 0.047). Similarly, patients with a vision worse than 6/60 post-treatment during the COVID-19 period were significantly higher at 7.00% compared with 1.58% before the COVID-19 pandemic (OR = 4.72; 95% CI: 1.53, 14.62; P = 0.007). Conclusion: The majority of ocular trauma cases in this study population were male adults between 21 years old and 40 years old, and welding was the commonest work-related injury. COVID-19 era has a higher percentage of patients presented with severe visual impairment, longer injury-to-treatment time and poorer post-treatment visual outcomes.

Case report: Bilateral eye injuries in members of one family due to a cluster munition in Ukraine.

The aim of the study was to report the effects of surgical treatment of three victims of a cluster munition in Ukraine. A 32-year-old woman and her sons-6-year-old male twins-presented in Poland after 18 days of delay in treatment. All ocular injuries were bilateral. One of the boys presented with total retinal detachment and a post-traumatic cataract as well as corneal sutures in one eye and a post-traumatic cataract in the other eye. The other boy had already developed atrophy in one eye and a vitreous hemorrhage in the other eye. The woman suffered from bilateral post-traumatic cataract with multiple glass intraocular foreign bodies (IOFBs). The surgical treatment included cataract surgery with intraocular lens implantation in three eyes, removal of IOFBs in one eye, and enucleation of the atrophic eye with implantation of an ocular prosthesis preventing constriction of face tissues. The eye with retinal detachment underwent pars plana vitrectomy, and the vitreous hemorrhage resolved itself. Postoperatively, visual acuity improved significantly in four of six eyes. Only in the eye with an open-globe injury and persistent retinal detachment, the final visual acuity was still poor. In conclusion, cluster munition may lead to bilateral ocular trauma with IOFBs, open-and close-globe injuries, and severe vision loss if left untreated. Modern ophthalmic surgery leads to vision with IOL improvement and solving the eyes after severe combat injury.

Eye disease and international travel: a critical literature review and practical recommendations.

RATIONALE FOR REVIEW: Eye diseases pose a significant public health and economic burden, particularly for travellers exposed to ocular hazards who may lack access to specialist eye care. This article offers an evidence-based review for travel-health practitioners, with a particular emphasis on ocular infections and trauma that are more prevalent among travellers. Providing an overview of these issues will allow travel health practitioners to comprehensively address ophthalmic considerations of travel. METHODS: A systematic literature search was conducted on PubMed and Embase electronic databases, using keywords related to travel medicine and ophthalmology. Inclusion was based on the relevant contribution to epidemiology, aetiology, diagnostics, management and long-term consequences of travel-related eye conditions. The data were analysed using narrative synthesis. KEY FINDINGS: This literature review highlighted that various travel-related eye conditions may occur. Travellers should be aware of the risk of travel-related ocular complications, which can arise from ocular infections, high-risk activities, high altitude and space travel. The economic and logistical challenges associated with medical tourism for ophthalmic procedures are discussed. For travellers with pre-existing eye conditions or visual impairment, careful planning may be needed to promote eye health and ensure safety of travel. CONCLUSIONS: Travel medicine practitioners should have a comprehensive understanding of the major ocular risks associated with overseas travel, including eye infections, eye injuries and solar eye damage. Further research in this area can enhance overall wellness and alleviate the burden of ocular diseases on travellers. Evidence-based guidelines based on research can also improve the quality of care and prevent long-term vision problems.

Analysis of Operated Patients with Ocular Trauma: A 10-Year Retrospective Study.

Background: Ocular trauma is one of the most common causes of hospitalization in patients with ocular injuries. It imposes many direct and indirect physical and psychological costs on the patient and the community. Materials and Methods: The present descriptive cross-sectional and retrospective study includes all patients with ocular trauma who underwent surgery in the referral center's ophthalmic operating room for 10 years. A checklist was completed for each patient, including demographic information and the variables required for the study. A total of 927 patients who underwent eye surgery due to ocular trauma were eligible for the study. All descriptive data were reported as the mean plus standard deviation for quantitative variables and distribution tables and frequency percentage for qualitative variables. Inferential tests such as independent t-test and Chi-square test were used to evaluate the research questions. Results: This study showed that most ocular traumas occur at a young age and mostly in males. The types of trauma in the studied eyes were divided into penetrating and non-penetrating in different age groups. The results showed that the most common type of surgery was corneal laceration repair, and in all patients, visual acuity improved significantly after surgery. In this study, a total of 81% of patients underwent only one operation. Conclusions: Training and caring for children and adolescents about high-risk behaviors and educating industry professionals to wear goggles, and increase workplace safety can reduce these types of trauma.

Assessing the Perceptions and Practices Toward Eye Injuries First Aid Among General Population in the Western Region of Saudi Arabia: A Cross-Sectional Study.

Aim  The eye is a vital and extraordinarily perceptive part of the human body. A wide spectrum of possible outcomes from eye injuries, from temporary vision loss to permanent blindness. There is a lack of information about how to handle an eye injury. Education and raising awareness are the best way to prevent severe complications and eventual loss of vision. Therefore, the purpose of this study is to evaluate and assess general population knowledge and first aid practices regarding eye injuries in the Western Region of Saudi Arabia, focusing on the importance of early management. Methodology A cross-sectional questionnaire was administered among residents of western Saudi Arabia using a validated questionnaire. One thousand two hundred seventy-nine adults of both genders were randomly chosen to represent the sample. In December 2022, we used a web-based survey to gather our data. Result This study analyzed data from 1279 responses on the online platform. Results showed that good knowledge was significantly higher among females than males, those without a history of eye injury than their peers with injuries, and those with higher educational levels than those with lower educational levels. Additionally, good knowledge was predicted by the female gender (OR = 1.6, 95% CI, 1.3 to 2.1, p < 0.001). Conclusion The study found that public awareness of eye injury first aid was good in the western region. The role of physicians should be expanded and health education campaigns and social media are recommended to achieve the goal of reduction and limiting the most crucial damage to the most sensitive organ in the body.

Thermal eye injuries from dermatologic laser treatments-an experimental study.

In recent years, severe ocular complications after dermatological laser therapies have been reported. One hypothesis is thermal damage due to heating of the metal eye shields. The aim of the present study is to evaluate the safety of ocular metal eye shields during laser therapy of the periocular region. For the experimental study, porcine eyelids were exposed to continuously increasing laser energy and multiple pulses using a number of dermatologic laser systems. Temperature differences of the convex and concave surface of metal eye shields were constantly measured using a thermocouple. Maximum increase of the convex surface of shields was + 8.9 °C (± 0.1 °C) provided by the long-pulsed alexandrite laser (20-25-J/cm2 energy, 15-mm spot size, 20-ms pulse duration, 1 Hz). Present data indicate that metal eye shields provide sufficient thermal protection when clinically used laser parameters are applied. Other safety precautions continue to be essential to protect both the patient and the laser operator. These include the use of nonreflective metal eye shields, precise knowledge of laser physics, and a clear understanding of how they interact with ocular and periocular anatomy.

Pseudomelanoma: occult intraocular foreign body mimicking choroidal melanoma.

Purpose: To report an occult intraocular foreign body mimicking choroidal melanoma. Methods: Medical records and imagings of the patient were retrospectively reviewed. Case description: A 76-year-old male was referred to our ocular oncology clinic with a suspicious hyperpigmented retinal lesion in the left eye. Biomicroscopy showed aphakia and peripheral iridectomy in the left eye. Fundoscopy revealed a pigmented, slightly elevated lesion on the macula of the left eye surrounded by diffuse atrophy. B-scan ultrasonography showed a preretinal hyperechoic lesion with posterior shadowing. There was no choroidal mass in B-scan or optical coherence tomography (OCT) imaging. On further questioning, it was disclosed that the patient had been hit by an iron fragment in the left eye forty years ago. Conclusion: Choroidal melanoma is a vision- and life-threatening intraocular malignant tumour. Various neoplastic, degenerative, and inflammatory conditions can simulate choroidal melanoma. A previous history of penetrating ocular trauma should lead the surgeon to re-evaluate a diagnosis of melanoma.

Pediatric canalicular laceration repair using the Mini Monoka versus Masterka monocanalicular stent / Correção de laceração canalicular pediátrica usando os stents monocanaliculares Mini-Monoka versus Masterka

ABSTRACT Purpose: One of the most important disadvantages of using Mini Monoka stents in pediatric canalicular laceration repair is premature stent loss. In this study, we aimed to compare clinical outcomes between the use of Mini Monoka and Masterka monocanalicular stents in children and discuss the potential causes of premature stent loss. Methods: The medical records of 36 patients who underwent surgical repair of canalicular lacerations were retrospectively reviewed. Children aged <18 years who underwent canalicular laceration repair with either Mini Monoka or Masterka and had at least 6 months of follow-up after stent removal were included in the study. The patients' demographics, mechanism of injury, type of stent used, premature stent loss, and success rate were analyzed. Success was defined as stent removal without subsequent epiphora and premature stent loss. Results: Twenty-seven children fulfilled our study criteria, and their data were included in the analyses. Mini Monoka was used in 14 patients (51.9%), whereas Masterka was used in 13 patients (48.1%). The preoperative clinical features, including age, sex, and mechanism of injury, were similar between the two groups. The mean age was 8.3 ± 5.5 years in the Mini Monoka group and 7.8 ± 5.9 years in the Masterka group (p=0.61). Three patients in the Mini Monoka group (21.4%) underwent reoperation due to premature stent loss. No premature stent loss was observed in the Masterka group. As a result, the rate of success was 78.6% in the Mini Monoka group, whereas it was 100% in the Masterka group (p=0.22). Conclusions: Even though the two groups did not show any statistically significant difference in success rate, we did not observe any premature stent loss in the Masterka group. Further studies with larger and randomized series are warranted to elaborate on these findings.

RESUMO Objetivo: Uma das desvantagens mais importantes do uso de stents Mini Monoka no reparo de lacerações canaliculares pediátricas é a perda prematura do stent. Neste estudo, objetivamos comparar os resultados clínicos dos stents monocanaliculares Mini Monoka e Masterka em crianças e discutir as possíveis causas da perda prematura do stent. Métodos: Foram incluídos nesta revisão retrospectiva 36 pacientes <18 anos de idade que se submeteram ao reparo cirúrgico de uma laceração canalicular com um stent Mini Monoka ou Masterka e tiveram pelo menos 6 meses de acompanhamento após a remoção do stent. Foram analisados os dados demográficos, o mecanismo da lesão, o tipo de stent utilizado, a ocorrência de perda prematura de stent e o sucesso da intervenção. O sucesso foi definido como a ausência de epífora após a remoção do stent, sem a perda prematura deste. Resultados: Vinte e sete pacientes preencheram os critérios do presente estudo e foram incluídos nas análises. O stent Mini Monoka foi usado em 14 pacientes (51,9%), enquanto o Masterka foi usado em 13 pacientes (48,1%). As características clínicas pré-operatórias, incluindo idade, sexo e mecanismo de lesão, foram semelhantes entre os dois grupos. A média de idade foi de 8,3 ± 5,5 anos no grupo Mini Monoka e de 7,8 ± 5,9 anos no grupo Masterka (p=0,61). Três pacientes do grupo Mini-Monoka (21,4%) tiveram que ser operados novamente por perda prematura do stent. Nenhuma perda prematura do stent foi observada no grupo Masterka. Como resultado, a taxa de sucesso foi de 78,6% no grupo Mini Monoka e de 100% no grupo Masterka (p=0,22). Conclusões: Embora nenhuma diferença estatisticamente significativa tenha sido detectada entre os dois grupos em termos de taxas de sucesso, não observamos nenhuma perda prematura de stent no grupo Masterka. São necessários mais estudos, com séries maiores e randomizadas, para chegar a maiores conclusões sobre esses achados.

Surgical approach to repair of traumatic avulsion and external herniation of the levator palpebrae superioris aponeurosis.

This report describes the unusual case and surgical repair of avulsion and external herniation of the levator palpebrae superioris (LPS) aponeurosis and attached muscle fibres associated with superior tarsal plate fracture in an 8-year-old Indigenous girl. To the authors' knowledge, isolated and complete levator palpebrae superioris avulsion with external herniation in trauma is previously unreported. Open injury to LPS requires swift surgical repair, and an anterior ptosis repair approach may facilitate identification of anatomical structures to prevent upper eyelid ptosis. Ultimately, the surgical repair in this case prevented further ptosis surgery and complications in a paediatric patient.