Traumatically ruptured globes in children.

This retrospective study was designed to document the etiology of traumatically ruptured globes in children and to determine the prognostic value of several clinical parameters with respect to visual outcome. Forty-six children 16 years of age and under seen in the emergency room over a 2-year period were found to have full thickness penetration of the globe. Fifty-nine percent of injuries occurred during recreational activities, and 59% occurred outside of the home. Boys outnumbered girls by a 6:1 ratio. For children, initial visual acuity proved to be less valuable as a prognostic indicator with regard to final vision than has been reported in adults. Smaller corneal wounds offered better visual outcomes. Four eyes were enucleated. Ten ruptures (22%) were related to activity involving guns. Four of six BB gun injuries were the result of a ricocheted BB. Visual outcomes in gun-related injuries were particularly poor.

The epidemiology of ruptured globes.

This retrospective study documented the demographics of 227 ruptured globes in 223 patients admitted to the Wills Eye Hospital over a two-year period from 1988 to 1990. The risk for a ruptured globe was greatest among 18-to-24-year-old men, during the noon to 8PM time frame, on Saturdays, and in the months of May, June, October, and November. The home was the most common injury setting, followed by the work place and assault. Twenty-four globes (11%) were enucleated within 11 weeks of hospital admission. These cases frequently were the result of assault, blunt-type injuries. A disproportionate number occurred in blacks.

An epidemiologic and pathologic study of globes enucleated following trauma.

This retrospective study examined demographic, clinical, and histopathologic factors in 24 traumatically ruptured globes that were enucleated at Wills Eye Hospital during a 2-year period. The majority of these injuries occurred in a violent assault setting with a blunt mechanism, during the evening and early morning hours, and in the fall and winter months. Most patients were black males, and 67% were substance abusers. Clinically, the initial visual acuity in 96% of the eyes was light perception or worse. Five of the eyes were enucleated primarily. Gross examination of the globes revealed that 92% of the wounds involved the sclera, 83% of the eyes had hyphema, and 71% of the lacerations were longer than 10 mm. Histopathologic examination demonstrated that the majority of eyes had fragmented or missing lenses, disrupted ciliary bodies, and detached choroids. Ninety-six percent of the retinas were detached. There was one case of acute endophthalmitis.