Characterization of Ocular Injuries Caused by Orbeez Hydrated Gel Pellet Projectiles: Clinical Insights and Implications.

PURPOSE: To examine the clinical characteristics of patients who have experienced blunt ocular injuries from "Orbeez" hydrated gel pellets (Spin Master Corp.), and to describe ocular morbidity, visual acuity (VA), and intraocular pressure (IOP) after Orbeez-related ocular trauma. DESIGN: Retrospective, institutional, observational case series. METHODS: Patients sustaining Orbeez-related ocular trauma at a single institution over a 13-month period were identified. Clinical parameters including VA, IOP, and anterior and fundus examination findings were assessed upon initial and final presentation. Basic statistical testing was performed to compare differences within this cohort. RESULTS: A total of 17 eyes from 17 patients with Orbeez-related trauma were identified. Orbeez-related blunt ocular injuries included corneal abrasion (n = 7), hyphema (n = 9), commotio retinae (n = 5), intraretinal hemorrhage (n = 3), preretinal hemorrhage (n = 1), vitreous hemorrhage (n = 2), and retinal tear (n = 1). Adolescents (14-18 years of age) showed higher rates of posterior segment complications compared to other ages (P = .0152). The presence of elevated IOP and hyphema upon initial examination correlated with increased likelihood of requiring invasive treatment following Orbeez impact (P = .0275). CONCLUSION: Orbeez-related ocular trauma may be associated with severe visual morbidity and varied anterior and posterior segment intraocular sequelae. Adolescents could be at increased risk for posterior segment complications following these injuries. Initial findings of elevated IOP and hyphema may indicate a need for more aggressive interventions. Prevention remains paramount in managing Orbeez-related ocular trauma; it is critical to raise awareness regarding the importance of wearing eye protection meeting high-impact standards and minimizing exposure to such projectiles.

Surgical outcomes after primary Baerveldt glaucoma implant surgery with vitrectomy for neovascular glaucoma.

This study aimed to evaluate the 3-year long-term outcomes of primary Baerveldt glaucoma implant (BGI) surgery for neovascular glaucoma (NVG). We retrospectively evaluated 27 consecutive patients with NVG between November 2013 and November 2017. All the patients were treated with panretinal photocoagulation and pars plana vitrectomy before BGI surgery without anti-vascular endothelial growth factor treatment. The surgical success of the BGI was defined as an IOP of <22 mmHg and <5 mmHg with or without antiglaucoma medication. The outcomes were assessed on the basis of intraocular pressure (IOP), visual acuity, postoperative complications, and cumulative success rate. Except for 2 mortality cases, 25 eyes (92.6%) were followed up for 3 years. The mean IOPs (mmHg)/numbers of glaucoma medications ± standard error of the mean before and 12 and 36 months after BGI surgery were 41.6/4.6 ± 1.9/0.2, 14.8/2.2 ± 0.8/0.4 and 16.9/2.6 ± 1.1/0.3, respectively. In all of the follow-up time points, the postoperative mean IOP and number of glaucoma medications were statistically significantly lower than the preoperative values (analysis of variance, P < 0.001). At 3 years after surgery, the rates of visual acuity improvement (logMAR ≤ -0.3), invariance (-0.3 < logMAR < 0.3), and worsening (logMAR ≥ 0.3) were 56.0% (14/25 eyes), 24.0% (6/25 eyes), and 20.0% (5/25 eyes), respectively. The most common postoperative complications were hyphema (4 eyes, 14.8%) and vitreous hemorrhage (5 eyes, 18.5%), and serious complications such as expulsive hemorrhage, endophthalmitis, and tube/plate exposure did not occur. The cumulative probabilities of surgical success after the operation were 100% at 1 year, 85.2% at 2 years, and 77.4% at 3 years. In conclusion, combined non-valved pars plana tube placement in conjunction with vitrectomy was successful at lowering IOP with relatively low complication rates.

Epidemiology and outcomes of hyphema: a single tertiary centre experience of 180 cases.

PURPOSE: To characterize the epidemiology and outcomes of hyphema. METHODS: Retrospective case series. Medical records from patients with traumatic and spontaneous hyphema seen at the Wilmer Eye Institute, Johns Hopkins, from 2011 through 2017 were evaluated. Aetiology, demographics, clinical characteristics, complications, management and outcomes were ascertained. Multivariable logistic regression was used to identify factors associated with elevated intraocular pressure (IOP), rebleeding and poor outcome (final visual acuity ≤ 20/40) in traumatic hyphema. A safe frequency of follow-up was retrospectively determined. RESULTS: Traumatic hyphema (n = 152) was more common in males (78%) and adults (55%), with sports/recreational activities being the most frequent cause (40%). Elevated IOP was the most common complication (39%). Rebleeding occurred in seven patients (5%) and was more likely with a higher IOP on presentation (OR:1.1; p = 0.004). Thirty-seven patients (24%) had a poor outcome, mostly due to traumatic sequelae such as cataract (32%) or posterior segment involvement (30%). A poor outcome was more likely with worse presenting visual acuity (OR: 9.1; p = 0.001), rebleeding (OR: 37.5; p = 0.035) and age > 60 years (OR: 16.0; p = 0.041). Spontaneous hyphema (n = 28) did not have a gender predominance and was more common in adults > 60 years (71%). The most common cause was iris neovascularization (61%). Complications and visual outcomes were worse compared with traumatic hyphema. CONCLUSIONS: Traumatic hyphema continues to be common in young males engaging in sports, necessitating increased awareness for preventive eyewear. Older age and rebleeding can lead to poor outcomes. Elevated IOP at presentation predisposes to rebleeding and warrants frequent follow-up. Otherwise, routine follow-up at days 1, 3, 5, 7 and 14 is sufficient for uncomplicated cases.

Incidence and seasonality of major ocular trauma: a nationwide population-based study.

We designed this study to identify the epidemiological characteristics and trends of various types of ocular trauma in the population of the Republic of Korea. We conducted a nationwide, population-based, cross-sectional study using the Korean National Health Insurance claims database for January 2010 to December 2018. We compiled the monthly numbers of patients diagnosed with hyphema and those who received open reduction surgery due to orbital blowout fracture (BOF), primary closure of the cornea or sclera (PCCS), or intraocular foreign body (IOFB) removal. We obtained annual and monthly incidence rates, and differences according to age, sex, yearly trends, and seasonal variations. The incidence rate (per 100,000 person-years) was high in the order of hyphema (18.43), BOF (11.58), PCCS (1.99) and IOFB removal (0.39). Male predominance was evident in all types of major ocular trauma, but the age distribution varied with the type: hyphemas were most prevalent at 10-14 years of age, BOFs at 25-29 years of age, and open globe injuries (OGIs) at age 60 and older. Although all types of trauma showed significant seasonality, hyphemas (amplitude: 174.81) and BOFs (23.17) showed higher amplitudes compared to OGIs (PCCS: 11.96; IOFB removal: 6.72). While the incidence of blunt trauma injuries, including hyphemas and orbital BOFs, decreased steadily from 2010 to 2018, that of OGIs showed no remarkable change.

Feline post-sterilization hyphema.

OBJECTIVE: To determine incidence and risk factors of post-sterilization hyphema in shelter cats. ANIMALS STUDIED: Retrospective medical record review of 1204 cats and prospective screening of 195 cats. PROCEDURES: The study consisted of three parts: (a) Survey responses were collected from 20 veterinarians, who perform high-quality high-volume spay-neuter (HQHVSN) in both shelter and public clinic settings; (b) medical records of 1204 cats were analyzed retrospectively over a 14-month time period; and (c) ophthalmic examinations, including tonometry, were performed prospectively on 195 cats before and after sterilization surgery over 8 weeks. RESULTS: Nine of 20 surveyed veterinarians reported having witnessed hyphema in cats following sterilization surgery. Retrospective review of 1204 medical record and prospective screening of 195 cats showed that three juvenile (<1 year of age) male cats (<2 kg) developed hyphema within 1 hour following surgery (0.2% incidence). In all three affected cats, anesthesia was induced with tiletamine/zolazepam (3 of 523 cats induced with this drug combination; 0.6% incidence), and hyphema resolved within 20 hours. Mean intraocular pressures as measured by Icare® TonoVet were (mean ± standard deviation) 11.5 ± 3.8 mm Hg and 21.7 ± 4.6 mm Hg for juvenile (<1 year of age) and adult (>1 year of age) cats, respectively. CONCLUSIONS: Survey responses and three observed cases confirm the existence of feline post-sterilization hyphema with an estimated incidence of 0.2%. The underlying mechanism for this occurrence remains unknown.

[Characteristics and management of Uveitis-Glaucoma-Hyphema syndrome]. / Caractéristiques et prise en charge du syndrome Uvéite-Glaucome-Hyphéma.

INTRODUCTION: Uveitis-Glaucoma-Hyphema syndrome (UGH) is caused by mechanical chafing of anterior segment structures by an intraocular lens, especially an anterior chamber lens. The objective of this study was to characterise the clinical course and risk factors of UGH syndrome at a time when posterior chamber implantation is the gold standard. PATIENTS AND METHODS: This was a retrospective study of 30 cases of UGH syndrome managed between January 2014 and September 2018. Data from the initial clinical examination, the type of implant involved and the clinical management were analysed. RESULTS: Thirty eyes of 28 patients were included. Intra ocular lenses were iris-sutured (15/30, 50 %), in the bag (6/30, 20 %), scleral-fixated (4/30, 13.3 %), in the ciliary sulcus (3/30,10 %) or "in and out" (2/30, 6.7 %). Initial management was medical (18 eyes) or surgical (12 eyes). Surgical procedures were explantation (n=4), IOL repositioning (n=7) or trabeculectomy (n=1). Recurrences occurred with medical treatment (9/18), but not in the surgical group (p=0.02). Ocular hypertension became chronic in 19 cases out of 30 (63.3 %). CONCLUSION: UGH syndrome can be caused by any type of pseudophakic lens. An intraocular lens in the bag should not rule out the diagnosis. Despite the decreasing popularity of anterior chamber intraocular lens implantation, UGH syndrome remains a current condition and must be recognised in order to adapt therapeutic management.

Iris aneurysm in feline hypertensive oculopathy.

OBJECTIVE: To describe and document the prevalence and cause of iris aneurysm in feline hypertensive oculopathy. ANIMALS STUDIED: Privately owned cats with systemic hypertension presented for sudden visual deficits and/or hyphema. PROCEDURES: A retrospective search of medical records of cats with systemic hypertension was performed in a specialized eye practice from October 2001 to August 2016. Inclusion criteria used for further evaluation were (1) systolic blood pressure exceeding 170 mm Hg measured by Doppler ultrasound, (2) typical fundus changes consistent with systemic hypertension (retinal folds, retinal edema, intraretinal bullous fluid accumulation, retinal detachment-partial or total, intra-/preretinal bleeding) in at least one eye, and (3) at least one follow-up visit with documented response to therapy with amlodipine. Cats with bilateral hyphema were excluded. RESULTS: A total of 206 cats fulfilled the inclusion criteria. Twenty-eight cats (14%) showed an aneurysm of the iridal vessels, 21 75% with some amount of hyphema. In total, hyphema was present in 62 cats (30%). Pearson correlation of fundus changes, hyphema, and aneurysm was performed. A high correlation between fundus changes without posterior segment hemorrhage and hyphema was found. The histopathology of one eye showed iridial vascular changes compatible with an aneurysm. In 75 cats, additional blood analysis was performed. Presumed chronic kidney disease (80%) was the most common cause of systemic hypertension with eye disease, followed by hyperthyroidism (20%). CONCLUSION: Vascular changes of the iris compatible with aneurysms were seen in 14% of cats with systemic hypertension and may result in vascular rupture and acute hyphema.

Epidemiology of Hyphema-Related Emergency Department Visits in The United States Between 2006 and 2015.

PURPOSE: To describe epidemiological trends, risk factors, and hospital-associated charges for patients presenting with hyphema to emergency departments (EDs) throughout the United States (U.S.). METHODS: Cross-sectional analysis of all hyphema-related ED cases in the U.S. Nationwide Emergency Department Sample (NEDS) between 2006 and 2015 to determine population-based incidence rates, patient demographics, visit characteristics and associated charges. RESULTS: Between 2006 and 2015, there were a total of 16,222 cases with hyphema as primary visit diagnosis (0.52 ED visits per 100,000 population). The mean (SD) age at presentation was 37.4 (24.8) years, and males accounted for 66.2% of these cases. Trauma (n = 4,994, 30.8%) was the most frequently identified etiology, with sports-related injuries as important contributor. On multivariate analysis, traumatic hyphema was more likely for patients aged 5-14 years (Odds ratio [OR] = 1.88 [95% Confidence interval [CI]: 1.04-3.40, p = 0.04]) than 0-4 years, males (OR = 1.33 [95% CI: 1.09-1.62, p = 0.01]), in May through September (OR = 1.66-1.93 [95% CI: 1.08-3.05, p = 0.005-0.03]),and for those in the highest income quartile (OR = 1.42 [95% CI: 1.10-1.83, p = 0.01]). Visits were less likely for patients aged ≥55 years (OR = 0.49 [95% CI: 0.25-0.994, p = 0.03]) than 0-4 years. During the study period, hyphema accounted for $21 million in ED associated and $9 million in inpatient charges. CONCLUSION: ED visits with hyphema as primary diagnosis occur at an annual rate of 0.52 per 100,000 population. Young males are particularly at risk and there has been an increase in the number of sports-related injuries which may represent a modifiable cause. Hyphema management costs $3 million in hospital-related charges annually.

Pattern of ocular injuries in Bangladesh and its surgical management at hospital setting: A retrospective study.

OBJECTIVE: To determine the pattern of ocular injuries and their surgical management.. Methods: The retrospective study was conducted at the Chittagong Eye Infirmary and Training Complex, Chittagong, Bangladesh, and comprised hospital data of patients with ocular injuries from October 1, 2016, to December 31, 2017. Information gathered related to type and cause of injuries, visual acuity, postoperative complications, follow-up visits, and outcome. SPSS version 22 was used for data analysis. Results: Of the total injuries, 370 (91%) were classified open globe and 36 (9%) as close globe. In terms of type of injury, 330 (81.4%) were penetrating, 30 (7.3%) ruptured globe, 29 (7.1%) lime burn and 17 (4.2%) injuries were traumatic hyphaema and chemical in nature. Open globe injuries were mostly found in subjects aged 18 years or below. Surgery was the main mode of management in 388 (95.5%) patients. Conclusion: Preventive measures along with high-quality management should receive priority for reducing monocular blindness.

Risk Factors of Hyphema following Surgeries for Primary Rhegmatogenous Retinal Detachment.

PURPOSE: This study aimed to evaluate the risk factors for hyphema complicating primary rhegmatogenous retinal detachment (RRD) surgeries and to analyze outcomes. METHODS: In this retrospective comparative study, we included 1,011 consecutive eyes. Two groups were compared according to the occurrence of postoperative hyphema. RESULTS: Postoperative hyphema occurred in 32 eyes (3.17%). High myopia was significantly related to the occurrence of hyphema (odds ratio [OR] 3.396, 95% confidence interval [CI] 1.502-7.675; p = 0.003). Combined scleral buckling and vitrectomy (SB + VT) was associated with a significantly higher incidence of hyphema (OR 21.266, 95% CI 4.855-93.152; p < 0.001). The final anatomical success rate did not differ significantly between the group with and the group without occurrence of hyphema; however, the primary anatomical success rate was worse in the eyes with hyphema. CONCLUSIONS: High myopia and combined SB + VT were risk factors for hyphema after RRD surgeries. The occurrence of hyphema did not affect the final anatomical success rate at 6 months.

PlexinD1 is required for proper patterning of the periocular vascular network and for the establishment of corneal avascularity during avian ocular development.

The anterior eye is comprised of an avascular cornea surrounded by a dense periocular vascular network and therefore serves as an excellent model for angiogenesis. Although signaling through PlexinD1 underlies various vascular patterning events during embryonic development, its role during the formation of the periocular vascular network is yet to be determined. Our recent study showed that PlexinD1 mRNA is expressed by periocular angioblasts and blood vessels during ocular vasculogenesis in patterns that suggest its involvement with Sema3 ligands that are concurrently expressed in the anterior eye. In this study, we used in vivo knockdown experiments to determine the role of PlexinD1 during vascular patterning in the anterior eye of the developing avian embryos. Knockdown of PlexinD1 in the anterior eye caused mispatterning of the vascular network in the presumptive iris, which was accompanied by lose of vascular integrity and profuse hemorrhaging in the anterior chamber. We also observed ectopic vascularization of the cornea in PlexinD1 knockdown eyes, which coincided with the formation of the limbal vasculature in controls. Finally we show that Sema3E and Sema3C transcripts are expressed in ocular tissue that is devoid of vasculature. These results indicate that PlexinD1 plays a critical role during vascular patterning in the iris and limbus, and is essential for the establishment of corneal avascularity during development. We conclude that PlexinD1 is involved in vascular response to antiangiogenic Sema3 signaling that guides the formation of the iris and limbal blood vessels by inhibiting VEGF signaling.

Caracterización clinicoepidemiológica de pacientes con hifema por traumatismo ocular / Clinical and epidemiological characterization of patients with hyphema due to ocular traumatism

Se realizó un estudio descriptivo, retrospectivo y longitudinal de 34 pacientes con hifema ocasionado por trauma, ingresados en el Servicio de Oftalmología Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, de enero a diciembre de 2013, con vistas a caracterizarles según algunas variables clinicoepidemiológicas. En la serie se observó un predominio del sexo masculino (64,7 %) y el grupo etario de 40-49 años (32,4 %); en tanto, el hifema de grado I fue el más representativo clínicamente (41,2 %), producido por traumas contusos en la mayoría de los afectados (76,5 %), y las complicaciones más frecuentes fueron la hipertensión ocular (23,5 %) y la uveítis (17,6 %). No obstante, el tratamiento adecuado y oportuno permitió que el mayor porcentaje de los pacientes mejoraran la agudeza visual.

A descriptive, retrospective and longitudinal study of 34 patients with hyphema caused by trauma, admitted in the Ophthalmology Service of "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital in Santiago de Cuba was carried out from January to December, 2013, aimed at characterizing them according to some clinical and epidemiological variables. A prevalence of the male sex was observed in the series (64.7%) and the age group 40-49 (32.4%); while, the degree I hyphema was clinically the most representative (41.2%), caused by contusion traumas in most of the affected ones (76.5%), and the most frequent complications were the ocular hypertension (23.5%) and uveitis (17.6%). However, the appropriate and opportune treatment allowed that the highest percentage of the patients improved the visual acuity.

Hyphema is a risk factor for failure of trabeculectomy in neovascular glaucoma: a retrospective analysis.

BACKGROUND: Several retinal ischemic diseases can cause neovascular glaucoma (NVG). Trabeculectomy with mitomycin C (MMC) is a relatively better treatment modality in the management of eyes with NVG than other glaucoma surgeries. The aim of this study was to investigate the factors that may influence the outcome of trabeculectomy with MMC for NVG. METHODS: Forty-nine NVG eyes from 43 patients (26 males and 17 females) underwent primary trabeculectomy with MMC. The mean follow-up period was 16.8 ± 8.1 months (range, 6 to 34 months). Twenty-one eyes of 21 patients received intravitreal bevacizumab (IVB) 3.6 ± 1.8 days before trabeculectomy with MMC. A Kaplan-Meier survival-curve analysis was used to summarize the cumulative probability of success. We examined the relationship between the surgical outcome and the following surgical factors: gender, age, history of panretinal photocoagulation, history of cataract surgery, history of vitrectomy, preoperative IVB, NVG in the fellow eye, and postoperative complications (hyphema, choroidal detachment, and formation of fibrin) by multivariate analysis. RESULTS: The survival rate was 83.7% after 6 months, 70.9% after 12 months, and 60.8% after 24 months. The Kaplan-Meier survival curves showed no significant difference in the survival rate between the eyes with preoperative IVB (n = 21) and the eyes without preoperative IVB (n = 28) (p = 0.14). The multiple logistic regression analysis showed that postoperative hyphema (odds ratio, 6.54; 95% confidence interval, 1.41 to 35.97) was significantly associated with the surgical outcome (p = 0.02). CONCLUSIONS: Postoperative hyphema was significantly correlated with the outcome of trabeculectomy for NVG. There was no significant association between preoperative IVB and postoperative hyphema or the results of trabeculectomy.

Intraoperative and early postoperative complications of manual sutureless cataract extraction.

OBJECTIVE: To determine the intraoperative and early postoperative complications of manual sutureless cataract extraction. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: Redo Eye Hospital, Rawalpindi, Pakistan, from January 2009 to December 2010. METHODOLOGY: Three hundred patients of cataract through purposive non-probability sampling were selected. The patients underwent manual sutureless cataract surgery (MSCS) by single experienced surgeon and intraoperative complications were documented. The surgical technique was modified to deal with any intraoperative complications accordingly. Patients were examined on the first postoperative day and on the first postoperative week for any postoperative complications. The data was entered in Statistical Package for Social Sciences (SPSS) version 13.0 and the results were calculated in frequencies. RESULTS: Among the 300 cases, 81.3% surgeries went uneventful whereas 18.6% had some complication. The common intraoperative complications were superior button-hole formation in 5%; posterior capsular rent in 5% and premature entry with iris prolapse in 3% cases. Postoperatively, the commonly encountered complications were striate keratopathy in 9.6% and hyphema 9%. At first week follow-up, 4% had striate keratopathy and 0.6% had hyphema. Striate keratopathy resolved with topical medication on subsequent follow-up. A total of 9 cases (3%) underwent second surgery: 2 cases for lens matter wash, 2 cases for hyphema and 5 cases needed suturing of wound for shallow anterior chamber due to wound leak. CONCLUSION: Superior button-hole formation, posterior capsular rent and premature entry were the common intraoperative complications of MSCS whereas the common early postoperative complications were striate keratopathy and hyphema.

Pediatric traumatic hyphema: a review of 138 consecutive cases.

PURPOSE: To report the demographics and outcomes in children (<18 years of age) who developed hyphema from ocular trauma and were subsequently cared for at a tertiary medical center. METHODS: The medical records of consecutive patients seen at Children's Hospital Colorado diagnosed with traumatic hyphema between September 1, 2003, and December 31, 2011, were retrospectively reviewed. The following data were recorded: patient age, parent/guardian-reported ethnicity, sex, injury location, visual acuity, and intraocular pressure (IOP) at presentation and follow-up. RESULTS: A total of 138 cases of unilateral hyphema were included, with 88% occurring in boys (mean age, 10.1 years; range, 1-19). Over 90% of injuries occurred in the home setting, with the most common mechanisms of injury being general play, projectiles from guns, and sports injuries occurring during games or practice. Only 3 patients had visual acuity <20/40 at 1 month's follow-up, and no patient experienced a rebleeding event. Most of the 33 patients with elevated IOP were managed medically; 4 (12%) required surgery. CONCLUSIONS: The majority of children with traumatic hyphema in this patient cohort were injured in the home setting. Very few patients underwent surgery for ocular hypertension, but higher IOP at presentation was associated with the need for surgical intervention. Outpatient care with activity restriction and topical medications usually led to resolution of hyphema without serious complications or visual loss.

Demographic and etiologic characteristics of children with traumatic serious hyphema.

BACKGROUND: We aimed to evaluate the etiologic factors, complications, follow-up, and treatment outcomes in serious hyphema following blunt ocular trauma in childhood. METHODS: The medical records of 136 patients diagnosed as grade 3 or 4 hyphema due to blunt ocular trauma between January 2006 and December 2011 were evaluated. Visual acuity (VA), complications, and medical and surgical treatments were analyzed. Factors affecting visual prognosis were compared in grade 3 and 4 hyphema cases. RESULTS: The mean age of patients was 9.7±4 years. Etiologic factors for trauma were stone in 53 (39%), bead bullet in 25 (18.4%) and others in 58 (42.6%) patients. The most common complication of grade 3 and 4 hyphema was traumatic mydriasis (19.1%), followed by cataract (9.6%) and glaucoma (5.1%). Medical treatment was successful in 114 (83.8%) patients, and 22 (16.2%) patients underwent surgery. Mean initial and final VA of grade 4 patients were found to be significantly lower than those of grade 3 patients. CONCLUSION: In grade 3 and 4 hyphema due to blunt trauma, visual prognosis worsened in the presence of additional ocular pathologies. Considering the bad visual prognosis of severe hyphema patients, prompt treatment and close follow-up may prevent complications resulting in poor VA.

An analysis of pure blowout fractures and associated ocular symptoms.

Blowout fractures are one of the commonly occurring facial bone fractures and clinically important, as they may cause serious complications such as diplopia, extraocular movement limitation, and enophthalmos. The purpose of this study was to evaluate the current patient demographics and surgical outcomes of 952 pure blowout fractures from 2 hospitals of the Catholic University of Korea, from 2003 to 2011. The medical records were reviewed according to the cause, fracture site, ocular symptoms, time of operation, and sequela. Male patients outnumbered female patients, and blowout fractures were most often seen in 21- to 30-year-old men. The most common cause was violent assault (40.7%). The medial orbital wall (45.8%) was the most common site, followed by floor (29.4%) and inferomedial wall (24.6%). The most common ocular injury was hyphema. Diplopia was presented in 27.6%; extraocular movement limitation was detected in 12.8% patients, and enophthalmos was encountered in 3.4% patients. Diplopia, extraocular movement limitation, and enophthalmos were significantly improved by surgical repair (P < 0.05). Postoperative complications were persistent diplopia (1.6%) and enophthalmos (0.4%). We surveyed a large series of blowout fracture in the Republic of Korea and recommend this study to serve as an important guideline in treating pure blowout fractures.

Hyphema caused by trauma.

INTRODUCTION: Diagnosis and in time treatment of traumatic hyphema could prevent the consequent complications such as, intraocular pressure, blood deposition in the cornea, cataract, the optic nerve damage, and reduction of visual acuity, etc. The aim of this study is identifying the prevalence of the traumatic hyphema incidence in the patients referring to the University Hospital of Boo-Ali-Sina in the city of Sari (Northern Iran) in 2009 -2010. METHOD: In this descriptive cross-sectional study, 28 medical records related to traumatic hyphema were investigated. A checklist was designed to extract the data. RESULTS: The most frequency of traumatic hyphema was related to male gender 22 (78/6%), 9 (32.1%) cases age 5-14 years, student 12 (42.9%)cases, 14(50%) urban, 10 (35.7%) cases length of stay was 3 days. The traumatic hyphema was most common in summer 11 (39.3%) cases. The majority 15 (53.6%) of subjects were unilateral (left eye). The mode of the trauma was contact with blunt object in 18 (64.2%) subjects. Protocol of treatment in most subjects 23 (82%) was medication and cornea operation in 2 (7.1%) cases. The highest frequency of the time period between the incidence of injury and referring to the hospital in less than 1 hour was reported in 10 (35.7%). CONCLUSION: In the present study, the traumatic hyphema was observed more in male, especially in the young and adolescent and in the students and workers. Therefore the issue of prevention of ocular trauma and instruction about the eye protection is very important.

[Ocular trauma. Blunt ocular trauma]. / Contusions oculaires à globe fermé

Ocular traumas represent a major public health problem with poorly understood ramifications at both the individual and community levels. Any of the ocular structures can be damaged in the case of closed globe injury. These lesions, often multiple, may appear immediately or in a delayed fashion. Classifications have been developed recently in order to better inform the patient of the visual prognosis. However, significant efforts are still needed, on the one hand, to assess and develop new therapies, and on the other hand, to implement effective policies to prevent ocular trauma.