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2.
Am J Ophthalmol ; 216: 55-58, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32247777

RESUMO

PURPOSE: To assess the efficacy of swept-source optical coherence tomography (SS-OCT) and ultrasound biomicroscopy (UBM) in detecting posterior capsule (PC) defect in patients with traumatic cataract. DESIGN: Observational case-series. METHODS: Sixty-seven eyes from 67 patients, with traumatic cataract severe enough to prevent slit lamp evaluation of the PC, were included in a simple sequence without randomization. Patients underwent both 50-MHz UBM and SS-OCT evaluation of the PC by different operators. Cataract surgery was then performed using a single technique. RESULTS: Sixty-seven eyes from 67 patients including 60 men and 7 women were studied. The mean age was 34 ± 14 years and the mean logarithm of minimal angle of resolution of visual acuity was 1.89 ± 0.71. The calculated sensitivity, specificity, and accuracy values for SS-OCT were 96.8% (95% confidence interval [CI] 83.81-99.43), 66.7% (95% CI 48.78-80.77), and 82% (95% CI 70.53-89.62), respectively. For UBM, sensitivity, specificity, and accuracy values were 82.6% (95% CI 62.86-93.02), 57.9% (95% CI 36.28-76.86), and 71.4% (95% CI 56.43-82.83), respectively. Positive predictive and negative predictive values for SS-OCT were 75% (95% CI 59.81-85.81) and 95.2% (95% CI 77.33-99.15) and for UBM were 70.4% (95% CI 51.52-84.15) and 73.3% (95% CI 48.05-89.1), respectively. CONCLUSION: Although both imaging techniques are effective, SS-OCT appears to be at least comparable, or superior in special circumstances, to UBM in detecting preoperative posttraumatic PC rupture. We recommend preoperative assessment of all traumatic cataracts with SS-OCT as a part of surgical planning.


Assuntos
Catarata/diagnóstico por imagem , Cristalino/lesões , Microscopia Acústica , Ruptura da Cápsula Posterior do Olho/diagnóstico por imagem , Cápsula Posterior do Cristalino/diagnóstico por imagem , Tomografia de Coerência Óptica , Adulto , Catarata/etiologia , Extração de Catarata , Ferimentos Oculares Penetrantes/diagnóstico por imagem , Ferimentos Oculares Penetrantes/etiologia , Reações Falso-Positivas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Acuidade Visual/fisiologia , Ferimentos não Penetrantes/diagnóstico por imagem , Ferimentos não Penetrantes/etiologia , Adulto Jovem
3.
Rev. cuba. oftalmol ; 33(1): e812, ene.-mar. 2020. graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1126730

RESUMO

RESUMEN Paciente de 56 años quien acudió a la consulta por disminución de la visión, dolor y enrojecimiento ocular izquierdo, con antecedentes patológicos personales de hipertensión arterial esencial y antecedentes patológicos oculares de trauma ocular con fragmento de madera al cortar leña hace 37 años. El cuerpo extraño penetró hasta la cámara anterior y permaneció intracorneal, ya que en aquel momento no pudo ser removido en su totalidad. Se describe la técnica quirúrgica empleada, sobre la cual la información revisada ha sido escasa referente a los procederes quirúrgicos de remoción de cuerpos extraños semejantes, por lo que la técnica descrita debe contribuir a enfrentar futuros casos similares(AU)


ABSTRACT A 56-year-old male patient attends consultation with left eye vision reduction, pain and redness. The patient has a history of essential hypertension and eye trauma caused by a wood splinter while chopping wood 37 years ago. The foreign body went in as far as the anterior chamber and remained intracorneal, since at that time it could not be totally removed. A description is provided of the surgical technique used. Scant information was found about surgical procedures to remove similar foreign bodies. Therefore, the technique herein described should be useful to treat analogous cases(AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Ferimentos Oculares Penetrantes/etiologia , Corpos Estranhos no Olho/diagnóstico por imagem , Microscopia/métodos
4.
Eur J Ophthalmol ; 30(2): 269-274, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30539664

RESUMO

BACKGROUND: To investigate epidemiology, etiology, and outcomes after repair of pediatric open-globe injury. METHODS: We retrospectively reviewed medical records of patients ⩽18 years who underwent primary open-globe repair. RESULTS: A total of 213 patients were identified. Male-female ratio was 1.44:1. Type of injury was penetration in 157 (74.4%) cases, rupture in 52 (24.4%) cases, and perforation in 2 (0.9%) cases. Knife injuries were the most common cause, affecting 38/196 (19.4%), followed by metallic object in 37/196 (18.9%) patients, glass in 26/196 (13.3%) patients, and pen or pencil in 24/196 (12.8%). Predictors of good visual outcome defined as (⩾20/40) were good initial visual acuity (⩾20/40; p < 0.0001), time from injury to arrival at the emergency room >24 h (p = 0.038), size of wound less than 10 mm (p < 0.0001), absence of iris prolapse (p < 0.0001), deep anterior chamber at presentation (p < 0.0001), absence of hyphema (p = 0.043), intact lens (p < 0.0001), and no retinal detachment during follow-up (p < 0.0001). A total of 27 (12.7%) cases were documented to have retinal detachment at any time during follow-up period. Predictors of retinal detachment were perforation and rupture (p < 0.0001), whereas penetration was not associated with development of retinal detachment, size of the wound ⩾10 mm (p < 0.0001), initial visual acuity ⩽20/200 (p < 0.0001), lens injury (p < 0.0001), and development of endophthalmitis (p < 0.027). Eight (3.7%) eyes had the clinical diagnosis of posttraumatic endophthalmitis. CONCLUSIONS: The most common type of injury was penetration and the most common tool was knife. Visual outcome was affected by the initial presentation. Retinal detachment was a significant predictor of a worse final visual outcome.


Assuntos
Ferimentos Oculares Penetrantes/epidemiologia , Hospitais Universitários/estatística & dados numéricos , Centros de Atenção Terciária/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Ferimentos Oculares Penetrantes/etiologia , Ferimentos Oculares Penetrantes/cirurgia , Feminino , Humanos , Lactente , Masculino , Procedimentos Cirúrgicos Oftalmológicos , Prognóstico , Estudos Retrospectivos , Acuidade Visual/fisiologia
5.
Br J Sports Med ; 54(1): 23-26, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30988018

RESUMO

OBJECTIVES: To describe ocular injuries caused by badminton and to explore the implications for future prevention strategies. METHODS: We enrolled 85 patients with ocular trauma caused by badminton. Information collected from patients included type of game, instigator, instrument of injury and lessons in badminton from a professional, and ocular trauma information such as type of injury, treatment and final outcomes. RESULTS: The 85 patients (52 men, 33 women) were aged 15-65 years with an average age of 42.9 (±10.7) years. In 60 cases the player was hit by a shuttlecock and in 25 the player was hit by a racquet. 73 cases occurred in doubles matches and 10 in singles matches. In 31 cases the trauma was caused by an opponent and in 52 cases by a partner; 2 cases involved bystanders, not players. About 70% (43/61) of the injured and 82% (40/49) of the instigators had not received badminton lessons from a professional. 80 injuries were non-penetrating and 5 were penetrating. There were 58 cases with hyphaema, 36 with secondary glaucoma, 23 with lens subluxation and 2 with retinal detachment. Surgery comprised phacoemulsification or lensectomy and vitrectomy in 16 cases, silicone oil tamponade in 2 cases, trabeculectomy in 3 cases and direct cyclopexy in 5 cases. CONCLUSION: The vast majority of the badminton related eye injuries occurred among doubles players and were instigated by the injured person's partner. Non-penetrating injury was more frequent; penetrating injury was usually more serious. We recommend that badminton players use protective eyewear and receive safety education and professional coaching/instruction on techniques to protect against serious eye injuries.


Assuntos
Traumatismos Oculares/etiologia , Traumatismos Oculares/prevenção & controle , Esportes com Raquete/lesões , Adolescente , Adulto , Traumatismos Oculares/complicações , Traumatismos Oculares/cirurgia , Ferimentos Oculares Penetrantes/complicações , Ferimentos Oculares Penetrantes/etiologia , Ferimentos Oculares Penetrantes/prevenção & controle , Ferimentos Oculares Penetrantes/cirurgia , Dispositivos de Proteção dos Olhos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Ferimentos não Penetrantes/complicações , Ferimentos não Penetrantes/etiologia , Ferimentos não Penetrantes/prevenção & controle , Ferimentos não Penetrantes/cirurgia , Adulto Jovem
6.
Eur J Ophthalmol ; 30(5): NP18-NP22, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31088114

RESUMO

PURPOSE: The aim is to report a case of conjunctival tattooing with inadvertent injection of tattoo ink into the vitreous cavity and its consequences, the scanning electron microscopy X-ray microanalysis of the ink components, and the microscopic findings of the affected conjunctiva and vitreous. METHODS: Descriptive case report. RESULTS: A 32-year-old man complained of ocular pain and blurred vision after undergoing a subconjuctival red ink tattoo in his left eye. Ophthalmologic examination revealed best corrected visual acuity of 20/80 and intraocular pressure of 26 mmHg. Pain was elicited with eye movements. The bulbar conjunctiva was colored intense red. In the anterior chamber, pigment granules and filaments were suspended on the aqueous humor, and lens capsule was also stained red. Ultrasonography showed high-density non-mobile echoes in the conjunctiva; anterior chamber and vitreous cavity revealed high-density mobile echoes corresponding to pigment particles. Conjunctival tattoo with inadvertent globe penetration was the clinical diagnosis. The patient received medical and surgical treatment. Histopathological examination of the conjunctiva showed red pigment globular deposits within the stroma, and neutrophils and sparse histiocytes with similar intracytoplasmic pigment granules were seen. No granulomatous foreign body reaction was noticed. Vitreous material contained pigment granules; no inflammatory cells were observed. Scanning electron microscopy X-ray microanalysis of the tattoo red ink revealed significant signals of iron, barium, and copper. CONCLUSION: Conjunctival tattoo is a new form of body decoration gaining worldwide popularity. This procedure is performed by untrained professionals causing severe ocular complications including blindness. Safety regarding tattoo ink needs further study as the composition varies among colors. Strict regulations on this matter should be considered.


Assuntos
Túnica Conjuntiva , Corpos Estranhos no Olho/etiologia , Ferimentos Oculares Penetrantes/etiologia , Tinta , Tatuagem/efeitos adversos , Corpo Vítreo/patologia , Adulto , Microanálise por Sonda Eletrônica , Corpos Estranhos no Olho/diagnóstico por imagem , Corpos Estranhos no Olho/terapia , Ferimentos Oculares Penetrantes/diagnóstico por imagem , Ferimentos Oculares Penetrantes/terapia , Dor Ocular/etiologia , Humanos , Pressão Intraocular/fisiologia , Masculino , Microscopia Acústica , Microscopia Eletrônica de Varredura , Tonometria Ocular , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia , Acuidade Visual/fisiologia , Corpo Vítreo/química
10.
Ophthalmic Surg Lasers Imaging Retina ; 50(7): 466-467, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31344249

RESUMO

Complications of posterior sub-Tenon's steroid injections like glaucoma, cataract, sub-conjunctival hemorrhage and ptosis are well known. The authors present this photo essay to highlight a rare but serious complication of globe perforation secondary to posterior sub-Tenon's triamcinolone injection and describe its management. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:466-467.].


Assuntos
Ferimentos Oculares Penetrantes/etiologia , Glucocorticoides/administração & dosagem , Injeções Intraoculares/efeitos adversos , Erros Médicos , Triancinolona Acetonida/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade
15.
BMC Ophthalmol ; 19(1): 26, 2019 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-30665380

RESUMO

BACKGROUND: A few case reports have described accidental eye injuries caused by fish hooks. The severity of ocular injuries is dependent on the involved ocular structures. Severe ocular injuries due to fish hooks are rare. We describe open globe and penetrating eyelid injuries from fish hooks at the Baltic Sea. METHODS: Nine patients with traumatic ocular injuries caused by fish hooks were included. The following parameters were evaluated: severity of injury, best corrected visual acuity at admission and last follow-up, and surgical treatment. RESULTS: All nine patients were male. Age ranged between 7 and 51 years with a median of 13 years. Sixty-seven percent of the patients were children. Four of the nine patients were 9 years or younger. In 5 eyes (55%) the injury was limited to the eyelid. An open globe injury was found in 4 patients (45%). The mean follow-up was 16.7 ± 32.8 months. All patients required surgical treatment. The number of operations ranged from 1 to 3, with a mean of 1.4. At admission and last follow-up, patients with eyelid injuries showed a median best corrected visual acuity (BCVA) of logMAR 0.0. Patients with open globe injuries showed a median best corrected visual acuity of logMAR 1.5 at admission, and of logMAR 0.6 at last follow-up. CONCLUSIONS: Nearly half of the patients suffered severe penetrating injuries. Especially children misjudge the risk potential of fishing due to their lack of experience. Fishing glasses should be worn not only for UV protection, but also as injury prevention strategy.


Assuntos
Corpos Estranhos no Olho/etiologia , Ferimentos Oculares Penetrantes/etiologia , Recreação , Adolescente , Adulto , Criança , Corpos Estranhos no Olho/fisiopatologia , Corpos Estranhos no Olho/cirurgia , Ferimentos Oculares Penetrantes/fisiopatologia , Ferimentos Oculares Penetrantes/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Acuidade Visual/fisiologia , Adulto Jovem
16.
Am J Emerg Med ; 37(3): 427-432, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-29887192

RESUMO

PURPOSE: While generally reducing morbidity and mortality, TASER® electrical weapons have risks associated with their usage, including burn injuries and head and cervical trauma associated with uncontrolled falls. The primary non-fatal complications appear to be significant eye injury but no analysis of the mechanisms or suggested treatments has been published. METHODS: We used a biomechanical model to predict the risk of eye injury as a function of distance from the weapon muzzle to the eye. We compared our model results to recently published epidemiological findings. We also describe the typical presentation and suggest treatment options. RESULTS: The globe rupture model predicted that a globe rupture can be expected (50% risk) when the eye is within 6 m of the muzzle and decreases rapidly beyond that. This critical distance is 9 m for lens and retinal damage which is approximately the range of the most common probe cartridges. Beyond 9 m, hyphema is expected along with a perforation by the dart portion of the probe. Our prediction of globe rupture out to 6 m (out of a typical range of 9 m) is consistent with the published risk of enucleation or unilateral blindness being 69 ±â€¯18%, with an eye penetration. CONCLUSIONS: Significant eye injury is expected from a penetration by an electrical weapon probe at close range. The risk decreases rapidly at extended distances from the muzzle. Not all penetrating globe injuries from electrical weapon probes will result in blindness.


Assuntos
Lesões por Armas de Eletrochoque/patologia , Ferimentos Oculares Penetrantes/patologia , Adolescente , Adulto , Fenômenos Biomecânicos , Cegueira/etiologia , Cegueira/patologia , Enucleação Ocular , Ferimentos Oculares Penetrantes/etiologia , Feminino , Balística Forense , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Polícia/legislação & jurisprudência , Estados Unidos , Adulto Jovem
17.
Eur J Ophthalmol ; 29(5): NP14-NP17, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30284472

RESUMO

AIM: To present a case with a large traumatic macular hole that we repaired with a retinal graft. CASE DESCRIPTION: A 24-year-old male patient presented with corneal penetration and an intraocular foreign body caused by a work accident. Vitrectomy and intraocular foreign body removal were performed. One month after the surgery, the patient had macula on retinal detachment in the nasal and superior quadrant. In addition, a giant macular hole was formed. However, the macula was atrophic because of the trauma, and we could not repair the hole with classic macular hole surgery techniques. For this reason, we used a retinal graft to cover the macular hole, and we observed that the hole was closed in follow-up visits. CONCLUSION: Retinal grafts can be used in patients with giant macular holes. They may be useful especially in patients with atrophic macula in trauma cases.


Assuntos
Lesões da Córnea/cirurgia , Corpos Estranhos no Olho/cirurgia , Ferimentos Oculares Penetrantes/cirurgia , Traumatismos Ocupacionais , Retina/transplante , Perfurações Retinianas/cirurgia , Lesões da Córnea/etiologia , Tamponamento Interno , Corpos Estranhos no Olho/etiologia , Ferimentos Oculares Penetrantes/etiologia , Humanos , Macula Lutea , Masculino , Descolamento Retiniano/etiologia , Descolamento Retiniano/cirurgia , Perfurações Retinianas/etiologia , Óleos de Silicone , Acuidade Visual/fisiologia , Vitrectomia/métodos , Adulto Jovem
18.
J Fr Ophtalmol ; 42(1): 37-43, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30559016

RESUMO

PURPOSE: To describe the ocular findings and management of Hymenoptera insect stings. METHODS: We treated and followed 8 patients with ocular Hymenoptera stings. All patients were admitted through emergencies and hospitalized at the Hedi Rays eye institute in Tunis. RESULTS: The site of the sting was the cornea in 5 cases, limbus in one case, conjunctiva in one case and upper lid in the last case. Retained stingers were objectified in 4 cases. Immediate surgical extraction carried out in all cases. We also followed one case of post-sting Adie's syndrome and one case of retrobulbar optic neuritis. The sting was conjunctival in one case and palpebral in the other case. Corticosteroids were ineffective in these two cases. CONCLUSION: Ocular Hymenoptera stings are rare environmental accidents. They may cause various severe ocular complications. Early management, adapted to the clinical manifestations, is the key to a good outcome.


Assuntos
Ferimentos Oculares Penetrantes/etiologia , Ferimentos Oculares Penetrantes/terapia , Himenópteros , Mordeduras e Picadas de Insetos/complicações , Mordeduras e Picadas de Insetos/terapia , Corticosteroides/administração & dosagem , Adulto , Animais , Ciclosporina/administração & dosagem , Ferimentos Oculares Penetrantes/patologia , Feminino , Humanos , Mordeduras e Picadas de Insetos/patologia , Masculino , Soluções Oftálmicas , Estudos Retrospectivos , Tunísia
19.
Orbit ; 38(6): 486-491, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30570433

RESUMO

We describe six patients with 12 separate episodes of self-inflicted periocular foreign body injuries, which presented to our institution recently. All patients were male, relatively young (mean 28.5 years old), incarcerated, and had significant underlying psychiatric conditions. The subjects had inserted staples (6), paperclips (2), or other small metallic wire segments (4) into the periocular region. Most cases (9/12) involved concurrent self-inflicted injury to other body parts. Ten cases involved foreign bodies inserted through the palpebral conjunctiva into the upper eyelid, while two cases involved insertion into the orbit. Identification and surgical retrieval of foreign bodies was successful in most cases (9/11) but was not attempted in one case. Self-inflicted periocular injuries, while rare, are challenging cases for which the ophthalmologist should be prepared. A multidisciplinary approach, including psychiatric assessment and treatment, is important for optimal care.


Assuntos
Túnica Conjuntiva/lesões , Corpos Estranhos no Olho/etiologia , Ferimentos Oculares Penetrantes/etiologia , Pálpebras/lesões , Metais , Órbita/lesões , Automutilação/etiologia , Adulto , Túnica Conjuntiva/diagnóstico por imagem , Corpos Estranhos no Olho/diagnóstico por imagem , Corpos Estranhos no Olho/cirurgia , Ferimentos Oculares Penetrantes/diagnóstico por imagem , Ferimentos Oculares Penetrantes/cirurgia , Pálpebras/diagnóstico por imagem , Humanos , Masculino , Procedimentos Cirúrgicos Oftalmológicos , Órbita/diagnóstico por imagem , Automutilação/diagnóstico por imagem , Automutilação/cirurgia , Tomografia Computadorizada por Raios X , Raios X , Adulto Jovem
20.
J Cataract Refract Surg ; 45(1): 8-10, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30391155

RESUMO

We describe a technique for pediatric traumatic cataract management in cases in which part of the anterior capsule has been ruptured. The technique requires creating a 2-incision push-pull capsulorhexis in the intact anterior capsule. The capsulorhexis is made in a manner that converts the edge of the ruptured anterior capsule into a band of capsule that holds the intraocular lens (IOL) in the bag, reducing the incidence of early, intermediate, or late postoperative lens-iris capture. It also reduces the chances of IOL displacement.


Assuntos
Ruptura da Cápsula Anterior do Olho/cirurgia , Capsulorrexe/métodos , Extração de Catarata/métodos , Catarata/etiologia , Ferimentos Oculares Penetrantes/cirurgia , Cristalino/lesões , Ferimentos não Penetrantes/cirurgia , Adolescente , Ruptura da Cápsula Anterior do Olho/etiologia , Criança , Pré-Escolar , Corantes/administração & dosagem , Ferimentos Oculares Penetrantes/etiologia , Humanos , Implante de Lente Intraocular , Azul Tripano/administração & dosagem , Viscossuplementos/provisão & distribução , Acuidade Visual/fisiologia , Vitrectomia/métodos , Ferimentos não Penetrantes/etiologia
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