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1.
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
3.
Saudi Med J ; 40(10): 1063-1066, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31588488

RESUMO

OBJECTIVES: To describe causes of blindness and visual impairment (VI) in children in Eastern province, Saudi Arabia. Methods: A record-based descriptive cross-sectional study was conducted. Medical records of patients aged 2 to 16 years who were following up in the Pediatric Ophthalmology Clinics, Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia between September and December 2018 were reviewed. Causes of vision loss according to visual acuity (VA) with best correction were recorded. Blindness was defined as VA less than 20/400, VI as VA from 20/400 to 20/60, and visual loss as VA of ≤20/60. RESULTS: Of 818 patients, 39% had visual loss, 22.9% were blind, and 71.2% had VI. Common etiologies of bilateral blindness were retinal dystrophy disease and Leber's congenital amaurosis, whereas unilateral blindness was most common due to trauma and refractive error (RE). Common etiologies of bilateral VI were RE, esotropia, and retinal dystrophy. Unilateral VI was mainly due to RE, cataract, congenital esotropia, and trauma. Of all patients, 58.8% had treatable causes, 22.6% had preventable causes, and 19.5% had non-preventable and non-treatable causes; mostly genetic or congenital (59.7%) rather than acquired (40.2%). CONCLUSION: Genetic or congenital causes are major factors causing blindness. Most causes are treatable and preventable, emphasizing on early detection and treatment of those causes.


Assuntos
Cegueira/etiologia , Adolescente , Fatores Etários , Cegueira/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Traumatismos Oculares/complicações , Traumatismos Oculares/epidemiologia , Feminino , Humanos , Masculino , Distrofias Retinianas/epidemiologia , Distrofias Retinianas/etiologia , Arábia Saudita/epidemiologia , Centros de Atenção Terciária/estatística & dados numéricos , Transtornos da Visão/epidemiologia , Transtornos da Visão/etiologia
4.
BMC Ophthalmol ; 19(1): 209, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640617

RESUMO

BACKGROUND: Crouzon syndrome (CS), which results from fibroblast growth factor receptor 2 mutations, is associated with craniosynostosis, exophthalmos, and other symptoms. Herein, we report the genetic abnormalities detected in a Chinese family with autosomal dominant CS, combined with luxation of the eyeball. This luxation was a consequence of the trauma to the shallow orbits. CASE PRESENTATION: The proband was a 4-year-old boy. He accidentally fell, following which luxation of the bulbus oculi occurred immediately. Computed tomography and magnetic resonance imaging clearly revealed ocular proptosis. Upon physical examination, the proband, his father, and grandfather had ocular proptosis, shallow orbits, and mid-face hypoplasia. However, their hands and feet were clinically normal. Genomic DNA was extracted from the peripheral blood through a polymerase chain reaction performed for the target sequence. Genetic assessments revealed a heterozygous missense mutation (c.1012G > C, p.G338R) in exon 10 of the human FGFR2, cosegregated with the disease phenotype in this family. These findings confirmed the diagnosis of CS. DISCUSSION: CS is usually caused by FGFR2 mutations. While there are a few reports of luxation of the bulbus oculi in Chinese families with CS, the ocular proptosis, shallow orbits, combined with luxation of eyeball after trauma observed in this patient were particularly interesting. Our findings enhance the current knowledge of traumatic luxation concomitant with CS.


Assuntos
Disostose Craniofacial/genética , DNA/genética , Traumatismos Oculares/complicações , Mutação de Sentido Incorreto , Órbita/lesões , Receptor Tipo 2 de Fator de Crescimento de Fibroblastos/genética , Ferimentos não Penetrantes/complicações , Pré-Escolar , China , Disostose Craniofacial/complicações , Disostose Craniofacial/metabolismo , Análise Mutacional de DNA , Traumatismos Oculares/diagnóstico , Humanos , Imagem por Ressonância Magnética , Masculino , Órbita/diagnóstico por imagem , Linhagem , Fenótipo , Receptor Tipo 2 de Fator de Crescimento de Fibroblastos/metabolismo , Tomografia Computadorizada por Raios X , Ferimentos não Penetrantes/diagnóstico
5.
Nepal J Ophthalmol ; 11(21): 91-97, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31523074

RESUMO

Orbital compartment syndrome is a rare presentation of orbital trauma and is an ophthalmic emergency. Delay in clinical diagnosis and subsequent surgical intervention will lead to loss of vision in nick of time. We presented a case series of orbital compartment syndrome secondary to trauma who presented to the emergency department of Tribhuvan University Teaching Hospital during the devastating earthquake in April 2015. Clinical diagnosis of orbital compartment syndrome was made in the bedside and all the patients underwent emergency lateral canthotomy and inferior cantholysis. This case series was aimed to describe clinical features and management of orbital compartment syndrome.


Assuntos
Síndromes Compartimentais/etiologia , Traumatismos Oculares/complicações , Órbita/lesões , Doenças Orbitárias/etiologia , Adolescente , Síndromes Compartimentais/diagnóstico , Síndromes Compartimentais/cirurgia , Traumatismos Oculares/diagnóstico , Feminino , Humanos , Imagem Tridimensional , Masculino , Procedimentos Cirúrgicos Oftalmológicos/métodos , Órbita/diagnóstico por imagem , Doenças Orbitárias/diagnóstico , Doenças Orbitárias/cirurgia , Tomografia Computadorizada por Raios X , Índices de Gravidade do Trauma , Adulto Jovem
6.
Graefes Arch Clin Exp Ophthalmol ; 257(11): 2541-2545, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31489490

RESUMO

BACKGROUND: Orbital roof fractures are a significant cause of morbidity in trauma and are associated with a spectrum of orbital and ocular injuries. This study aims to characterize orbital roof fracture patterns and quantify the rate of acute intervention as compared with non-roof involving orbital wall fractures. METHODS: This study is a retrospective analysis of 340 orbital wall fractures diagnosed by CT imaging from August 2015 to October 2016. Orbital wall fractures were categorized as roof involving (N = 50) and non-roof involving (N = 290). Comparisons were made between these two groups to indicate a statistically significant difference in mechanism of injury, subjective symptoms, CT and exam findings, and final plan of care to include acute ophthalmologic intervention at the time of consultation. RESULTS: Assault (40.7%) was the most common cause of non-roof-involving fractures while falls from height (20.0%) were associated with a higher rate of roof fractures. Roof-involving orbital wall fractures were associated with a higher prevalence of corneal abrasions (16.3%), lid lacerations (23.4%), and traumatic optic neuropathy (10.4%). A reliable subjective exam on initial ophthalmic consultation was not achieved in a larger proportion of roof fracture patients (30%). Despite this, the rate of acute intervention in this group (34%) was almost double, including lateral canthotomy and cantholysis. CONCLUSIONS: Concomitant ocular injury is common in roof-involving orbital wall fractures, and may require more urgent ophthalmologic evaluation and acute intervention. As subjective patient data is often less readily available, a high index of suspicion and thorough investigation is warranted in caring for patients with roof-involving orbital wall fractures.


Assuntos
Traumatismos Oculares/complicações , Órbita/lesões , Fraturas Orbitárias/diagnóstico , Adulto , Traumatismos Oculares/diagnóstico , Traumatismos Oculares/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade/tendências , Órbita/diagnóstico por imagem , Fraturas Orbitárias/complicações , Fraturas Orbitárias/epidemiologia , Estudos Retrospectivos , Centros de Traumatologia/estatística & dados numéricos , Estados Unidos/epidemiologia
7.
Med Hypotheses ; 131: 109286, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31443768

RESUMO

Traumatic retinal injuries are commonly encountered in most retinal subspecialty clinics. Retinal dialysis, detachment and other complications consequent to blunt trauma are often thought to be due to equatorial expansion of the globe following an antero-posterior compressive force. However, stretching of the globe along the primary anatomical equator may not hold true for the adjusted globe position as a consequence of the protective Bell's phenomenon which gets activated before impact. The upward and outward rolling of the globe likely creates a new equator, with the compressive forces acting along this new plane, thereby leading to stretching along the ocular coats closer to the retinal periphery. Additionally, the coup and countercoup mechanisms with increased vulnerability of temporal sclera predisposes to retinal complications more commonly along the temporal and the nasal retina. Further, retinal complications involving other quadrants can also be explained through understanding of the Bell's phenomenon.


Assuntos
Traumatismos Oculares/complicações , Movimentos Oculares/fisiologia , Modelos Biológicos , Reflexo/fisiologia , Retina/lesões , Perfurações Retinianas/etiologia , Ferimentos não Penetrantes/complicações , Animais , Traumatismos Oculares/fisiopatologia , Cabras , Humanos , Músculos Oculomotores/lesões , Pressão , Perfurações Retinianas/prevenção & controle , Ferimentos não Penetrantes/fisiopatologia
9.
Graefes Arch Clin Exp Ophthalmol ; 257(11): 2547-2558, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31363832

RESUMO

PURPOSE: To evaluate the effectiveness of temporary keratoprosthesis combined with vitreoretinal surgery and penetrating keratoplasty in patients with or without trauma. METHODS: This retrospective study included 49 eyes in 49 non-trauma patients and 51 eyes in 48 ocular trauma patients who underwent penetrating keratoplasty and vitreoretinal surgery with Eckardt temporary keratoprosthesis between 2009 and 2016, with a follow-up of at least 12 months. Study variables included previous corneal, glaucoma, or retinal surgeries; various intraoperative surgical maneuvers; lens status; vitreoretinal and corneal pathology; functional outcomes; anatomical retinal reattachment; graft clarity; and need for glaucoma surgery or treatment. RESULTS: The mean age was 56 years in the non-trauma group and 42 years in the ocular trauma group. A total of 45% of the non-trauma cases and 24% of the ocular trauma cases had a single functional eye. Pseudophakic and aphakic keratopathy was diagnosed in 41% of the non-trauma group and corneal laceration in 65% of the ocular trauma group. In the ocular trauma group, injuries were open globe injury in 78%, closed globe injury in 12%, and intraocular foreign body in 10%. Retinal detachment with proliferative vitreoretinopathy was present in 39% of patients in the non-trauma group and in 35% of the ocular trauma group. Improvement or stability of visual acuity was higher among ocular trauma patients (86%) than in non-trauma patients (78%). The rate of clear corneal grafts was 49% in both groups. Retinal attachment was achieved in 90% and 78% of patients in the non-trauma and ocular trauma groups, respectively. The use of retinotomy had a positive influence on the final attached retina (p = 0.016). The placement of a scleral buckle significantly increased the risk of glaucoma (p = 0.004). Poor functional outcome was related to persistent retinal detachment (10% versus 16% in the non-trauma and ocular trauma groups, respectively), phthisis (25% versus 12%), hypotony (33% versus 18%), corneal graft end failure (51% in both groups), and secondary glaucoma (18% versus 24%). CONCLUSION: In patients with both vitreoretinal and corneal pathology, the use of Eckardt temporary keratoprosthesis combined with vitreoretinal surgery and penetrating keratoplasty resulted in improvement of visual acuity, particularly in the groups of ocular trauma and monocular patients. The high rate of retinal reattachment and the low rate of graft rejection was probably related to the use of new vitreoretinal techniques, including retinotomy in selected patients.


Assuntos
Córnea/cirurgia , Doenças da Córnea/cirurgia , Traumatismos Oculares/complicações , Ceratoplastia Penetrante/métodos , Próteses e Implantes , Doenças Retinianas/cirurgia , Cirurgia Vitreorretiniana/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Córnea/patologia , Doenças da Córnea/complicações , Traumatismos Oculares/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Doenças Retinianas/complicações , Estudos Retrospectivos , Acuidade Visual , Adulto Jovem
10.
BMC Ophthalmol ; 19(1): 164, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31357978

RESUMO

BACKGROUND: To investigate the long-term outcomes and complications of scleral-fixated intraocular lens (SFIOL) implantation without conjunctival peritomies and sclerotomy in patients with a history of ocular trauma with inadequate capsular support during primary pars plana vitrectomy or silicone oil removal. METHODS: Records of ocular trauma patients who underwent implantation of SFIOL without conjunctival peritomies and sclerotomy during primary pars plana vitrectomy or silicone oil removal. RESULTS: Sixty-nine eyes of 69 patients were included in this study. The median follow-up period was 34 months (range, 6-99 months). The average patient age at the time of surgery was 44 years old (range, 4-80 years). At the end of follow-up, the preoperative mean of best corrected visual acuity (BCVA) was 0.79 ± 0.86 log of the minimum angle of resolution (logMAR), which improved 0.20 ± 0.26 logMAR postoperatively (P = 0.01). BCVA improved or remained unchanged in 64 eyes (92.8%), VA decreased two lines in five eyes (7.2%). Early postoperative complications included transient corneal edema in seven eyes (10.1%), minor vitreous hemorrhage in four eyes (5.8%), transient elevated intraocular pressure (IOP) in one eye (1.4%), and hypotony in three eyes (4.3%). Late postoperative complications included persistent elevated IOP in five eyes (7.2%), epiretinal membrane formation in three eyes (4.3%), and cystoid macular edema noted in one eye (1.4%). CONCLUSIONS: Use of a scleral-fixated intraocular lens implantation without conjunctival peritomies and sclerotomy in ocular trauma patients during either primary pars plana vitrectomy or second silicone oil removal is a valuable approach for the management of traumatic aphakia in the absence of capsular support.


Assuntos
Afacia/cirurgia , Traumatismos Oculares/complicações , Implante de Lente Intraocular/métodos , Esclera/cirurgia , Técnicas de Sutura , Acuidade Visual , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Afacia/diagnóstico , Afacia/etiologia , Criança , Pré-Escolar , Túnica Conjuntiva , Traumatismos Oculares/diagnóstico , Traumatismos Oculares/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Vitrectomia , Adulto Jovem
11.
Br J Oral Maxillofac Surg ; 57(6): 578-581, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31155398

RESUMO

We present a case series of three patients who developed acute traumatic orbital third nerve palsies. To our knowledge, reported cases have mainly been localised to the intracranial course of the nerve and often associated with visual impairment. Those in which the orbit is the site of injury are rare. Our case series highlights the importance of careful preoperative assessment of patients with orbital trauma (particularly when there is a coexisting fracture) and the need to assess ocular movements and pupillary reactions to distinguish between a neurogenic and soft tissue injury. Early diagnosis is helpful in deciding on the timing of the operation and enables patients to be given appropriate counselling to make sure that their expectations are realistic.


Assuntos
Traumatismos Oculares , Doenças do Nervo Oculomotor , Fraturas Orbitárias , Traumatismos Oculares/complicações , Movimentos Oculares , Humanos , Doenças do Nervo Oculomotor/etiologia , Órbita , Fraturas Orbitárias/complicações
13.
J Fr Ophtalmol ; 42(8): 852-863, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31202775

RESUMO

INTRODUCTION: Cyclodialysis is a rare condition that is difficult to manage. We present the case of a woman with a cyclodialysis complicated by chronic hypotony requiring two surgeries to achieve reattachment of the ciliary body. We also report the results of a review of the literature regarding the treatment of this condition. DESCRIPTION: This is a 46-year-old woman with history of trauma to the right eye. Examination revealed an intra-ocular pressure (IOP) of 7mmHg, a shallow anterior chamber and signs of chronic hypotony on fundus examination (vascular tortuosity, hypotony maculopathy) due to an extensive 360° cyclodialysis, confirmed by ultrasound biomicroscopy. Transcleral cryotherapy as a first-line approach did not achieve reattachment of the ciliary body. Secondary pars plana vitrectomy with gas tamponade (C2F6) reattached the ciliary body and restored the intraocular pressure (12mmHg) and normal fundus appearance. The patient recovered corrected visual acuity of 20/20. DISCUSSION: To our knowledge, there is no standardized management for cyclodialysis. The study of the literature available on the Medline database showed that direct cyclopexy remains the most common treatment, followed by vitrectomy with internal tamponade. Neither the extent nor the duration of the cyclodialysis can predict the visual recovery, which can be major even after weeks of hypotony. CONCLUSION: The management of cyclodialysis is not well-defined; it remains a true therapeutic challenge.


Assuntos
/terapia , Corpo Ciliar/lesões , Corpo Ciliar/patologia , Terapia Combinada , Crioterapia/métodos , /etiologia , Traumatismos Oculares/complicações , Traumatismos Oculares/terapia , Feminino , Humanos , Pessoa de Meia-Idade , Hipotensão Ocular/diagnóstico , Hipotensão Ocular/etiologia , Hipotensão Ocular/terapia , Padrões de Prática Médica/estatística & dados numéricos , Padrões de Prática Médica/tendências , Tonometria Ocular , Vitrectomia/métodos
14.
BMJ Case Rep ; 12(6)2019 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-31178435

RESUMO

Gel blasters fire a hydrated gel polymer and are developed to circumvent the restrictions placed on paintball and airsoft guns. Because there are no reported cases of injury caused by gel blasters in the literature, some Australian jurisdictions have categorised them as a toy. Presented here are two cases of potentially blinding blunt ocular trauma which question the misguided notion they are a harmless toy. Two children each with a macrohyphaema were managed at a tertiary ophthalmology centre within 2 weeks of each other after being struck by a gel blaster projectile. Their vision ultimately returned to normal, but both face lifelong risks of ocular complications. These cases highlight the need for vigilance, and the appropriate restriction of powerful weapons, with the inherent need for eye protection when operating any such projectiles reiterated. It is recommended their licensing is made congruous with paintball guns to prevent false reassurance of their safety.


Assuntos
Traumatismos Oculares/etiologia , Jogos e Brinquedos/lesões , Ferimentos não Penetrantes/etiologia , Adolescente , Austrália , Pré-Escolar , Traumatismos Oculares/complicações , Humanos , Masculino , Recuperação de Função Fisiológica , Centros de Atenção Terciária , Acuidade Visual , Ferimentos não Penetrantes/complicações
15.
Cornea ; 38(7): 868-872, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31045962

RESUMO

PURPOSE: To evaluate the causes and management outcomes of acquired corneal opacity in a preschool age group (0-5 years) at a tertiary care hospital. METHODS: Medical records of all cases (0-5 years) with acquired corneal opacity presenting to the cornea clinic of a tertiary eye care hospital from February 2013 to January 2014 were evaluated for age of onset, age at presentation, sex, laterality, cause of opacity, visual acuity, nutritional status, and socioeconomic class of the parents. The etiology of corneal opacity and the type of intervention with outcome at 3 months follow-up were recorded. RESULTS: A total of 106 cases were included in the study. The most common cause of corneal scarring was healed infective keratitis (35.8%). Chemical injury, mechanical trauma, and keratomalacia were the other causes, affecting 21.8%, 20.8%, and 16% of the cases, respectively. Optical iridectomy was the most commonly performed procedure (35.8%), followed by lens aspiration with intraocular lens implantation (17.9%) and penetrating keratoplasty (17%). The mean corrected visual acuity (spectacle or contact lens) at the time of presentation and at 3 months after treatment was 2.9 ± 0.3 (perception of light) and 2.2 ± 0.9 (hand motions) logarithm of minimum angle of resolution (logMAR) units, respectively. CONCLUSIONS: Chemical injury and keratomalacia are the major causes of acquired corneal opacity in preschool age groups in India and are associated with poor visual prognosis.


Assuntos
Opacidade da Córnea , Procedimentos Cirúrgicos Oftalmológicos/métodos , Pré-Escolar , Opacidade da Córnea/etiologia , Opacidade da Córnea/cirurgia , Queimaduras Oculares/induzido quimicamente , Traumatismos Oculares/complicações , Feminino , Humanos , Índia , Ceratite/complicações , Masculino , Acuidade Visual , Deficiência de Vitamina A/complicações
16.
Ophthalmic Surg Lasers Imaging Retina ; 50(5): 309-313, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-31100162

RESUMO

Commotio retinae is retinal opacification resulting from countercoup injury after blunt trauma. This case series describes two girls with commotio retinae following blunt ocular trauma after rubber band injuries. Optical coherence tomography (OCT) showed defects in the outer retinal layers. OCT angiography showed no perfusion defects. OCT after 1-year follow-up revealed persistent outer retinal layer defects. This report emphasizes the importance of preventing rubber band injuries. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:309-313.].


Assuntos
Traumatismos Oculares/complicações , Retina/lesões , Doenças Retinianas/etiologia , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Ferimentos não Penetrantes/complicações , Criança , Traumatismos Oculares/diagnóstico , Feminino , Humanos , Retina/diagnóstico por imagem , Doenças Retinianas/diagnóstico , Ferimentos não Penetrantes/diagnóstico
17.
J Fr Ophtalmol ; 42(8): 864-873, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31122763

RESUMO

BACKGROUND: Eye injuries can result in long-term disability, and healthcare providers need better tools to predict outcomes. Few prognostic models for poor visual acuity have been examined using variables usually present in very severe injuries, which creates a gap in prognosis. Therefore, a model associated with severe and less severe injuries is examined. METHODS: Eye injuries hospitalized in Bosnia and Herzegovina from 2006 through 2014 were included. A total of 258 eye injuries met the inclusion criteria of being an acute mechanical, chemical or physical eye injury. Prognostic variables were grouped by patient characteristics, eye injury characteristics and eye injury diagnosis. Poor final visual acuity was the main outcome measure (vision less than 20/200). Multivariable regression analysis used stepwise selection to identify the strongest set of predictive variables. RESULTS: Lens subluxation (95 % CI: 2.09-14.83), vitreous prolapse (95 % CI: 2.76-26.87), vitreous hemorrhage (95 % CI: 1.71-10.03), posterior segment intraocular foreign body (95 % CI: 1.19-39.09), and vitritis (95 % CI: 0.97-11.12) were significantly associated with poor final visual acuity. The predictive model identified the combination of age over 36, lens subluxation, vitreous prolapse and hemorrhage, vitritis, and macular hemorrhage as the combination most likely to have poor visual acuity. The final model resulted in a strong fit as measured by AIC, log likelihood, goodness-of-fit, and the c-statistic. CONCLUSIONS: This model can be used in clinical practice to evaluate the severity and predict final visual acuity in both severe and less severe eye injuries. The model accounts for characteristics of the injury as well as the patient. Additional studies with larger samples could further verify this model.


Assuntos
Técnicas de Diagnóstico Oftalmológico , Traumatismos Oculares , Modelos Estatísticos , Transtornos da Visão , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bósnia e Herzegóvina/epidemiologia , Demografia , Traumatismos Oculares/complicações , Traumatismos Oculares/diagnóstico , Traumatismos Oculares/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Projetos de Pesquisa , Estudos Retrospectivos , Fatores de Risco , Índices de Gravidade do Trauma , Transtornos da Visão/diagnóstico , Transtornos da Visão/epidemiologia , Transtornos da Visão/etiologia , Acuidade Visual , Adulto Jovem
18.
Adv Emerg Nurs J ; 41(2): 122-128, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31033659

RESUMO

Eye trauma is a common presenting complaint in the emergency department. Correctly identifying the underlying pathology in eye trauma is critical to developing appropriate treatment plans that reduce the risk of long-term sequelae, and reduce or eliminate threats to vision. The clinical evaluation and diagnosis can be complex, and the presentation of serious eye conditions can be similar to that of more benign conditions. This article focuses on traumatic uveitis. It addresses the elements of history and examination that should suggest uveitis as the cause of pain and redness following trauma to the eye. It also outlines specific findings that can help differentiate uveitis from other causes of eye pain and redness following trauma. Included is a brief description of the pathophysiology of uveitis and the mechanism by which this inflammatory condition can result in loss of vision. Discussion includes recommended treatment. It offers a straightforward approach to making the diagnosis of traumatic uveitis.


Assuntos
Serviço Hospitalar de Emergência , Traumatismos Oculares/complicações , Uveíte/diagnóstico , Uveíte/etiologia , Diagnóstico Diferencial , Traumatismos Oculares/tratamento farmacológico , Traumatismos Oculares/enfermagem , Feminino , Humanos , Pessoa de Meia-Idade , Uveíte/tratamento farmacológico , Uveíte/enfermagem
19.
BMJ Case Rep ; 12(4)2019 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-30948405

RESUMO

A 69-year-old patient presented to us with traumatic mydriasis with irregular pupil measuring 7 mm, with superior loss of iris tissue and large inferior peripheral iridotomy and pseudophakia. The patient had history of blunt trauma 3 years ago in a fire cracker injury. He was operated elsewhere primarily after the trauma for cataract surgery with intraocular lens implantation and had suboptimal visual outcome with glare and photophobia. He presented to us with irregular pupil and inferior iridectomy with pseudophakia. The uncorrected visual acuity was 20/150 improving to 20/50 with glasses. He had a history of cataract surgery with intraocular lens (IOL) implantation done elsewhere several years back. The patient was not a diabetic or hypertensive. There was a para central corneal scar causing irregular corneal astigmatism. Extra focus pinhole IOL was implanted in sulcus having a pinhole aperture 1.36 mm. Preoperative total corneal higher-order aberrations were 3.3 µ and total corneal coma was 0.97 µ. Postoperatively uncorrected distance visual acuity improved to 20/40 intermediate uncorrected visual acuity improved to 20/30 and uncorrected near visual acuity was J3.


Assuntos
Astigmatismo/cirurgia , Traumatismos Oculares/complicações , Iris/lesões , Implante de Lente Intraocular/métodos , Midríase/cirurgia , Idoso , Astigmatismo/etiologia , Humanos , Masculino , Midríase/etiologia
20.
Mycopathologia ; 184(3): 441-453, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30949880

RESUMO

Colletotrichum species are known as important pathogens of plants with an impact on crop production. Some of these species are also known as a cause of rare ophthalmic infections in humans. A case of keratitis caused by Colletotrichum dematium after corneal trauma in a 56-year-old woman is presented. Infection was diagnosed based on positive microscopy and culture. The fungal isolate was identified by morphological characteristics and DNA sequencing of the ITS rDNA region, ß-tubulin (tub2) and glyceraldehyde-3-phosphate dehydrogenase (gapdh) genes. The patient responded well to topical therapy with amphotericin B combined with intravenous amphotericin B but improvement was associated with the corneal collagen cross-linking. The review of the literature revealed another 13 cases of C. dematium keratitis, all but one patient having at least one keratitis risk factor in their history. Almost all patients (n = 12) were treated with topical polyene antibiotics (natamycin or amphotericin B), improvement and cure were achieved in eight of them.


Assuntos
Colletotrichum/isolamento & purificação , Traumatismos Oculares/complicações , Ceratite/diagnóstico , Ceratite/patologia , Micoses/diagnóstico , Micoses/patologia , Administração Tópica , Adolescente , Adulto , Anfotericina B/administração & dosagem , Antifúngicos/administração & dosagem , Colletotrichum/classificação , Colletotrichum/genética , DNA Espaçador Ribossômico/genética , Feminino , Gliceraldeído-3-Fosfato Desidrogenase (Fosforiladora)/genética , Humanos , Ceratite/microbiologia , Masculino , Técnicas Microbiológicas , Pessoa de Meia-Idade , Técnicas de Diagnóstico Molecular , Micoses/microbiologia , Análise de Sequência de DNA , Resultado do Tratamento , Tubulina (Proteína)/genética , Adulto Jovem
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