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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
2.
Orv Hetil ; 160(49): 1941-1947, 2019 Dec.
Artigo em Húngaro | MEDLINE | ID: mdl-31786937

RESUMO

Introduction and aim: To analyse and classify the ocular trauma cases at the in-patient ophthalmological department of the Markusovszky University Teaching Hospital between 2014 and 2018. Method: We analysed the eye injury cases between 01. 01. 2014 and 31. 12. 2018 in the in-patient clinic of our hospital. 98 eyes of 97 patients were included in this study. To classify the injuries, we used the Birmingham Eye Trauma Terminology (BETT) and the new expanded classification of Shukla et al. Results: From the 97 patients, 16 were female and 81 male. The average age was 43.3 ± 22.5 (min.: 3, max.: 92) years; 20 patients were younger than 18 years old. 46.4% of the cases were right eyes, 52.5% were left eyes, and 1% was bilateral. The average time from the injury until the treatment was 1.3 days. The average time spent in hospital because of the injury was 5.2 days. The average observation time was 9.7 months. 95.8% of the injuries were mechanical eye injuries. From this group, 74.2% localized only to the globe, 20.4% were adnexal injuries and 5.4% were destructive eye injuries. From the globe injuries, 15 were closed globe, 60 were open globe injuries, and in 21 cases there were intraocular foreign body present. In 93% of the cases it was possible to keep or improve the best corrected visual acuity during the treatment. Conclusion: With the new classification, we could classify all of the eye injury cases easily. Depending on the type of the eye injury, with appropriate treatment we can keep or improve the visual function of the eye. Orv Hetil. 2019; 160(49): 1941-1947.


Assuntos
Traumatismos Oculares/classificação , Pacientes Internados/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Traumatismos Oculares/epidemiologia , Traumatismos Oculares/etiologia , Feminino , Departamentos Hospitalares , Hospitais Universitários , Humanos , Hungria/epidemiologia , Masculino , Pessoa de Meia-Idade , Acuidade Visual
7.
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
8.
J Pediatr Ophthalmol Strabismus ; 56(3): 162-167, 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31116863

RESUMO

PURPOSE: To report the occurrence of lens injury during intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection in infants with retinopathy of prematurity (ROP). METHODS: ROP cases presenting to a tertiary care center with cataract following intravitreal injection were retrospectively studied from June 2017 to May 2018. The indication, setting, and method of injection were noted. Ultrasound biomicroscopy (UBM) details were recorded. The main measures were morphology of cataract, posterior capsular defect, and intraocular lens (IOL) placement. RESULTS: Three children (mean age: 14 ± 8.6 months, two male and one female) received injection elsewhere under topical anesthesia in the neonatal intensive care unit (NICU) for type 1 ROP (stage 3 in zone I or II with significant plus disease) 9 to 18 months earlier. All cases developed cataract caused by intravitreal needle damaging the posterior capsule. In one case, a dense zonular cataract was present and peripheral dehiscence of the posterior capsule became evident only during lens aspiration. The second and third cases had a central posterior subcapsular cataract. Preexisting central dehiscence of the posterior capsule was noted on UBM and confirmed during surgery. A multi-piece IOL was securely placed in all cases. At last follow-up (median: 6 months; range: 3 to 6 months), the IOL was stable and centered in all cases with a clear visual axis. CONCLUSIONS: The increasing occurrence of cataract in treatment-requiring ROP following intravitreal anti-VEGF injections being given by practitioners in the NICU setting under topical anesthesia that hinders optimal visualization and technique is a significant concern. [J Pediatr Ophthalmol Strabismus. 2019;56(3):162-167.].


Assuntos
Bevacizumab/administração & dosagem , Traumatismos Oculares/etiologia , Injeções Intravítreas/efeitos adversos , Implante de Lente Intraocular/métodos , Cristalino/lesões , Facoemulsificação/métodos , Retinopatia da Prematuridade/tratamento farmacológico , Inibidores da Angiogênese/administração & dosagem , Pré-Escolar , Traumatismos Oculares/diagnóstico , Feminino , Seguimentos , Humanos , Doença Iatrogênica , Lactente , Cristalino/diagnóstico por imagem , Cristalino/cirurgia , Masculino , Microscopia Acústica , Receptores de Fatores de Crescimento do Endotélio Vascular/antagonistas & inibidores , Estudos Retrospectivos
9.
Medicine (Baltimore) ; 98(18): e15429, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31045804

RESUMO

RATIONALE: Most laser-induced retinal injuries are caused by accidental laser discharge during the preparation of laser devices without protective goggles, laser injury during the cosmetic procedure in a dermatologist, is very rare, with no prior case reports. PATIENT CONCERNS: A 55-year-old Asian male dermatologist visited our hospital with a 2-week history of visual disturbance in his right eye. He had experienced sudden central scotoma in the right eye while using a Q-switched Nd:YAG laser (1064 nm, 2 J/cm, 6-mm spot size, 750 ps) 2 to 3 cm from the target without proper eye protection. He had applied a glass slide firmly onto the treatment area prior to commencing the procedure. The choroidal neovascularization (CNV) was detected via optical coherence tomography angiography (OCTA) 2 weeks after the laser injury. DIAGNOSIS: Foveal CNV secondary to laser energy reflected from the glass slide. INTERVENTION: Intravitreal bevacizumab (1.25 mg/0.05 mL) injection was performed. OUTCOMES: Regression of CNV was observed. LESSONS: Retinal injury can occur not only by direct laser beam exposure but also by way of a beam reflected from a glass slide. Operators should always use laser safety eyewear during cosmetic procedures involving laser devices, so as to prevent the occurrence of ocular complications. Thorough short-term follow-up with OCTA is recommended for the prompt detection of CNV in cases of retinal laser injury.


Assuntos
Neovascularização de Coroide/etiologia , Traumatismos Oculares/etiologia , Lasers de Estado Sólido/efeitos adversos , Inibidores da Angiogênese/uso terapêutico , Bevacizumab/uso terapêutico , Neovascularização de Coroide/tratamento farmacológico , Dermatologistas , Humanos , Masculino , Pessoa de Meia-Idade
12.
Regul Toxicol Pharmacol ; 105: 69-76, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30978367

RESUMO

The use of lower cut-off values/concentration limits for the calculation of mixture classification in UN GHS/EU CLP versus the previous regulatory scheme (EU Dangerous Preparations Directive, DPD), has resulted in an increased number of classifications in the highest eye hazard category. Herein, a semi-quantitative categorisation of severity of eye effects, following accidental human exposures to detergents, was compared to the classification category of the products. Three schemes were evaluated: EU DPD; EU CLP (based on all available data and information, including weight of evidence); and EU CLP (based entirely on the calculation method). As reported by four EU Poison Centres, the vast majority of exposures had caused minor or no symptoms. Classification was a poor predictor of effects in man subjected to accidental exposure. Note however that this is also because effects are not only driven by the intrinsic hazard (as reflected in the classification), but also by the exposure conditions and mitigation (i.e. rinsing). EU CLP classification using all available data and information was more predictive of medically relevant symptoms than the EU CLP calculation method. The latter led to a poorer differentiation between irritating products versus products potentially causing serious eye damage.


Assuntos
Detergentes/toxicidade , Traumatismos Oculares/classificação , Irritantes/toxicidade , Animais , Traumatismos Oculares/etiologia , Humanos , Centros de Controle de Intoxicações , Índices de Gravidade do Trauma
13.
Int Ophthalmol ; 39(10): 2407-2411, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30868329

RESUMO

Fireworks are an integral aspect of national, cultural and religious festivals globally, featuring in a vast range of celebrations including Diwali in India and New Year's Eve in the USA. We have seen a trend in eye injuries related to the use of fireworks, with millions of people, of which a large proportion comprising children, are injured annually-and rather than falling, as one would hope, this number is remaining stable. A comprehensive study of the impact of firework-related injuries to the eye is not available, and the efforts to mitigate this are not widely discussed in the literature. This literature review therefore focusses on studying the impact of firework-related eye injuries, the effect of legislation on mitigating these injuries and their associated morbidity.


Assuntos
Traumatismos por Explosões/etiologia , Explosões , Traumatismos Oculares/etiologia , Férias e Feriados , Explosões/legislação & jurisprudência , Explosões/estatística & dados numéricos , Traumatismos Oculares/prevenção & controle , Humanos
14.
Vet Ophthalmol ; 22(5): 666-673, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30716186

RESUMO

PURPOSE: To describe the clinical and histopathologic features secondary to ocular and periocular snakebites in dogs requiring enucleation. METHODS: Retrospective review of patients with recorded snakebite envenomation from the archives of the Comparative Ocular Pathology Laboratory of Wisconsin (COPLOW) and Texas A&M Veterinary Medical Teaching Hospital (1997-2017). The cases included in this study required witnessed snakebites to the dog by the owner, clinical signs supportive of periocular or ocular envenomation, and/or histopathologic lesions compatible with snakebites. Two groups were established: ocular bites (OB) and periocular bites (PB). RESULTS: Nineteen cases were included in the study (OB = 16/19; PB = 3/19). Dogs affected were typically older (median 8 years; range 1-18), and both sexes were equally represented. Left eyes (14/19) were more likely to sustain snake-induced trauma compared to right eyes (5/19). Fifteen breeds were identified, with terriers (9/19) commonly represented. Snakes bites occurred in six US states, with the majority of cases from Texas (7/19), California (5/19), and Arizona (4/19). Common clinical signs included facial edema, corneal ulceration, keratomalacia, uveitis, hyphema, and secondary glaucoma. All eyes demonstrated vision loss prior to enucleation. Histologically, the ocular and periocular tissues contained extensive necrosis associated with envenomation. Retinal detachment, lens capsule rupture, and intraocular hemorrhage/inflammation were commonly found. CONCLUSIONS: Snakebite envenomation is a largely necrotizing disease process that can result in profound infiltrative and destructive ocular changes presumed to be related to the proteolytic factors and necrotoxins in venom. Ocular alterations secondary to snakebites may be irreversible regardless of supportive therapy instituted.


Assuntos
Doenças do Cão/etiologia , Enucleação Ocular/veterinária , Traumatismos Oculares/veterinária , Mordeduras de Serpentes/veterinária , Animais , Doenças do Cão/patologia , Doenças do Cão/cirurgia , Cães , Traumatismos Oculares/etiologia , Traumatismos Oculares/patologia , Traumatismos Oculares/cirurgia , Feminino , Masculino , Estudos Retrospectivos , Mordeduras de Serpentes/complicações , Mordeduras de Serpentes/patologia
17.
Cornea ; 38(4): 498-501, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30601290

RESUMO

PURPOSE: To report a case of partial scleral rupture after laser in situ keratomileusis (LASIK) surgery. METHODS: This is a retrospective case report describing a late complication of LASIK surgery. RESULTS: A 32-year-old white woman with a history of LASIK surgery performed with a mechanical microkeratome 4 years previously presented for evaluation of partial bilateral scleral ruptures. An arcuate filtering bleb along the contour of the cornea was found on the right eye with associated hypotony and corneal astigmatism. There were no signs or symptoms of prior inflammation, and rheumatologic workup was negative. Imaging revealed scleral microbreaks in the absence of adjacent thinning. CONCLUSIONS: The pattern and location of thinning without findings consistent with inflammatory disease suggest that the partial bilateral scleral rupture was because of mechanical damage at the time of LASIK, possibly compounded by the hormonal changes of pregnancy.


Assuntos
Traumatismos Oculares/etiologia , Ceratomileuse Assistida por Excimer Laser In Situ/efeitos adversos , Esclera/lesões , Adulto , Feminino , Humanos , Gravidez , Estudos Retrospectivos , Ruptura
18.
Dermatol Surg ; 45(2): 210-215, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30608286

RESUMO

BACKGROUND: Internal eye shields are designed for use in periorbital procedures, but their use in Mohs micrographic surgery (MMS) of the eyelids has rarely been reported in the literature. OBJECTIVE: The authors aim to discuss different types of internal eye shields as well as their indication, proper use, and potential complications. MATERIALS AND METHODS: The authors performed a literature search on PubMed with the keywords "internal eye shield," "corneal shield," "scleral shield," and "periorbital Mohs micrographic surgery" with no restriction on publication time frame due to the scarcity of relevant literature. RESULTS: Experts seem to agree that use of eye shield for MMS of the eyelids is a reasonable measure to undertake to prevent operative injuries. Although either plastic or stainless steel eye shield can be used, plastic eye shields are often preferred and recommended in procedures where electrosurgical devices need to be used. CONCLUSION: Although the authors recommend the use of internal eye shields for MMS of the eyelids for preventing operative injuries, this recommendation (Grade C) is based on very limited evidence (Level 5). More research and higher-powered studies are needed for conclusive evidence and to establish clear guidelines for providers.


Assuntos
Traumatismos Oculares/prevenção & controle , Dispositivos de Proteção dos Olhos , Neoplasias Palpebrais/cirurgia , Neoplasias Faciais/cirurgia , Cirurgia de Mohs , Procedimentos Cirúrgicos Oftalmológicos , Desenho de Equipamento , Traumatismos Oculares/etiologia , Humanos , Complicações Pós-Operatórias/prevenção & controle
19.
BMC Ophthalmol ; 19(1): 37, 2019 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-30696405

RESUMO

PURPOSE: Pediatric ocular trauma is a major source of morbidity and blindness and the number of epidemiological studies is incommensurate with its significance. We sought to determine differences in epidemiologic patterns of pediatric ocular injuries based on intention. METHODS: A retrospective review of the National Trauma Data Bank (2008-2014) was performed and patients < 21 years old, admitted with trauma and ocular injury, were identified using ICD-9CM codes. Demographic data, types of injury and external circumstances including intention were tabulated and analyzed with students' t and chi-squared tests and logistic regression. Statistical significance was set at p < 0.05. RESULTS: Fifty-eight thousand seven hundred sixty-five pediatric patients were admitted for trauma and ocular injuries. The mean(SD) age was 11.9(6.9) years. Most patients were male (68.7%) and White (59.1%). Unintentional injuries (76.3%) were mostly associated with falls (OR = 13.4, p < 0.001), assault (16.3%) with firearms (OR = 9.15, p < 0.001) and self-inflicted trauma (0.7%) also with firearms (OR = 44.66, p < 0.001). There was increasing mean(SD) age from unintentional, 12.9(6.6) years and assault 12.3(8.1) years to self-inflicted trauma, 17(3.4) years. The 0-3 year age group had highest odds of open adnexa wounds (OR = 30.45, p < 0.001) from unintentional trauma, and traumatic brain injury (TBI) (OR = 5.77, p < 0.001) and mortality (OR = 8.52, p < 0.001) from assault. The oldest 19-21 year group, had highest odds visual pathway injuries (OR = 8.34, p < 0.001) and TBI (OR = 1.54, p = 0.048) from self-inflicted trauma and mortality (OR = 2.08, p < 0.001) from unintentional trauma. CONCLUSION: Sight-threatening injuries were mostly associated with unintentional trauma in the youngest group and self-inflicted trauma in the oldest group. Patterns emerged of associations between demographic groups, mechanisms, types of injury and associated TBI with intention of trauma.


Assuntos
Traumatismos Oculares/epidemiologia , Acidentes por Quedas/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Criança , Pré-Escolar , Traumatismos Oculares/complicações , Traumatismos Oculares/etiologia , Traumatismos Oculares/mortalidade , Feminino , Armas de Fogo/estatística & dados numéricos , Humanos , Lactente , Modelos Logísticos , Masculino , Estudos Retrospectivos , Comportamento Autodestrutivo/complicações , Violência/estatística & dados numéricos , Transtornos da Visão/etiologia , Vias Visuais/lesões , Adulto Jovem
20.
Orbit ; 38(3): 236-239, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29565705

RESUMO

A 51-year-old female underwent four upper zygomatic dental implants (ZI) and one upper and four lower conventional implants. Immediately postoperatively, the patient had pain and diplopia upon manual elevation of the edematous eyelid. Panoramic x-ray showed a malpositioned right upper ZI, requiring removal of the right upper ZI the following day. The patient had delayed referral to ophthalmology one month later for persistent diplopia. Computed tomography scan and magnetic resonance imaging demonstrated a right inferolateral fracture with fibrosis surrounding the inferior oblique muscle. Clinical exam showed right lower eyelid retraction, right hypotropia, and inability to elevate in adduction, consistent with a right inferior oblique paresis. Surgical exploration revealed incarceration of lid and orbital tissue into the fracture. After repositioning of the prolapsed tissue, a high-density porous polyethylene implant was placed for fracture repair. The inferior fornix was reconstructed with amniotic membrane and 5-fluorouracil was injected into the scar tissue. Six months later, the patient underwent strabismus surgery with resolution of symptoms.


Assuntos
Implantes Dentários/efeitos adversos , Traumatismos Oculares/etiologia , Músculos Oculomotores/lesões , Fraturas Orbitárias/etiologia , Estrabismo/etiologia , Remoção de Dispositivo , Diplopia/etiologia , Traumatismos Oculares/diagnóstico por imagem , Traumatismos Oculares/cirurgia , Dor Ocular/etiologia , Feminino , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Músculos Oculomotores/diagnóstico por imagem , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos , Fraturas Orbitárias/diagnóstico por imagem , Fraturas Orbitárias/cirurgia , Estrabismo/diagnóstico por imagem , Estrabismo/cirurgia , Tomografia Computadorizada por Raios X , Zigoma/cirurgia
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