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Trauma

  • Thomas H. Williamson
Chapter

Abstract

Ocular trauma remains a leading cause of visual loss, most often affecting men (on average five males are affected to one female). Patients are usually aged less than 30 years, and trauma is often associated with alcohol and illicit drug usage (Parver et al. 1993). In the elderly, males and females are equally involved (Tielsch et al. 1989). Incidence has been estimated as 3:10,000 of population (Tielsch and Parver 1990; Canavan et al. 1980). Severe injuries account for 5 % of all eye injuries (Schein et al. 1988). Aetiology is variable, but certain associations are common, for example, assault, sport, children at play, road traffic accidents and industrial, domestic and war injuries (Liggett et al. 1990a; Khatry et al. 2004; Appiah 1991; Ahmadieh et al. 1993). The patterns of ocular trauma are constantly changing depending on social, demographic and geographical variations. The clinical characteristics vary widely. Intraocular foreign bodies are common in war (Ahmadieh et al. 1993) and road traffic accidents especially when car seat belts are not worn (Ghoraba 2002). In children, sharp objects are commonly implicated, and the complication of amblyopia limits visual recovery (Alfaro et al. 1994a). The wearing of spectacles has been found to be protective (May et al. 2000).

Keywords

Foreign Body Retinal Detachment Macular Hole Vitreous Haemorrhage Vitreous Cavity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

trauma (827,812 KB)

References

  1. Ahmadieh H, Soheilian M, Sajjadi H et al (1993) Vitrectomy in ocular trauma. Factors influencing final visual outcome. Retina 13(2):107–113PubMedCrossRefGoogle Scholar
  2. Ahmadieh H, Sajjadi H, Azarmina M et al (1994) Surgical management of intraretinal foreign bodies. Retina 14(5):397–403PubMedCrossRefGoogle Scholar
  3. Alappatt JJ, Hutchins RK (1998) Retinal detachments due to traumatic tears in the pars plana ciliaris. Retina 18(6):506–509PubMedGoogle Scholar
  4. Alfaro DV, Tran VT, Runyan T et al (1992) Vitrectomy for perforating eye injuries from shotgun pellets. Am J Ophthalmol 114(1):81–85PubMedGoogle Scholar
  5. Alfaro DV, Chaudhry NA, Walonker AF et al (1994a) Penetrating eye injuries in young children. Retina 14(3):201–205PubMedCrossRefGoogle Scholar
  6. Alfaro DV, Roth D, Liggett PE (1994b) Posttraumatic endophthalmitis. Causative organisms, treatment, and prevention. Retina 14(3):206–211PubMedCrossRefGoogle Scholar
  7. Alfaro DV, Roth DB, Laughlin RM et al (1995) Paediatric post-traumatic endophthalmitis. Br J Ophthalmol 79(10):888–891PubMedCrossRefGoogle Scholar
  8. Allen JC (1969) Sympathetic ophthalmia, a disappearing disease. JAMA 209(7):1090PubMedCrossRefGoogle Scholar
  9. Ambler JS, Meyers SM (1991) Management of intraretinal metallic foreign bodies without retinopexy in the absence of retinal detachment. Ophthalmology 98(3):391–394PubMedGoogle Scholar
  10. Appiah AP (1991) The nature, causes, and visual outcome of ocular trauma requiring posterior segment surgery at a county hospital. Ann Ophthalmol 23(11):430–433PubMedGoogle Scholar
  11. Aylward GW, Cooling RJ, Leaver PK (1993) Trauma-induced retinal detachment associated with giant retinal tears. Retina 13(2):136–141PubMedCrossRefGoogle Scholar
  12. Banaee T, Ahmadieh H, Abrishami M, Moosavi M (2007) Removal of traumatic cyclitic membranes: surgical technique and results. Graefes Arch Clin Exp Ophthalmol 245(3):443–447PubMedCrossRefGoogle Scholar
  13. Billi B, Lesnoni G, Scassa C et al (1995) Copper intraocular foreign body: diagnosis and treatment. Eur J Ophthalmol 5(4):235–239PubMedGoogle Scholar
  14. Canavan YM, O’Flaherty MJ, Archer DB, Elwood JH (1980) A 10-year survey of eye injuries in Northern Ireland, 1967–76. Br J Ophthalmol 64(8):618–625PubMedCrossRefGoogle Scholar
  15. Cardillo JA, Stout JT, LaBree L et al (1997) Post-traumatic proliferative vitreoretinopathy. The epidemiologic profile, onset, risk factors, and visual outcome. Ophthalmology 104(7):1166–1173PubMedCrossRefGoogle Scholar
  16. Chiquet C, Zech JC, Gain P et al (1998) Visual outcome and prognostic factors after magnetic extraction of posterior segment foreign bodies in 40 cases. Br J Ophthalmol 82(7):801–806PubMedCrossRefGoogle Scholar
  17. Chow DR, Garretson BR, Kuczynski B et al (2000) External versus internal approach to the removal of metallic intraocular foreign bodies. Retina 20(4):364–369PubMedGoogle Scholar
  18. Coleman DJ (1982) Early vitrectomy in the management of the severely traumatized eye. Am J Ophthalmol 93(5):543–551PubMedGoogle Scholar
  19. Conway BP, Michels RG (1978) Vitrectomy techniques in the management of selected penetrating ocular injuries. Ophthalmology 85(6):560–583PubMedGoogle Scholar
  20. Cooney MJ, Pieramici DJ (1997) Eye injuries caused by bungee cords. Ophthalmology 104(10):1644–1647PubMedCrossRefGoogle Scholar
  21. Dobbie JG, Phillips CI (1962) Detachment of ora serrata and pars ciliaris retinae in “idiopathic” retinal detachment. Arch Ophthalmol 68:610–614PubMedCrossRefGoogle Scholar
  22. Enger C, Schein OD, Tielsch JM (1996) Risk factors for ocular injuries caused by air guns. Arch Ophthalmol 114(4):469–474PubMedCrossRefGoogle Scholar
  23. Esmaeli B, Elner SG, Schork MA, Elner VM (1995) Visual outcome and ocular survival after penetrating trauma. A clinicopathologic study. Ophthalmology 102(3):393–400PubMedGoogle Scholar
  24. Essex RW, Yi Q, Charles PG, Allen PJ (2004a) Post-traumatic endophthalmitis. Ophthalmology 111(11):2015–2022PubMedCrossRefGoogle Scholar
  25. Essex RW, Charles PG, Allen PJ (2004b) Three cases of post-traumatic endophthalmitis caused by unusual bacteria. Clin Experiment Ophthalmol 32(4):445–447PubMedCrossRefGoogle Scholar
  26. Essex RW, Tufail A, Bunce C, Aylward GW (2007) Two-year results of surgical removal of choroidal neovascular membranes related to non-age-related macular degeneration. Br J Ophthalmol 91(5):649–654PubMedCrossRefGoogle Scholar
  27. Feist RM, Lim JI, Joondeph BC et al (1991) Penetrating ocular injury from contaminated eating utensils. Arch Ophthalmol 109(1):63–66PubMedCrossRefGoogle Scholar
  28. Fortuin ME, Blanksma LJ (1986) An unusual complication of perforating wounds of the eye. Doc Ophthalmol 61(3–4):197–203PubMedCrossRefGoogle Scholar
  29. Foster RE, Martinez JA, Murray TG et al (1996) Useful visual outcomes after treatment of Bacillus cereus endophthalmitis. Ophthalmology 103(3):390–397PubMedGoogle Scholar
  30. Ghoraba H (2002) Posterior segment glass intraocular foreign bodies following car accident or explosion. Graefes Arch Clin Exp Ophthalmol 240(7):524–528PubMedCrossRefGoogle Scholar
  31. Gozum N, Kir N, Ovali T (2003) Internal ophthalmomyiasis presenting as endophthalmitis associated with an intraocular foreign body. Ophthalmic Surg Lasers Imaging 34(6):472–474PubMedGoogle Scholar
  32. Gupta AK, Ghosh B, Mazumdar S, Gupta A (1996) An unusual intraocular foreign body. Acta Ophthalmol Scand 74(2):200–201PubMedCrossRefGoogle Scholar
  33. Hamanaka N, Ikeda T, Inokuchi N et al (1999) A case of an intraocular foreign body due to graphite pencil lead complicated by endophthalmitis. Ophthalmic Surg Lasers 30(3):229–231PubMedGoogle Scholar
  34. Han DP (1993) Retinal detachment caused by air bag injury. Arch Ophthalmol 111(10):1317–1318PubMedCrossRefGoogle Scholar
  35. Hutton WL, Snyder WB, Vaiser A (1976) Vitrectomy in the treatment of ocular perforating injuries. Am J Ophthalmol 81(6):733–739PubMedGoogle Scholar
  36. John G, Witherspoon CD, Feist RM, Morris R (1988) Ocular lawnmower injuries. Ophthalmology 95(10):1367–1370PubMedGoogle Scholar
  37. Jonas JB, Knorr HL, Budde WM (2000) Prognostic factors in ocular injuries caused by intraocular or retrobulbar foreign bodies. Ophthalmology 107(5):823–828PubMedCrossRefGoogle Scholar
  38. Joseph DP, Pieramici DJ, Beauchamp NJ Jr (2000) Computed tomography in the diagnosis and prognosis of open-globe injuries. Ophthalmology 107(10):1899–1906PubMedCrossRefGoogle Scholar
  39. Karel I, Diblik P (1995) Management of posterior segment foreign bodies and long-term results. Eur J Ophthalmol 5(2):113–118PubMedGoogle Scholar
  40. Khatry SK, Lewis AE, Schein OD et al (2004) The epidemiology of ocular trauma in rural Nepal. Br J Ophthalmol 88(4):456–460PubMedCrossRefGoogle Scholar
  41. Kilmartin DJ, Dick AD, Forrester JV (2000) Prospective surveillance of sympathetic ophthalmia in the UK and Republic of Ireland. Br J Ophthalmol 84(3):259–263PubMedCrossRefGoogle Scholar
  42. Knox FA, Best RM, Kinsella F et al (2004) Management of endophthalmitis with retained intraocular foreign body. Eye 18(2):179–182PubMedCrossRefGoogle Scholar
  43. Kraus-Mackiw E (1990) Prevention of sympathetic ophthalmia. State of the art 1989. Int Ophthalmol 14(5–6):391–394PubMedCrossRefGoogle Scholar
  44. Kuhn F, Morris R, Witherspoon CD et al (1996) A standardized classification of ocular trauma. Ophthalmology 103(2):240–243PubMedGoogle Scholar
  45. Kuhn F, Morris R, Mester V, Witherspoon CD (2001) Internal limiting membrane removal for traumatic macular holes. Ophthalmic Surg Lasers 32(4):308–315PubMedGoogle Scholar
  46. Kuhn F, Maisiak R, Mann L et al (2002) The ocular trauma score (OTS). Ophthalmol Clin North Am 15(2):163–165, viPubMedCrossRefGoogle Scholar
  47. Lambert HM, Sipperley JO (1983) Intraocular foreign body from a nylon line grass trimmer. Ann Ophthalmol 15(10):936–937PubMedGoogle Scholar
  48. Liddy L, Stuart J (1972) Sympathetic ophthalmia in Canada. Can J Ophthalmol 7(2):157–159PubMedGoogle Scholar
  49. Lieb DF, Scott IU, Flynn HW Jr et al (2003) Open globe injuries with positive intraocular cultures: factors influencing final visual acuity outcomes. Ophthalmology 110(8):1560–1566PubMedCrossRefGoogle Scholar
  50. Liggett PE, Pince KJ, Barlow W et al (1990a) Ocular trauma in an urban population. Review of 1132 cases. Ophthalmology 97(5):581–584PubMedGoogle Scholar
  51. Liggett PE, Gauderman WJ, Moreira CM et al (1990b) Pars plana ­vitrectomy for acute retinal detachment in penetrating ocular injuries. Arch Ophthalmol 108(12):1724–1728PubMedCrossRefGoogle Scholar
  52. Long JC, Danielson RW (1953) Traumatic detachment of retina and of pars ciliaris retinae. Am J Ophthalmol 36(4):515–516PubMedGoogle Scholar
  53. Man CY, Steel D (2010) Visual outcome after open globe injury: a comparison of two prognostic models–the ocular trauma score and the classification and regression tree. Eye (Lond) 24(1):84–89CrossRefGoogle Scholar
  54. Mandelcorn MS (1977) Results after vitrectomy in trauma. Can J Ophthalmol 12(1):34–37PubMedGoogle Scholar
  55. Martin DF, Awh CC, McCuen BW et al (1994) Treatment and pathogenesis of traumatic chorioretinal rupture (sclopetaria). Am J Ophthalmol 117(2):190–200PubMedGoogle Scholar
  56. Mason JO III, Feist RM, White MF Jr (2002) Ocular trauma from paintball-pellet war games. South Med J 95(2):218–222PubMedGoogle Scholar
  57. May DR, Kuhn FP, Morris RE et al (2000) The epidemiology of serious eye injuries from the United States Eye Injury Registry. Graefes Arch Clin Exp Ophthalmol 238(2):153–157PubMedCrossRefGoogle Scholar
  58. Meredith TA, Gordon PA (1987) Pars plana vitrectomy for severe penetrating injury with posterior segment involvement. Am J Ophthalmol 103(4):549–554PubMedGoogle Scholar
  59. Miller JJ, Scott IU, Flynn HW Jr et al (2008) Endophthalmitis caused by Bacillus species. Am J Ophthalmol 145(5):883–888PubMedCrossRefGoogle Scholar
  60. Mody KV, Blach RK, Leaver PK, McLeod D (1978) Closed vitrectomy after trauma. Trans Ophthalmol Soc UK 98(1):55–58PubMedGoogle Scholar
  61. Morris RE, Witherspoon CD, Helms HA Jr et al (1987a) Eye Injury Registry of Alabama (preliminary report): demographics and prognosis of severe eye injury. South Med J 80(7):810–816PubMedCrossRefGoogle Scholar
  62. Morris RE, Witherspoon CD, Feist RM et al (1987b) Bilateral ocular shotgun injury. Am J Ophthalmol 103(5):695–700PubMedGoogle Scholar
  63. Narang S, Gupta V, Gupta A et al (2003) Role of prophylactic intravitreal antibiotics in open globe injuries. Indian J Ophthalmol 51(1):39–44PubMedGoogle Scholar
  64. Parver LM, Dannenberg AL, Blacklow B et al (1993) Characteristics and causes of penetrating eye injuries reported to the National Eye Trauma System Registry, 1985–1991. Public Health Rep 108(5):625–632PubMedGoogle Scholar
  65. Pearlman JA, Au Eong KG, Kuhn F, Pieramici DJ (2001) Airbags and eye injuries: epidemiology, spectrum of injury, and analysis of risk factors. Surv Ophthalmol 46(3):234–242PubMedCrossRefGoogle Scholar
  66. Peyman GA, Raichand M, Goldberg MF, Brown S (1980) Vitrectomy in the management of intraocular foreign bodies and their complications. Br J Ophthalmol 64(7):476–482PubMedCrossRefGoogle Scholar
  67. Pieramici DJ, Kuhn F (2003) Frontal air bags and eye injury patterns in automobile crashes. Arch Ophthalmol 121(12):1807–1808PubMedCrossRefGoogle Scholar
  68. Pieramici DJ, MacCumber MW, Humayun MU et al (1996a) Open-globe injury. Update on types of injuries and visual results. Ophthalmology 103(11):1798–1803PubMedGoogle Scholar
  69. Pieramici DJ, Capone A Jr, Rubsamen PE, Roseman RL (1996b) Lens preservation after intraocular foreign body injuries. Ophthalmology 103(10):1563–1567PubMedGoogle Scholar
  70. Pieramici DJ, Eong KG, Sternberg P Jr, Marsh MJ (2003) The prognostic significance of a system for classifying mechanical injuries of the eye (globe) in open-globe injuries. J Trauma 54(4):750–754PubMedCrossRefGoogle Scholar
  71. Pulido JS, Gupta S, Folk JC, Ossoiny KC (1997) Perforating BB gun injuries of the globe. Ophthalmic Surg Lasers 28(8):625–632PubMedGoogle Scholar
  72. Ramsay RC, Cantrill HL, Knobloch WH (1985) Vitrectomy for double penetrating ocular injuries. Am J Ophthalmol 100(4):586–589PubMedGoogle Scholar
  73. Reynolds DS, Flynn HW Jr (1997) Endophthalmitis after penetrating ocular trauma. Curr Opin Ophthalmol 8(3):32–38PubMedCrossRefGoogle Scholar
  74. Russell SR, Olsen KR, Folk JC (1988) Predictors of scleral rupture and the role of vitrectomy in severe blunt ocular trauma. Am J Ophthalmol 105(3):253–257PubMedGoogle Scholar
  75. Ryan SJ (1978) Results of pars plana vitrectomy in penetrating ocular trauma. Int Ophthalmol 1(1):5–8PubMedCrossRefGoogle Scholar
  76. Salehi-Had H, Andreoli CM, Andreoli MT et al (2009) Visual outcomes of vitreoretinal surgery in eyes with severe open-globe injury presenting with no-light-perception vision. Graefes Arch Clin Exp Ophthalmol 247(4):477–483PubMedCrossRefGoogle Scholar
  77. Schein OD, Hibberd PL, Shingleton BJ et al (1988) The spectrum and burden of ocular injury. Ophthalmology 95(3):300–305PubMedGoogle Scholar
  78. Schein OD, Enger C, Tielsch JM (1994) The context and consequences of ocular injuries from air guns. Am J Ophthalmol 117(4):501–506PubMedGoogle Scholar
  79. Schmidt GW, Broman AT, Hindman HB, Grant MP (2008) Vision survival after open globe injury predicted by classification and regression tree analysis. Ophthalmology 115(1):202–209PubMedCrossRefGoogle Scholar
  80. Sneed SR, Weingeist TA (1990) Management of siderosis bulbi due to a retained iron-containing intraocular foreign body. Ophthalmology 97(3):375–379PubMedGoogle Scholar
  81. Soheilian M, Peyman GA, Wafapoor H et al (1996) Surgical management of traumatic retinal detachment with perfluorocarbon liquid. The Vitreon Study Group. Int Ophthalmol 20(5):241–249PubMedGoogle Scholar
  82. Thompson JT, Parver LM, Enger CL et al (1993) Infectious endophthalmitis after penetrating injuries with retained intraocular foreign bodies. National Eye Trauma System. Ophthalmology 100(10):1468–1474PubMedGoogle Scholar
  83. Tielsch JM, Parver LM (1990) Determinants of hospital charges and length of stay for ocular trauma. Ophthalmology 97(2):231–237PubMedGoogle Scholar
  84. Tielsch JM, Parver L, Shankar B (1989) Time trends in the incidence of hospitalized ocular trauma. Arch Ophthalmol 107(4):519–523PubMedCrossRefGoogle Scholar
  85. Tyagi AK, Kheterpal S, Callear AB et al (1998) Simultaneous posterior chamber intraocular lens implant combined with vitreoretinal ­surgery for intraocular foreign body injuries. Eye 12(Pt 2):230–233PubMedCrossRefGoogle Scholar
  86. Wani VB, Al Ajmi M, Thalib L et al (2003) Vitrectomy for posterior segment intraocular foreign bodies: visual results and prognostic factors. Retina 23(5):654–660PubMedCrossRefGoogle Scholar
  87. Weiss MJ, Hofeldt AJ, Behrens M, Fisher K (1997) Ocular siderosis. Diagnosis and management. Retina 17(2):105–108PubMedCrossRefGoogle Scholar
  88. Winthrop SR, Cleary PE, Minckler DS, Ryan SJ (1980) Penetrating eye injuries: a histopathological review. Br J Ophthalmol 64(11):809–817PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Thomas H. Williamson
    • 1
  1. 1.Department of OphthalmologySt. Thomas’ HospitalLondonUK

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