Prevalence of Ocular Trauma at the Reference Health Center (CSREF) of Kati

Introduction: The authors wanted to study the prevalence of ocular trauma in the ophthalmology unit of the CSREF of Kati. Patients and method: This is a retrospective study, covering the period from January to December 2015, carried out in the ophthalmology unit of the CSREF in Kati. Results: The sample consisted of 568 patients, or 6.82% of ophthalmological consultations. Children aged 0 to 14 years accounted for 154 (27.11%) of the trauma cases. Bruises constitute the main circumstance (58.1%) of eye trauma, followed by domestic accidents (15.6%). Closed globe ocular trauma was the main type of trauma (61.6%), followed by ocular adnexal trauma (30.1%) and open globe trauma (8.3%) in which the penetrating wound was the lesion, the least common (2.6%) but the most serious. Medical treatment was the most used therapeutic modality in 82.4% of cases, followed by surgery with 17.6% of cases. The evolution of the lesions after treatment was favorable in 85.6% of cases and unfavorable in 14.4% of cases. Complications were observed in 5.8% of cases and sequelae in 8.6% of cases. Conclusion: Ocular trauma constitutes an important reason for ophthalmological consultation at the CSREF of Kati. The severity of some of these lesions requires frequent recourse to surgery. The complexity of the treatment should encourage us to favor preventive measures.

Mechanical Eye Trauma Epidemiology, Prognostic Factors, and Management Controversies—An Update

Purpose of Review: The management of eye injuries is both difficult and argumentative. This study attempts to highlight the management of ocular trauma using currently available information in the literature and author experience. This review presents a workable framework from the first presentation, epidemiology, classification, investigations, management principles, complications, prognostic factors, final visual outcome and management debates. Review Findings: Mechanical ocular trauma is a leading cause of monocular blindness and possible handicap worldwide. Among several classification systems, the most widely accepted is Birmingham Eye Trauma Terminology (BETT). Mechanical ocular trauma is a topic of unsolved controversy. Patching for corneal abrasion, paracentesis for hyphema, the timing of cataract surgery and intraocular lens implantation are all issues in anterior segment injuries. Regarding posterior segment controversies, the timing of vitrectomy, use of prophylactic cryotherapy, the necessity of intravitreal antibiotics in the absence of infection, the use of vitrectomy vs vitreous tap in traumatic endophthalmitis is the issues. The pediatric age group needs to be approached by a different protocol due to the risk of amblyopia, intraocular inflammation, and significant vitreoretinal adhesions. The various prognostic factors have a role in the final visual outcome. B scan is used to exclude R.D, Intraocular foreign body (IOFB), and vitreous haemorrhage in hazy media. Individual surgical strategies are used for every patient according to the classification and extent of the injuries. Conclusion: This article examines relevant evidence on the management challenges and controversies of mechanical trauma of the eye and offers treatment recommendations based on published research and the authors’ own experience.

Pediatric Eye Trauma: Epidemiological, Clinical and Therapeutic Aspects at CADESSO in Donka, Guinea

Introduction: Eye trauma represents all morbid lesions on the eyeball due to external violence. In children, they are an important cause of morbidity and the leading cause of monocular blindness. The aim of this study was to determine the sociodemographic, clinical and therapeutic characteristics of eye trauma in children aged 0 to 16 at the Application Centre for the Diploma of Specialized Higher Studies in Ophthalmology (CADESSO) in Donka, Guinea. Patients and Method: This was a prospective longitudinal study with descriptive purposes from January 1 to December 31, 2019 involving 205 children victims of eye trauma. Variables related to sociodemographic, clinical and therapeutic characteristics were studied. Informed consent from patients and/or their parents was sought and obtained. The confidentiality of the files was guaranteed. The data entry was done on EPI-Info version 7 and the analysis using the Stata software. The tables were made in Excel 2010. Pearson’s Chi2 test was used for the comparison of proportions. Results: Pediatric eye trauma accounted for 9.31% of pediatric visits and 30.92% of all eye trauma cases. There was a male predominance with a sex ratio of 1.59. Age groups from 0 - 4 years;5 - 8 years and 9 - 12 were the most affected with 26.8%, 28.8% and 27.3% respectively and a decrease in the number of cases in the 13 - 16 age group (17.1%). Gambling and sports accidents accounted for 33.2%, followed by domestic accidents for 16.6% and physical injury for 8.2%. Eye contusion was the most represented at 66.3% followed by wounds of the globe 23.9% and burns at 5.9%. One hundred and twenty-six patients had received a determination of visual acuity (VA) at admission;99 were assessed at discharge and 27 were lost to follow-up. The VA ≥ 5/10th increased from 43.4% at admission to 79.8% after treatment. We had found 67% of vision ≥ 5/10 in eye bruises against 5% in eyeball wounds. Anti-inflammatories (99.5%)) were almost used. The sequelae were dominated by corneal opacities (71.9%). Conclusion: Child eye trauma is a public health problem in Guinea. The best means of care remains prevention, which must be of interest to the child and his environment.

Unusual Eye Trauma Caused by Hula Hoop:A Case Report

Introduction: Eye injuries are common in sports and have the potential for major morbidity with sight threatening consequences. However, a small number of sports, such as soccer, rugby or hockey are responsible for most injuries. To our knowledge, hula hoop penetrating eye injury is not described in literature. In this report, we present a case of an unusual eye injury caused by a hula hoop. Case presentation: A 17-year-old female was admitted as an urgent penetrating right eye injury caused by a hula hoop. Penetrating wound covered 2/3 of the cornea and was associated with iris prolapses and incarceration;iridodialysis of more than half of the circumference, and traumatic cataract. Her best corrected visual acuity of the right eye was “hand motion”. The second corneal wound in parallel with the first one was noticed while she was being treated surgically under general anesthesia. Iris was repositioned, anterior chamber was formed with the viscoelastic and wounds were repaired using 10-0 nylon sutures. Iridopexy was performed using straight needle 10-0 prolene, while standard cataract surgery with phacoemulsification and IOL implantation were done. The postoperative recovery was uneventful beside elevated intraocular pressure (TOD = 24 mmHg) that was treated successfully by topical beta blockers. Six months later, her best corrected visual acuity was 0.6 stenopeic, with evident linear corneal opacification and traumatic mydriasis. Conclusions: Although seemingly impossible, hula hooping can be dangerous to the eyes if practiced in incommodious areas and close to other people.

Changed trends of major causes of visual impairment in Sichuan,China from 1987 to 2006

AIM: To study the trends of major causes of visual impairment(VI) in adults in Sichuan,China and evaluate the effect of aging on the trends. ·METHODS: We used data from the National Sample Survey on Disabilities(NSSD) in Sichuan province conducted in 1987 and 2006. The age-adjusted prevalence of major causes of VI and the prevalence stratified by age in each cause were calculated and compared. The association between age and each cause of VI was also analyzed.·RESULTS: Retinal disease increased and became the second leading cause of VI in 2006 while blinding trachoma decreased markedly. Cataract and non-trachomatous corneal diseases were among the leading causes of VI in both years. We found associations between age and causes of VI,with age showing the strongest association with cataract and relatively lower associations with other causes. · CONCLUSION: In the last two decades,dramatic changes occurred in the major causes of VI with significantly increased retinal disease and decreased blinding trachoma. Aging of the population might be an important factor accounting for the changed trends of VI. Understanding the prevalence of VI,its major causes and trends over time can assist in prioritizing and developing effective interventional strategies and monitoring their impact.

Management and treatment of bizarre open globe trauma in three steps:a case report

This is a case presentation of a very bizarre open globe trauma with anterior segment foreign body-fishing hook stuck in the cornea and iris. Complications due to this kind of eye trauma might be very hazardous and with serious impact on visual function. We are representing our approach and experience of three step management of this kind of eye injury: first-extract the foreign body, close and reconstruct the eyeball, second-fight inflammation, and third-restore the visual function by cataract surgery.

Predictors of visual outcome in traumatic cataract

Traumatic cataract resulting from open- or closed-globe ocular trauma is one of the most common causes of blindness. Visual outcome is unpredictable because this is not determined solely by the lens. There is a lack of a standard classification, investigations, and treatment guidelines related to the outcome, with considerable debate regarding predictive models. We review the predictors of visual outcome following surgical treatment of traumatic cataracts, which may act as a guide to clinicians.

Epidemiological profile of pediatric ocular trauma in a tertiary hospital of northern India

Purpose： Ocular trauma is one of the most common causes of acquired blindness in children. It measures about 8%-14% of total childhood injuries. This study aims to determine the epidemiological profile of ocular trauma in the pediatric age group attending a tertiary hospital in northern India. Methods： A retrospective study was conducted in our hospital between June 2014 to July 2015 and all the children aged 0-16 years presenting with ocular trauma in eye outpatient department and emergency were enrolled in the study. Various epidemiological parameters like age, sex distribution, duration of presentation, mode of injury, type of injury and final visual outcome were analyzed. Results： Of total 357 patients, 271 （76%） were below the age of 12 years： 41.1% of children with ocular trauma belonged to age group 2-6 years. The male to female ratio was 2.9：1. Out of total patients, 242 （67.8%） presented with closed globe injury. Among the closed globe injury, the history of fall was present in about 35% of children, followed by trauma while playing with bat/ball （15.7%） and finger nail trauma （13.2%）. Among open globe injury, trauma with needle, knife, glass and pen were common causes. Home was the most common place of injury （47.8%）, followed by streets （17.9%） and playground （14.9%）. Conclusion： Children are vulnerable to ocular trauma and need more supervision. Sharp objects like needles, knives, household chemicals like acids should be out of reach of children.