Lower Lid Entropion Secondary to Missed Intraorbital Foreign Body in a Child

Background: Intraorbital foreign bodies can result in various complications if not appropriately managed. Aim: To report a case of lower lid entropion secondary to a missed intraorbital foreign body. Case Presentation: A 7-year-old boy presented with inward turning of the left lower lid for three days prior to admission. A week before, the child was in the garden when part of the roof of their home suddenly broke off, with pieces of the debris falling near him. He complained of left eye irritation, but a visit to a general practitioner found no eye abnormalities. Three days after that, the mother sought an ophthalmology opinion as she noticed inversion of the left lower lid. On examination, visual acuity in both eyes was 6/6. There was left lower lid entropion, and a deeply embedded foreign body seen in the lower lid. No other eye abnormalities noted. Computed tomography scan of the orbits revealed a welldefined foreign object in the lower orbit, fracturing the antero-superior wall of the left maxillary sinus. The left eye foreign body was removed uneventfully via a transconjunctival approach. Conclusion: A thorough examination is mandatory in any case of ocular trauma especially in young children, who are usually unable to provide a clear history of the injury.

Traumatic endophthalmitis following penetrating ocular injuries with retained intraocular foreign bodies

Objective: To evaluate the outcome and analyze the methods of surgical treatment of traumatic endophthalmitis following penetrating eye injuries with retained eye foreign bodies. Methods: A total of 62 consecutive cases (58 men, 4 women) from January 1999 to December 2001 with IOFBs following penetrating eye injuries were retrospectively studied. The ages ranged from 8 to 46 years (mean 23 years). Sixty patients (63 eyes) underwent pars plana vitreotomy and 1 patient underwent external magnet extraction. The follow up ranged from 3 to 36 months (mean 12.5 months). Results: Ten eyes developed endophthalmitis, among which 7 ( 10.94 %) were diagnosed preoperatively. The most frequently cultured organism was Staphylococcus epidermis ( 44.44 %, 4/9). Postoperatively, retinal detachment due to vitreoretinal proliferation occurred in 5 patients with endophthalmitis and in 9 patients without endophthalmitis. All the retinal detachments were reattached with additional vitreoretinal surgery. Two eyes with endophthalmitis and two without endophthalmitis were eviscerated. Conclusions: Post traumatic endophthalmitis with intraocular foreign bodies (IOFBs) deserves great attention because of its high incidence and poor prognosis. Vitrectomy is suggested for the treatment of IOFBs and its complications, and it should be performed as soon as possible. Routine intravenous administration of antibiotics combined with periocular injection and topical antibiotics postoperatively are recommended.

Trochlear calcification and intraorbital foreign body in ocular trauma patients

Objective： To distinguish trochlear calcification and intraorbital foreign body after eye injury in order to avoid misdiagnosis as well as mistreatment. Methods： The orbital CT images of 403 patients, who visited the Eye Hospital or the Second Affiliated Hospital of Wenzhou Medical College during May 2005-April 2007, were reviewed. The diagnosis of trochlear calcification and intraorbital foreign body was made together by a skilled radiologist as well as an ophthalmologist. General information and CT characteristics in the patients with trochlear calcification were collected. Results： Using CT scan images, 27 among 403 patients （6.69%） were identified with trochlear calcification. Three patients （3/27, 11.11%） were misdiagnosed by radiologists as intraorbital foreign body. Among the 27 patients with trochlear calcification, 23 （85.19%） were male and 4 （ 14.81% ）were female, with an unilateral calcification in 7 patients （7/27, 25.93%） and bilateral in 20 （74.07%）. The highest occurrence of trochlear calcification was in 31-40 years old group （13/403, 3.23%） which reached to 12.87% （13/101） after age-correction. There were 3 types of trochlear calcification on the basis of CT images： commas, dot and inverted ＂U＂. Conclusions： The trochlear calcification is not an uncommon phenomenon and should not be diagnosed as intraorbital foreign body, especially when it co-exists with eye injury in 31-40 years old group. Injury history and our classification method on the basis of CT images could help to avoid misdiagnosis.

Status of ocular trauma in hospitalized patients in Kashan, 2011： As a sample of industrial city

Purpose： Ocular trauma is the third leading cause of hospitalization in ophthalmology patients, imposing direct and indirect physical and psychological costs on society. This study aims to investigate the status of ocular trauma in hospitalized patients in the industrialized city of Kashan in 2011. Methods： This cross-sectional descriptive applied study was conducted in 2012 on patients hospitalized for ocular trauma. Data, including age, gender, occupation, education, timing of admission following accident, location of accident, type of injury, damaging instrument, and type of trauma, were collected using a questionnaire designed by a trained nurse, and analyzed using SPSS-lfi software by means of means _＋ standard deviation, frequency, and percentage for descriptive data and t-test, one-way analysis of variance, Chi-square and Fisher exact test for analysis at significance level ofp 〈 0.05. Results： In total, 82 patients were hospitalized due to ocular traumas. The majority of patients were male （65 patients, 79.3%）. Their mean age was （25.4 ± 21.4） years, with an age range of 20-40 years （30 patients, 36.6%）. Hyphema was the most common injury （26 patients, 25.5%）, home was the most frequent incident location （32 patients, 39%）, and knife or other cutting tools were mostly responsible for injuries （18 patients, 21.9%）. Patients were hospitalized for 1-6 days, and the average length of stay in hospital was 2.63 days. Frequency distribution of injuries based on whether or not ruptures differed significantly among different age groups. Conclusion： The majority of ocular trauma occurred in young males. Knife was the principle culprit for eye injuries, followed by vehicles. To reduce such incidents, it is recommended that people be trained to avoid high-risk behaviors when using knives and to better heed driving rules and regulations.