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[Retinal detachment after perforating eye injuries. III. Analysis of retinal detachment after perforating eye injuries and determination of the characteristics of the retinal detachment after perforating eye injuries].

In 1977-1987 the authors operated, using the cryosurgical method post-traumatic retinal detachment in 69 patients. Retinal detachment developed in 37 patients after simple perforation of the eye by a foreign intraocular body. In all patients the perforation penetrated as far as the vitreous space. In patients with retinal detachment the authors investigated the following: the patient's age, refraction, period of retinal detachment, extent of retinal detachment, the state of the macula, the characteristics of the retinal defect (site, size and number), type of retinal detachment and associated adverse factors. In the characteristics of retinal detachment after perforating eye injuries the first place was held by prognostically adverse vitreous traction in 73.9%.

Adolescent

Traumatic injuries: office treatment of eye injury. 1. Injury due to foreign materials.

Patients with eye injuries caused by foreign materials are often seen by the primary physician. The causative agents may be foreign objects, noxious liquids or vapors, ultraviolet irradiation, or contact lenses. Injuries caused by foreign bodies that do not penetrate the outer coats of the eye can be treated by the nonspecialist; the intraocular presence of an object requires prompt referral to an ophthalmologist. Ultraviolet light irradiation and contact lenses worn for a prolonged period cause a great deal of pain to the eye but injury is not serious and the eye heals well. Injury from chemicals may be moderate or severe; if pain and functional impairment persist after copious irrigation of the eye with sterile saline solution, the patient should be referred to an ophthalmologist.

Contact Lenses

Shotgun eye injuries. Ocular risk and eye protection efficacy.

BACKGROUND: Little is known about the efficacy of shotgun eye protection. Shotguns can easily propel pellets with enough energy to penetrate the human eye, and a large percentage of shotgun eye injuries occur during shotgun sports such as hunting, trap, skeet, and sporting clays. Many of these injuries are preventable with proper eye protection. Although it is known that polycarbonate is the best lens material for shotgun eye protection, there has been no research that addresses the vision protective system design and its influence on eye protection. METHODS: A field study was performed during which shotshells were fired at 1:1 scale photographs of human faces to determine the risk of ocular trauma. The protective efficacy of three types of polycarbonate protective eye wear (standard industrial safety glasses with snap-on side shields, wrap-around racket sport glasses, and three-piece glasses with integral side shields) was tested by firing shotshells at them at various distances. Both frontal and side protection was evaluated. RESULTS: Results showed that the eye is at a high risk (55% to 100%) of being hit with shot pellets at ranges of 15 to 40 yards. It also was determined that the protective eye wear will give good frontal eye protection from shotgun pellets but integral side shields and a headband are necessary to obtain adequate side protection. CONCLUSION: These findings, coupled with the poor visual prognosis of ocular shotgun injuries, indicate that polycarbonate protective eye wear with integral side shields and headbands should be worn by all involved with shotgun sports.

Eye Injuries, Penetrating

Eye injuries.

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Eye Injuries

Penetration eye injuries in the workplace. The National Eye Trauma System Registry.

Occupational eye injuries are common and preventable. Between 1985 and 1991, there were 635 work-related penetrating eye injuries among the 2939 cases (22%) reported to the National Eye Trauma System Registry by 48 collaborating centers in 28 states and Washington, DC. The median age of the injured workers was 30 years; 75% were younger than 40 years; and 97% were male. The commonest causes of injuries were projectiles (457 cases), sharp objects (166 cases), blunt objects (60 cases), and blasts (22 cases); these terms are not mutually exclusive. Specific objects causing injuries included nails, wire, screwdrivers, and other hand tools. There was evidence of alcohol use by at least 2% of the injured workers. When they were injured, 6% of the workers were wearing safety glasses; 3% were wearing nonsafety eyewear. Posterior segment trauma, which occurred in 63% of the cases, included vitreous hemorrhage (42%), intraocular foreign bodies (35%), and retinal detachment (10%). Hyphema occurred in 35% and traumatic cataract in 32% of the cases. Initial visual acuity after injury was hand motion or worse in 43% of the cases. National Eye Trauma System Registry data are useful to identify strategies to prevent occupational eye injuries such as wider use of safety glasses and improvement in engineering controls.

Accidents, Occupational

Prevention of sports-related eye injury.

Sports-related eye injury is an important cause of vision loss. Many eye injuries can be prevented through the supervision of play, the enforcement of game rules and the use of eye protective devices. State-of-the-art eye protective devices incorporate highly impact-resistant optical material, usually polycarbonate lenses, in a sturdy frame. Protective devices are available for use in racquet sports, baseball, basketball, football, ice hockey and other sports.

Adolescent

Work-related penetrating eye injuries.

A review of all penetrating eye injuries treated at the Manchester Royal Eye Hospital over 5 years (January 1st 1982 to December 31st 1986) was undertaken. There were 258 penetrating eye injuries of which 69 (26.7%) were due to work-related accidents. All were men and 52 (75.4%) of them were under the age of 40 years. Hammering and chiselling were the commonest activities at the time of the injury and accounted for 25 cases (36.2%). Thirty-six patient (52.1%) had intraocular foreign bodies. Thirty-six patients (52.1%) achieved a good visual result (6/12 or better) and 9 had no perception of light, 7 of whom had enucleations. The period of inpatient treatment ranged from 1 to 26 days. From the analysis of the activities at the time of the injury, 61 injuries (88.4%) may be considered to be preventable with appropriate eye protection.

Accidents, Occupational

Perforating eye injuries caused by occupational accidents treated at Helsinki University Eye Hospital 1970--1977.

This study concerns perforating eye injuries caused by occupational accidents in the years 1970--1977. These injuries represented 40% of all perforations treated during this period at Helsinki University Eye Hospital. The results were compared with the previous series from this hospital for the years 1950--1951 and 1930--1939. Of the patients 92% were males, a slight percentage decrease from the fifties. The youngest age group, 16--25 years, was also the largest (30%). Earlier the next age group, 26--35 years, was largest. The proportion of workers in building construction with eye injuries increased remarkably to 26.6%. Metal workers made up another large group affected by eye perforations (24.5%). Agricultural work lost its importance as the cause of perforations as compared with the previous decades. The commonest cause of eye accidents was still hammering. Flying objects, especially metal splinters, were important causes now as well as in the previous series. Prognosis was much better in the present series than earlier: 60% of patients achieved vision of 0.5 or better, as compared with 40% in the fifties and 20% in the thirties.

Accidents, Occupational

Eye injuries in indoor cricket at Wellington Hospital: a survey January 1987 to June 1989.

About 30% of all sports injuries to the eye seen at Wellington Hospital are due to indoor cricket. An analysis of 29 eye injuries, January 1987 to June 1989 was carried out. Traumatic iritis, mydriasis and commotio retinae were the common injuries. There were eight blow out fractures of the orbit. Only two patients had permanent loss of vision due to choroidal tears with best vision in the damaged eye reduced to 6/9. A total of 88 eye clinic visits and 24 inpatient days were involved. The incidence of these injuries could be reduced by wearing eye and/or facial protection.

Adolescent

Occupational eye injuries in soldiers.

Soldiers have occupational exposure to eye hazards that in many ways are comparable to those in civilian industry. We conducted a prospective, community based, case-control study at three large troop installations of an infantry division to characterize nonmilitary-unique, occupational eye injuries and associated risk factors and to assess current occupational health practice in eye injury prevention in the division. The findings indicate that the most important risk factors are youth, a history of an eye injury in the preceding two years, and, paradoxically, the perception that supervisors are concerned and well informed about eye injury prevention. Injury severities were mild resulting in an average of 1 day of lost employment per injury. The economic impact for the entire US Army Europe is estimated to approximate $1,100,000 per year.

Accidents, Occupational

Eye injuries associated with anesthesia. A closed claims analysis.

Claims against anesthesiologists for eye injuries were analyzed as part of the ASA Closed Claims Project. Eye injury occurred in 3% of all claims in the database (71 of 2,046). The payment frequency for eye injury claims was higher than that for non-eye injury claims (70% vs. 56%; P less than or equal to 0.05). The median cost of eye injury claims was less than that for other claims ($24,000 vs. $95,000; P less than or equal to 0.01). Two distinct subsets were identified. The first was characterized by corneal abrasion during general anesthesia (25 of 71 claims; 35%). Claims for corneal abrasion were characterized by low incidence of permanent injury (16%) and low median payment ($3,000). Reviewers were able to identify a mechanism of injury in only 20% of claims for corneal abrasion. The second subset of eye injury was characterized by patient movement during ophthalmologic surgery (21 of 71; 30%). Blindness was the outcome in all cases. Sixteen of the claims involving movement occurred during general anesthesia, and 5 occurred during monitored anesthesia care. The median payment for claim involving movement was 10 times greater than for non-movement claims ($90,000 vs. $9,000; P less than or equal to 0.01). Anesthesiologist reviewers deemed the care rendered in the general anesthesia "movement" claims as meeting standards in only 19% of claims. From the perspective of patient safety, as well as risk management, these data suggest two specific needs: research directed at better understanding of the etiology of corneal abrasion and clinical strategies designed to assure patient immobility during ophthalmic surgery.

Adult

Predictors of blinding or serious eye injury in blunt trauma.

Multivariate analysis was used to identify factors predicting injury and visual outcome in 94 blunt trauma patients evaluated for eye injuries among 6700 admissions to a level I trauma center over a 29-month period. Patients with penetrating eye injuries were excluded from this review. Eye injury was detected in 93% or 87 of the patients evaluated. Seven percent of eye injuries resulted in blindness, 22% were serious (visual acuity between 20/40 and 20/200 or eye injury requiring surgery), and 71% were temporary (final visual acuity of 20/40 or better). The presence of an afferent pupillary defect or a nonreactive pupil was the most important factor in predicting the severity of eye injury (p = 0.0023), followed by facial fractures (p = 0.0084), and no eye opening or eye opening to pain within the Glasgow Coma Scale (p = 0.02). Eye injury is an infrequent complication of blunt trauma. Appropriate consultation for evaluation of this problem can be obtained based on findings from the initial history and screening physical examination.

Adolescent

Eye injuries.

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Burns, Chemical

[Eye injuries in squash].

The characteristics of a type of ball game that has only become popular in the last ten to twenty years, the game of Squash are being described. The causes and degree of possible ocular injuries are based on personal observation and the available literature. The conclusion is that patients presenting respective ocular changes should not attempt to play this hazardous ball game.

Athletic Injuries