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Parija S, Chakraborty K, Ravikumar SR. Firework related ocular injuries in Eastern India - A clinico-epidemiological analysis. Indian J Ophthalmol 2021; 69:3538-3544. [PMID: 34826991 PMCID: PMC8837315 DOI: 10.4103/ijo.ijo_753_21] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose :Ocular trauma is one of the major preventable causes of ocular morbidity and blindness in children and young adults. Firework injuries account for 20% of ocular trauma. The purpose of this study was to describe the clinical profile and assess the severity of the ocular injuries sustained from fireworks in Eastern India mainly during the festive season. Methods :This was a retrospective, hospital-based case study of patients with ocular injuries sustained from fireworks during the year 2017-2020. The study was conducted at a tertiary care hospital in Eastern India. Demographic details, type of injury, duration of injury, visual status, diagnostic tests, and management were recorded. Results Sixty-five patients were reported to suffer from firework-related ocular injuries. The majority of cases were male (51/78.5%). The mean age was 21.78 ± 16.82 years (range: 0-90 years). Children and young adult males were mostly affected (n = 40, 61.5%). Most common offending agent was the bottle rockets (n = 23, 35.4%), followed by bomb and crackers in (n = 18, 27.7%). Majority of the injuries occurred at home environment (n = 37, 56.9%), followed by street (n = 15, 23.1%). About (n = 39, 60%) of the injuries occurred among bystanders. About 40 cases (61.5%) hailed from rural areas. The majority of the cases (n = 46, 70.8%) suffered from closed globe injuries and surgical intervention was required in (n = 40, 61.5%) of the cases. The mean length of hospital stay of fewer than 5 days was required in (n = 42, 64.6%). The final visual acuity of 6/18 or better was achieved in 41 cases (63.1%). Conclusion :Ocular injuries from fireworks remain a public health problem. Awareness among the masses, preventive measures, and strict implementation of government legislation may help in bringing down the incidence of firework-related ocular morbidity and blindness.
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Affiliation(s)
- Sucheta Parija
- Department of Ophthalmology, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India
| | - Koyel Chakraborty
- Department of Ophthalmology, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India
| | - S R Ravikumar
- Department of Community Medicine and Family Medicine, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India
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Elahi S, Saad A, Gatinel D. Descemet Membrane Endothelial Keratoplasty for corneal decompensation due to migrating metallic intracorneal foreign bodies in an aphakic eye following a 39-year-old blast injury: A case report. Am J Ophthalmol Case Rep 2021; 23:101162. [PMID: 34296044 PMCID: PMC8281592 DOI: 10.1016/j.ajoc.2021.101162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 04/06/2021] [Accepted: 07/05/2021] [Indexed: 11/26/2022] Open
Abstract
Purpose To report the use of Descemet Membrane Endothelial Keratoplasty (DMEK) for secondary surgical removal of intraocular foreign bodies (IOFB) years after the trauma as migration occurred through the endothelium, damaging the endothelium, and causing corneal edema. Observations We report the case of a blast injury in 1972, that led to left eye traumatic cataract managed with vitrectomy and lensectomy. Although thorough removal was attempted, some corneal and conjunctival foreign bodies remained. Despite aphakia, the patient maintained acceptable best corrected visual acuity (BCVA) (0.30 LogMAR) but >30 years later, experienced visual deterioration. IOFB protruding through the Descemet membrane (DM) were seen, with extensive edema. Descemet Membrane Endothelial Keratoplasty was performed in an attempt to treat the endothelium and remove the foreign bodies protruding through the DM. The procedure was done uneventfully under sulfur hexafluoride gas (SF6) and the patient improved. Four years after the surgery, BCVA was 0.63, however, 6 years later, a new episode of migrating intracorneal foreign bodies with corneal edema reduced BCVA to 0.40. The decision was made to observe the patient, and delay a second DMEK. Conclusions and importance Corneal decompensation caused by IOFB breaching the Descemet membrane can safely be managed with a DMEK. DMEK is feasible even in complex cases and should be attempted due to its lower risk of graft rejection and likely benefits, while saving the option of more aggressive transplantation techniques, such as penetrating keratoplasty, in cases of failure.
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Affiliation(s)
- Sina Elahi
- Fondation Ophtalmologique Adolphe de Rothschild, Rue Manin, Paris, France
| | - Alain Saad
- Fondation Ophtalmologique Adolphe de Rothschild, Rue Manin, Paris, France
- American University of Beirut - Medical Center Beirut, Lebanon
- Corresponding author. Rothschild Foundation, Paris, France.
| | - Damien Gatinel
- Fondation Ophtalmologique Adolphe de Rothschild, Rue Manin, Paris, France
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Liu ZW, Peng J, Chen CL, Cui XH, Zhao PQ. Analysis of the etiologies, treatments and prognoses in children and adolescent vitreous hemorrhage. Int J Ophthalmol 2021; 14:299-305. [PMID: 33614461 DOI: 10.18240/ijo.2021.02.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 09/16/2020] [Indexed: 12/31/2022] Open
Abstract
AIM To determine the etiologies, treatment modalities and visual outcomes of vitreous hemorrhage (VH; range from birth to 18y). METHODS A total of 262 eyes from 210 patients between January 2010 and September 2016 were included. All children underwent an appropriate ocular and systemic examination. Data collected included demographics, clinical manifestations, details of the ocular and systemic examination, management details, final fundus anatomy and visual acuity (VA). RESULTS The most common etiologies were non-traumatic VH (64.89%), most of which were due to retinopathy of prematurity (ROP; 37.10%); while traffic accidents, including 16 (21.00%) eyes, was the most common ocular traumas. Surgery, performed in 143 (54.58%) eyes, was the most common management modality. The initial mean baseline visual acuity was 2.77±0.21 logarithm of the minimal angle of resolution (logMAR) in children and adolescent with traumatic VH, which was significantly improved to 2.15±1.31 logMAR (P<0.05). CONCLUSION VH in children and adolescent has a complicated and diverse etiology. ROP is the primary cause of non-traumatic VH, which is the most common etiology. Appropriate treatment of traumatic VH is associated with obvious improvement in visual acuity. The initial VA is one of most important predictors of outcome.
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Affiliation(s)
- Zheng-Wei Liu
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.,Department of Ophthalmology, Shanghai Baoshan District Wusong Central Hospital (Zhongshan Hospital Wusong Branch, Fudan University), Shanghai 200940, China
| | - Jie Peng
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Chun-Li Chen
- Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China
| | - Xue-Hao Cui
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.,Department of Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin 300000, China
| | - Pei-Quan Zhao
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
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Shiuey EJ, Kolomeyer AM, Kolomeyer NN. Assessment of Firework-Related Ocular Injury in the US. JAMA Ophthalmol 2021; 138:618-623. [PMID: 32271352 DOI: 10.1001/jamaophthalmol.2020.0832] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Fireworks are popularly used for recreation but can lead to potentially blinding injuries. Studies quantifying the trend and national prevalence of firework-related ocular injuries are limited. Objective To characterize firework-related ocular injuries treated in emergency departments (EDs) in the US from 1999 to 2017. Design, Setting, and Participants This cross-sectional study used the National Electronic Injury Surveillance System, a stratified probability sample of more than 100 hospital-affiliated US EDs representing more than 5300 nationwide hospitals. Deidentified individuals in the National Electronic Injury Surveillance System database who experienced eye injury due to fireworks between January 1, 1999, and December 31, 2017, were included. Analysis began February 2019. Main Outcomes and Measures Annual prevalence of firework-related ocular injury, firework type stratified by demographic information, diagnosis, event location/date, and patient disposition. Results A total of 34 548 firework-related ocular injuries were seen in US EDs during the 19-year study period (estimated from 1007 individuals in the National Electronic Injury Surveillance System database). Overall, 664 individuals (65.9%) were 18 years or younger, 724 (71.9%) were male, and 512 (50.8%) were white. Twenty-eight patients (2.8%) sustained a ruptured globe, while 633 (62.9%) sustained ocular burn injuries, 118 (11.7%) had ocular foreign bodies, 97 (9.6%) had conjunctival irritation, and 46 (4.6%) experienced other severe eye trauma. Of 1007 individuals, 911 (90.5%) were treated and released without transfer, while 87 (8.7%) required admission or transfer to another hospital. The most common specified firework types included firecrackers (193 [19.2%]), bottle rockets (177 [17.6%]), sparklers (88 [8.7%]), roman candles (66 [6.6%]), and novelty devices (65 [6.5%]) (eg, poppers and snappers). Bottle rockets disproportionately caused the most severe injuries, including ruptured globe (odds ratio, 5.82; 95% CI, 2.72-12.46; P < .001). A total of 411 cases (74.9%) occurred at home. Injuries most commonly occurred near the time of Independence Day and New Year's Day: 707 patients (70.2%) presented in July, 74 (7.4%) in June, 101 (10.0%) in January, and 47 (4.7%) in December. Conclusions and Relevance These findings support that firework-related ocular injuries range from mild irritation to ruptured globe, and most occur frequently in those who are young, male, and white. Focused preventive methods and regulations may be imperative in decreasing fireworks-related ocular morbidity, namely from bottle rockets and especially near national holidays.
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Affiliation(s)
- Eric J Shiuey
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Anton M Kolomeyer
- Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, Philadelphia
| | - Natasha Nayak Kolomeyer
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.,Wills Eye Hospital, Glaucoma Service, Philadelphia, Pennsylvania
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Changing Trends in Firework-Related Eye Injuries in Southern China: A 5-Year Retrospective Study of 468 Cases. J Ophthalmol 2020; 2020:6194519. [PMID: 32832138 PMCID: PMC7428839 DOI: 10.1155/2020/6194519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 07/14/2020] [Indexed: 11/18/2022] Open
Abstract
Firework-related eye injury is a horrible medical problem and creates huge health and social burdens. Herein, we explored the changing trends and demographic and clinical features of firework-related eye injury, in an effort to inform strategies to prevent this injury. We reviewed the data of 468 hospitalized patients who underwent surgery for firework-related eye injury at the Zhongshan Ophthalmic Center between January 2013 and December 2017. During this period, the trend in firework-related eye injuries was stable (mean, 93 ± 14 cases per year), and fireworks were the major cause of explosive eye injury. The average age of the patients was 24 ± 18 years and 87% of the patients were male, with boys under 10 years of age comprising the largest group (27% of patients). There were an average of 24 ± 7 cases per year from urban areas and 70 ± 8 cases from rural areas (P < 0.05). Furthermore, 21 ± 5% of cases occurred during Spring Festival. After treatment, the best corrected visual acuity was increased compared to that before treatment, and the intraocular pressure tended to become normal by the final visit (P < 0.05). The top three diagnoses were cataract (39%), retinal detachment (18%), and choroidal detachment (14%). Additionally, the most common surgery was cataract extraction (25%), followed by pars plana vitrectomy (19%) and pars plana vitrectomy plus pars plana lensectomy (10%). Over the five-year study period, day surgery hospitalization increased from 1% to 32%. This was associated with a corresponding decrease in the length of hospitalization, without adverse events, demonstrating that day surgery is feasible in firework-related eye injury cases. The present study results suggest that greater attention should be paid to firework-related eye injury, and a variety of measures should be taken to prevent this kind of ocular tragedy.
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Wang Y, Zhang X, Liu T, Liu M, Li H, Huang Y, Hu X, He W, Luo G, Qian W. Epidemiology and Outcome Analysis of Burns During Explosion Accident at a Major Center in Southwestern China From 2002 to 2016. J Burn Care Res 2020; 42:49-62. [PMID: 32632451 DOI: 10.1093/jbcr/iraa103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Explosions always lead to serious public health, social, and economic problems. We investigated the epidemiology, outcomes, and costs of burn patients caused by explosion accident in Southwest China to explore more effective prevention and treatment strategies. This retrospective study included 497 inpatients with burns during explosion accident admitted to the Institute of Burn Research of Army Medical University from 2002 to 2016. A total of 497 cases (77.78% males) were found, accounting for 2.37% of the total burn patients. The average age was 34.38 ± 15.02 years. The most common etiology was gas explosions (51.51%). Most of the cases were caused by work-related activities. The average TBSA was 31.30 ± 28.32%. The median length of stay (LOS) was 31 days. The LOS was correlated with TBSA, full-thickness burns, older age, number of operations and outcome. The major factors determining the cost were larger TBSA, full-thickness burns, and higher cure rate. The mortality was 6.44%. Larger TBSA and older age were the most important risk factors for the mortality. This study suggested that special attention should be paid to prevent burns during explosion accident in adult males with occupational exposure. In the future, more effective and practical strategies for preventing and treating burns during explosion accident based on related risk factors should be implemented.
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Affiliation(s)
- Yangping Wang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Xiaorong Zhang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Tengfei Liu
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Menglong Liu
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Haisheng Li
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Yong Huang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Xiaohong Hu
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Weifeng He
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Gaoxing Luo
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Wei Qian
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
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Diagnostik und Akuttherapie von Augenverletzungen durch Feuerwerkskörper. Ophthalmologe 2019; 116:1152-1161. [DOI: 10.1007/s00347-019-01000-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hoskin AK, Mackey DA, Keay L, Agrawal R, Watson S. Eye Injuries across history and the evolution of eye protection. Acta Ophthalmol 2019; 97:637-643. [PMID: 30907494 DOI: 10.1111/aos.14086] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 02/16/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE To describe the history of eye injuries and the consequent evolution of eye protection. METHODS A comprehensive search of Medline and the grey literature using the terms 'ocular trauma' and 'eye protection' or 'injury prevention' and 'history'. References were used to identify other relevant publications. Publications were classified according to the setting of eye injury: occupational, recreational or combat-related. RESULTS Eye protection has been described in a wide range of sources, including in literature and art. With advances in eye protection material and design, as well as government and societal promotion of appropriate eye protection usage in the workplace, the epidemiology of ocular trauma has changed over time. In developed countries, the use of eye protection in the workplace has reduced the proportion of occupation-related eye injuries over the last century, with a higher proportion occurring during sports or at home. New protection devices and policies have evolved to meet this change. CONCLUSION Vision loss has broad implications for the individual and for society and despite available prevention strategies, ocular trauma is a significant cause of preventable monocular and bilateral vision loss. The use of appropriate eye protection has reduced the burden of ocular trauma. History provides lessons for informing current eye protection and eye injury prevention strategies.
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Affiliation(s)
- Annette K. Hoskin
- Save Sight Institute The University of Sydney Sydney NSW Australia
- Lions Eye Institute Nedlands WA Australia
- Department of Ophthalmology University of Western Australian Nedlands WA Australia
| | - David A. Mackey
- Lions Eye Institute Nedlands WA Australia
- Department of Ophthalmology University of Western Australian Nedlands WA Australia
| | - Lisa Keay
- School of Optometry and Vision Science UNSW Sydney Australia
- The George Institute for Global Health UNSW Sydney NSW Australia
| | | | - Stephanie Watson
- Save Sight Institute The University of Sydney Sydney NSW Australia
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Frimmel S, de Faber JT, Wubbels RJ, Kniestedt C, Paridaens D. Type, severity, management and outcome of ocular and adnexal firework-related injuries: the Rotterdam experience. Acta Ophthalmol 2018. [PMID: 29536639 DOI: 10.1111/aos.13711] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To study the type, severity, management and outcome of firework-related adnexal and ocular injuries during New Year's Eve festivities. METHODS A retrospective analysis of 123 injured patients (143 eyes) treated at the Rotterdam Eye Hospital between 2009 and 2013. All ages were included and analysed according to age, gender, active participant or bystander, laterality, location, dimension and severity of injury. Outcome parameter was the final best-corrected visual acuity. RESULTS The mean age was 22 ± 13 years with 87% males and 53% bystanders. 52% were ≤18 years. There was a higher number of female than male bystanders (63% versus 51%, p = 0.30). 50% of the eyes sustained mild, 13% moderate and 37% severe trauma. Adults suffered more from severe injuries compared to children (42% versus 31%). The most frequent intervention was gunpowder removal (20%), followed by traumatic cataract surgery (12%) and amniotic membrane grafting (8%). 76% of patients were followed over 1 year. At the end of follow-up, 88 (61.5%) eyes had recovered fully, while 55 (38.5%) eyes suffered from persistent complications with reduced vision ≤0.8 in 30% of injured eyes. 15 patients (12%, 10 adults, five children) were considered legally blind (vision ≤0.1). Three (2%) eyes were subject to evisceration. CONCLUSION Every year, around New Year's Eve 30-45 victims were referred to the Rotterdam Eye Hospital; 50% sustained moderate-to-severe trauma. In severe firework injuries, patients required multiple treatments that may not prevent permanent blindness and/or functional/cosmetic disfigurement. The majority was bystander and younger than 18 years.
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Affiliation(s)
- Sonja Frimmel
- The Rotterdam Eye Hospital; Rotterdam The Netherlands
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Elangovan S, Rajalakshmi AR, Velayutham V, Ranjit Prabhu D. An analysis of ocular firecracker injuries in five consecutive years during a festive season in a tertiary eye care hospital in South India. EXPERT REVIEW OF OPHTHALMOLOGY 2016. [DOI: 10.1080/17469899.2016.1176913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Loporchio D, Mukkamala L, Gorukanti K, Zarbin M, Langer P, Bhagat N. Intraocular foreign bodies: A review. Surv Ophthalmol 2016; 61:582-96. [PMID: 26994871 DOI: 10.1016/j.survophthal.2016.03.005] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 03/06/2016] [Accepted: 03/10/2016] [Indexed: 01/15/2023]
Abstract
Intraocular foreign body injuries may result in a wide range of intraocular pathology and visual outcomes based on the mechanism of injury, type of foreign body, and subsequent complications. We have reviewed the literature to describe the epidemiology and mechanisms of such injuries; types of foreign bodies; imaging tools for diagnosis; current trends in management, presurgical, and surgical interventions; as well as visual prognosis and potential complications. The purpose of this review is to familiarize clinicians with the recent advances in diagnosis and management of such injuries.
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Affiliation(s)
- Dean Loporchio
- Institute of Ophthalmology and Visual Science, Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey 07103, USA
| | - Lekha Mukkamala
- Institute of Ophthalmology and Visual Science, Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey 07103, USA
| | - Kavya Gorukanti
- Institute of Ophthalmology and Visual Science, Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey 07103, USA
| | - Marco Zarbin
- Institute of Ophthalmology and Visual Science, Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey 07103, USA
| | - Paul Langer
- Institute of Ophthalmology and Visual Science, Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey 07103, USA
| | - Neelakshi Bhagat
- Institute of Ophthalmology and Visual Science, Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey 07103, USA.
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