An Uncommon Meridional Globe Rupture due to Blunt Eye Trauma

Study on maintenance of eyeball morphology by foldable capsular vitreous body in severe ocular trauma

OBJECTIVES

To explore the feasibility and safety of using a foldable capsular vitreous body (FCVB) in managing severe ocular trauma and silicone oil-dependent eyes.

METHODOLOGY

This is a retrospective study of 61 ocular trauma patients (61 eyes) who presented to the Department of Eye Emergency, Hebei Eye Hospital from May 1, 2018, to May 31, 2019, including 51 male patients (51 eyes) and 10 female patients (10 eyes) with an average age of 44.98 ± 14.60 years old. The oldest patient was 75 years old, and the youngest was 8 years old. These cases represented 51 eyes with severe eyeball rupture and 10 eyes with severe, complicated ocular trauma, which became silicone oil-dependent after the operation. These patients received FCVB implants, and data regarding their visual acuity, intraocular pressure, changes in eye axis, cornea, retina, and FCVB state were recorded after the operation.

RESULTS

In all patients, the FCVB was properly positioned and well supported with the retina. All 61 patients cleared a follow-up window of 1-36 months with no reports of important changes in their visual acuity. Among the patients, 91.8% reported normal intraocular pressure, the retinal reattachment rate reached 100%, and the eyeball atrophy control rate reached 100%. There was no report of rupture of the FCVB, allergies to silicone, intraocular infection, intraocular hemorrhage, silicone oil emulsification, or sympathetic ophthalmia.

CONCLUSIONS

Foldable capsular vitreous bodies (FCVBs) designed to mimic natural vitreous bodies are suitable as long-term ocular implants that can provide sustained support for the retina without the need for any special postoperative postures. Their barrier function may effectively prolong the retention time of the tamponade and prevent various complications caused by direct contact of the eye tissues with the tamponade.

Eye disease and international travel: a critical literature review and practical recommendations

RATIONALE FOR REVIEW

Eye diseases pose a significant public health and economic burden, particularly for travellers exposed to ocular hazards who may lack access to specialist eye care. This article offers an evidence-based review for travel-health practitioners, with a particular emphasis on ocular infections and trauma that are more prevalent among travellers. Providing an overview of these issues will allow travel health practitioners to comprehensively address ophthalmic considerations of travel.

METHODS

A systematic literature search was conducted on PubMed and Embase electronic databases, using keywords related to travel medicine and ophthalmology. Inclusion was based on the relevant contribution to epidemiology, aetiology, diagnostics, management and long-term consequences of travel-related eye conditions. The data were analysed using narrative synthesis.

KEY FINDINGS

This literature review highlighted that various travel-related eye conditions may occur. Travellers should be aware of the risk of travel-related ocular complications, which can arise from ocular infections, high-risk activities, high altitude and space travel. The economic and logistical challenges associated with medical tourism for ophthalmic procedures are discussed. For travellers with pre-existing eye conditions or visual impairment, careful planning may be needed to promote eye health and ensure safety of travel.

CONCLUSIONS

Travel medicine practitioners should have a comprehensive understanding of the major ocular risks associated with overseas travel, including eye infections, eye injuries and solar eye damage. Further research in this area can enhance overall wellness and alleviate the burden of ocular diseases on travellers. Evidence-based guidelines based on research can also improve the quality of care and prevent long-term vision problems.

Comparison of Both Eyes Anterior Segment Structures of Patients with Unilateral Blunt Trauma

BACKGROUND

To evaluate anterior segment optical coherence tomography (AS-OCT) data in patients with unilateral blunt ocular trauma (BOT), to determine the relationship of results with hyphema development METHODS: 21 patients who received unilateral BOT were included in the study. Healthy eyes of patients were included in the control group. Iris stromal thickness (IST), schlemm canal area (SCA) and pupil diameter were measured by AS-OCT of the participants. In addition, eyes with ocular trauma were divided into those with and without hyphema and compared in terms of these parameters.

RESULTS

The mean nasal and temporal (n-t) IST was measured as 373± 40 µm and 369 ± 35 µm in BOT in comparison with 344 ± 35 µm and 335 ± 36 µm in control eyes, respectively (p = 0.000 and p = 0.001, respectively). The mean nasal and temporal (n-t) SCA was measured as 12,571 ± 880 µm² and 12,162 ± 1,181 µm² in developed hyphema in comparison with 10,455 ± 1,506 µm² and 10,188 ± 939 µm² in did not develop hyphema, respectively (p = 0.016 and p = 0.002 respectively).

CONCLUSION

The ISTs of the traumatized eyes in the nasal and temporal quadrants were statistically thicker than the other healthy eyes. SCA in both nasal and temporal quadrants of eyes with hyphema was statistically significantly larger than the group without hyphema.

Traumatic enucleation of the left globe after a road traffic accident - A case report of an uncommon occurrence in maxillofacial trauma

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Sometimes the orbital mechanisms to protect the globe fail.

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Although rare, globe avulsion can occur after maxillofacial blunt trauma.

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Despite all efforts, permanent major sequels can occur after facial trauma.

Introduction

Serious injuries of the globe are uncommon in closed maxillofacial trauma, as the anatomical configuration of the orbit offers important protective mechanisms against external trauma. Thus, the objective of this work is to report a case of a rare traumatic enucleation of the globe resulting from maxillofacial blunt trauma.

Presentation of case

A 42-year-old man was hit by a car with a major complaint of facial pain. The patient had several facial fractures including: Le Fort I, naso-orbit-ethmoidal, anterior sinus wall and an exposed fracture of the orbit-zygomatic complex (OZC). The patient underwent to open reduction and internal fixation of facial fractures and enucleation of the left globe, however, evolved with postoperative infection and complications associated with, a so far unknown, type 2 diabetes. After secondary surgeries for removal infected bones and diabetes control, all injuries were fully healed, and the patient remained with major sequels.

Discussion

In this case, we hypothesized a high-energy trauma resulting in multiple facial fractures, especially involving the OZC, dislocated the thick lateral wall of the orbit within the orbital cavity and reduced the orbital volume. This resulted in an exaggerated increase in intraorbital pressure, which exceeded the capacity of all anatomical protective mechanisms of the globe, and pushed the globe outwards, causing a complete avulsion.

Conclusion

Besides all anatomical structures to protect the globe, rarely high energy maxillofacial trauma can cause severe damage to the globe resulting in loss of vision and globe avulsion.