Mobile battery blast injuries: An emerging ocular health hazard in children

PURPOSE

To assess clinical features, visual outcomes, and setting of mobile battery blast-induced eye injuries in children.

METHODS

Retrospective case sheets of children with mobile battery blast injuries were reviewed at a tertiary eye care center from January 2015 to March 2022. We noted the mode of injury, battery status, and clinical presentation and analyzed the treatment outcomes.

RESULTS

The study included 14 eyes of 11 patients. Three patients (27%) had bilateral ocular injuries. The most common reasons for the blast were wiring a bulb to the battery or charging the battery with a universal mobile charger, seen in four cases each. Three eyes had closed-globe injuries (CGIs), whereas 11 had open-globe injuries (OGIs). Of the 11 eyes with OGI, four also had a retained intraocular foreign body (IOFB). Only four (36%) eyes having OGI could achieve vision better than 6/60. All three eyes with CGIs developed secondary glaucoma, and two underwent trabeculectomy. However, the visual prognosis was better (>6/36) in eyes with CGI. Overall, mean visual acuity at the final follow-up was improved to 1.41 ± 1.14 logMAR from 2.32 ± 0.76 logMAR at presentation. This was also found to be statistically significant with a P value of 0.02.

CONCLUSION

Battery blast-induced ocular injuries, although rare, often lead to poor outcomes. Apart from charging, playing with discarded or damaged batteries was a common reason for battery blasts in our series.

Multiple Approaches for Managing Complex Ophthalmic Blunt Trauma: A Case Report

Introduction

Ophthalmic trauma is defined as injuries affecting the ocular structures, including the globe, eyelid, lacrimal system, and surrounding orbital walls. Blunt trauma acts as the leading cause of injury and it may affect both the anterior and posterior parts of the globe. Prompt diagnosis, early management, and sustained follow-up are mandatory for an optimal outcome.

Purpose

This report presents a one-step surgery management process for an intricate case of blunt facial trauma with complex ophthalmic and nasal injury.

Patients and Methods

A 45-year-old male with blunt force trauma of the left eye from a wooden block, suffered from naso-orbital-ethmoidal fractures, eyelid laceration with canalicular, close-globe injuries of traumatic cataract and vitreous hemorrhage with retinal detachment. A simultaneous one-step surgery was performed by a trauma team of ophthalmological and ENT surgeons during the height of the COVID-19 pandemic to lessen the risk of cross-transmission. After ruling out the possibility of open-globe rupture, traumatic cataract extraction, retinal detachment surgery, the repair of an eyelid laceration with canalicular involvement, and septorhinoplasty were performed on concomitantly.

Results

Anatomical success was achieved for the repair of the nasoorbitoethmoidal (NOE) type II fracture and close-globe injuries, including the anatomical reattachment of the retina. However, the functional outcome remained unsatisfactory. Visual acuity failed to show further improvement at a later follow-up. Traumatic optic neuropathy was, at the final follow-up, considered to be the cause of the suboptimal visual acuity.

Conclusion

A single-step multi-procedure for a complex ophthalmic blunt trauma, as demonstrated in this case, may be beneficial for reducing the complications that might arise due to treatment delay. The complex nature of the injury, however, creates the higher possibility for residual post-operative complications. Risks of residual functional impairment should be considered in such complex trauma prior to surgery, to determine the surgical prognostic value and provide appropriate consent to the patient.

Epidemiology of hospitalized ocular injuries in the upper East region of ghana

Summary

AIM OF STUDY

The Upper East is the poorest and most rural region in Ghana and ocular injuries are a major public health problem. This study aims at providing epidemiologic data on the burden of this problem in order to facilitate the provision of integrated eye care and safety strategies for the prevention of such injuries in the region.

DESIGN

A retrospective case series.

METHODS

Computerized records of all eye injuries admitted to the clinic between January and December 2004 were retrieved and analyzed using the Epi-Info software. Injuries were classified using the Birmingham Eye Trauma Terminology while Snellen visual acuities were classified/banded using the WHO categories of visual impairments.

RESULTS

Ninety six eyes of 96 patients were admitted over the study period. Seventy five percent of the patients were males and 82.3% below the age of 30 years. Half of the patients had to travel beyond 100 km to get ophthalmic assistance. Only one third of the cases reported within 24 hours while 21% reported after one week of their injuries. These delayed periods of reporting showed no statistically significant relationship with the distances travelled to the hospital (p=0.76; chi2 test), nor the eventual visual outcome achieved following treatment. Open-globe injuries were by far the most common (60/96) and were 4.7 times more likely (Chi squared test) to produce poor visual outcome (p=0.02 CL 1.75-12.63).

CONCLUSION

Current eye care strategies do not adequately address the issue of eye injuries in the region. There is the need to provide integrated approach by incorporating primary eye care strategies into the existing primary health care system.