scholarly journals Missed Diagnosis of an Intraorbital Foreign Body of Homemade Fireworks Origin: A Case Report

2015 ◽  
Vol 6 (3) ◽  
pp. 448-452 ◽  
Author(s):  
Dan-dan Zhou ◽  
Kai Niu ◽  
Cheng-wei Lu ◽  
Ji-long Hao ◽  
Bing-jie Zhang ◽  
...  
Keyword(s):  
Emergency Department ◽  
Foreign Body ◽  
Retinal Detachment ◽  
Traumatic Injury ◽  
Vitreous Hemorrhage ◽  
Initial Assessment ◽  
Retinal Tear ◽  
Orbital Wall ◽  
Oral Steroids ◽  
The Right

Purpose: We report a rare case of traumatic injury to the eye caused by homemade fireworks in a Chinese juvenile patient with a metal ring left in the orbit after having been sutured at the Emergency Department. Methods: An 11-year-old boy presented with a traumatic injury to the right eye from homemade fireworks. Following initial assessment involving maxillofacial computed tomography (CT) and suturing at the Emergency Department, he was transferred to our department for further evaluation because of his poor sight 1 day later. On examination, a skin laceration beneath the right eyebrow was noted, but the superior orbit was not fully visible on the maxillofacial CT performed 1 day previously. Therefore, an orbital CT scan was carried out on the second day, which showed a hyperdense ring embedded in the superior border of the orbital wall; the ring was surgically removed. On postoperative day 7, a fundus examination revealed resolving vitreous hemorrhage, blunt traumatic retinal detachment, and a large retinal tear superior to the macula. The patient refused to take surgery for retinal detachment into consideration. Therefore, we opted for oral steroids and careful observation. Results: After 2 months' observation, the large retinal tear had healed and white fibrous scar tissue had developed, and the retinal detachment superior to the macula had reattached itself spontaneously. The patient's vision had further improved to 20/200. During 1 year of follow-up, he remained clinically stable. Conclusion: To avoid missing the diagnosis, a complete history of the mechanism of injury and accurate imaging still prove most useful. Complete removal of the foreign body by the emergency physician is necessary because of the ocular toxicity of an iron-containing foreign body. As evidenced by the current case, oral steroids and observation for a period of several months is a management of choice for traumatic retinal detachment and retinal tear superior to the macula associated with homemade fireworks in children.

scholarly journals Bilateral Giant Retinal Tear and Sequential Vitrectomy

2017 ◽  
Vol 8 (2) ◽  
pp. 436-439
Author(s):  
Mushawiahti Mustapha ◽  
Edward Roufail Franzco
Keyword(s):  
Case Report ◽  
Retinal Detachment ◽  
Silicone Oil ◽  
Perfluorocarbon Liquid ◽  
Excellent Outcome ◽  
Retinal Tear ◽  
Giant Retinal Tear ◽  
Retinal Tears ◽  
The Right ◽  
Outcome Of Surgery

Purpose: To describe the excellent outcome of surgery for bilateral giant retinal tears (GRTs) with better options of endotamponade. Methods: This is a case report of a 62-year-old man who presented with bilateral GRTs and associated retinal detachment. The tear in the right eye was supero-temporal and silicone oil was used as an endotamponade. The tear in the left eye was infero-temporal and perfluorocarbon liquid was used as an endotamponade. Results: The outcome at 6 months after surgery was excellent with visual acuities of 6/6 in both eyes. Conclusion: Improved availability of endotamponade agents allows repair of bilateral GRTs to be done at the same time, with good surgical outcomes.

scholarly journals Results of intraocular foreign body removal from the posterior segment by direct approach

2015 ◽  
Vol 8 (4) ◽  
pp. 24-29 ◽  
Author(s):  
Vadim Petrovich Nikolaenko ◽  
Mariya Valerievna Kataeva
Keyword(s):  
Foreign Body ◽  
Retinal Detachment ◽  
Vitreoretinal Surgery ◽  
Vitreous Hemorrhage ◽  
Cataract Extraction ◽  
Intraocular Foreign Body ◽  
Direct Approach ◽  
Eye Injuries ◽  
Foreign Body Removal ◽  
History Analysis

Objective: to evaluate early and remote complication of intraocular foreign body (FB) removal by direct approach, and to determine indications for splinter removal through the wound. Material and methods. Case history analysis was performed in 31 patients with missile eye injuries. In all patients, FB was removed by direct approach at initial surgical debridement. Results. Foreign body penetration was accompanied with injuries of different eye segments, which were manifested by vitreous hemorrhage, hyphema, subretinal hemorrhage, retinal detachment, traumatic cataract. In 12 patients, there was a need in additional surgical treatment consisting in retinal laser barrage, vitrectomy, cataract extraction. As a result of treatment, visual acuity increased in 58.06% of injured. At the remote post-op period, retinal detachment developed in 16.13% cases, and vitreoretinal procedures were performed. Conclusions. Intraocular foreign body removal from the posterior eye segment using direct approach is appropriate if the FB is in the wound or in its immediate proximity. Most serious complications of missile injury are proliferative vitreoretinopathy and retinal detachment, demanding vitreoretinal surgery.

Rhegmatogenous retinal detachment with giant retinal tear in a child with Marfan’s syndrome: a rare ocular emergency

2021 ◽  
Vol 14 (6) ◽  
pp. e241354
Author(s):  
Parrina Sehgal ◽  
Subina Narang ◽  
Deepak Chandra
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Marfan’S Syndrome ◽  
Marfan's Syndrome ◽  
Retinal Tear ◽  
Giant Retinal Tear ◽  
Pars Plana ◽  
23 Gauge ◽  
The Right

A 7-year-old boy with Marfanoid habitus presented with sudden and painless decrease in the vision of the right eye. Ocular examination revealed rhegmatogenous retinal detachment with 360° giant retinal tear in the right eye and small peripheral retinal breaks with lattice degeneration in the left eye. The patient underwent a 23-gauge pars plana vitrectomy with scleral buckling in the right eye and laser around the breaks in the left eye. At 1-week follow-up visit, the child presented with similar complaints in the left eye as were seen in the right eye. This was later managed effectively with 23-gauge pars plana vitrectomy only. So, with our case report, we would like to highlight the need for aggressive screening in children who are diagnosed with Marfan’s syndrome and the need for prophylactic treatment in the unaffected eye.

scholarly journals Big intraocular foreign body: Case report

2013 ◽  
Vol 141 (7-8) ◽  
pp. 516-518
Author(s):  
Aleksandar Gakovic ◽  
Igor Kovacevic ◽  
Jovana Bisevac ◽  
Bojana Radovic ◽  
Katarina Cubrilo ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Foreign Body ◽  
Retinal Detachment ◽  
Detailed Examination ◽  
Posterior Segment ◽  
Intraocular Foreign Body ◽  
Traumatic Cataract ◽  
Normal Limits ◽  
The Right ◽  
Fitting In

Introduction. Penetrated injuries are most difficult injuries of the eye. Intraocular foreign body (IOFB) may lodge in any of the structures it encounters, from anterior chamber to the retina and choroid. Notable effects caused by foreign body injury include traumatic cataract, vitreous liquefaction, retinal and subretinal hemorrhages, retinal detachment and development of endophtalmitis. Case Outline. A 49?year?old man sustained injury of the right eye with a piece of metal wire. On admission visual acuity was VOD: 1.0 and lower intraocular tension TOD=6 mmHg (10?22 mmHg). Corneal entry wound was noticed near limb on 11h with a prominating foreign body of 18 mm in length that passed through the iris, lens and vitreous. X?ray findings confirmed existence of a large foreign body extending along the entire length of the globe. IOFB removal was done with anatomic forceps. On postoperative detailed clinical examination we observed retinal rupture in the upper temporal quadrant fitting in the area of the IOFB damaged retina. Laser photocoagulation of retinal tear (laser retinal barrage) was done. Visual acuity on discharge was the same (1.0) and intraocular tension was within normal limits (10 mmHg). Conclusion. Penetrated injury of eye requires detailed examination of all eye structures, beginning from the anterior to posterior segment. Timely diagnosed ruptures of the posterior segment of eye before the development of traumatic cataract, and adequate therapeutic procedures prevent serious complications of IOFB penetrated eye injury such as retinal detachment and permanent reduction of visual acuity.

scholarly journals Management of Trauma Patient in the Hospital Settings

2018 ◽  
Vol 2 (2.2) ◽  
pp. 12-13
Author(s):  
Agron Dogjani
Keyword(s):  
Emergency Department ◽  
Rural Areas ◽  
Traumatic Injury ◽  
Injured Patient ◽  
Tissue Perfusion ◽  
The Body ◽  
Morbidity And Mortality ◽  
Initial Assessment ◽  
Initial Care ◽  
Injury Burden

Introduction: Trauma can be defined as a ‘blunt or penetrating external force exerted on the body resulting in injury’. Traumatic injury is a leading cause of death globally among persons under the age of 45 years. Over 5 million deaths occur each year as a result of injuries, representing 9% of the world's mortality. Non-fatal injuries are among the leading global cause of emergency department (ED) visits, hospitalizations, and long-term morbidity, accounting for a large part of health systems workload. Although road injuries, falls and self-harm are the top three causes of injury burden globally, their relative importance may differ according to the region. The initial assessment and management of traumatized patients should take place in a specialized area of an emergency department or a specialized trauma center. The time of injury is the essence of survival for life-threatening trauma. Appropriate initial care at the scene affects the morbidity and mortality of the traumatized patient. Prolonged transport time or inadequate hospital care increases the demand for early restoration of rapid tissue perfusion before the physiological changes of the injured patient reach the hospital. On the other hand, the lack of medical emergencies in rural areas and the lack of knowledge of management protocols by trauma management personnel increase morbidity and mortality in this group of patients. This presentation addresses the management of traumatized patients after these patients reach an emergency department at a regional/municipal hospital or a traumatic center.  

scholarly journals A Case of Presumed Dyskeratosis Congenita Causing Severe Retinal Vascular Occlusion

2021 ◽  
pp. 344-349
Author(s):  
Takahisa Hirokawa ◽  
Shou Oosuka ◽  
Masahiro Tonari ◽  
Hiroshi Mizuno ◽  
Teruyo Kida ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rare Case ◽  
Bone Marrow Failure ◽  
Vitreous Hemorrhage ◽  
Vascular Occlusion ◽  
Dyskeratosis Congenita ◽  
Vitreous Surgery ◽  
Hard Exudates ◽  
Retinal Vascular Occlusion ◽  
The Right

Dyskeratosis congenita (DKC) is a rare, multisystem, bone marrow failure disease characterized by abnormalities such as in the skin, mucosa, nervous system, and lungs. Here we report a rare case of presumed DKC causing total retinal detachment in the right eye and severe peripheral retinal vascular occlusion in the left eye. A 3-year-old boy was presented with vitreous hemorrhage and total retinal detachment in the right eye and was scheduled to undergo vitreous surgery in the right eye and detailed ophthalmologic examination of the left eye under general anesthesia. Since a systemic examination revealed anemia and marked thrombocytopenia, he underwent a detailed pediatric examination. Although genetic testing revealed no significant pathologic mutations, the presence of shortened telomere length and other clinical findings suggested the possibility of DKC. His right eye had severe proliferative vitreoretinopathy, and retinal reattachment was not achieved with vitreous surgery, thus resulting in phthisis bulbi. The left eye showed a wide retinal avascular area in the temporal retina, retinal neovascularization, and hard exudates on fluorescein fundus angiography and was treated with laser photocoagulation using a binocular indirect ophthalmoscopic photocoagulator. Following laser surgery, the new blood vessels regressed, and the visual acuity was maintained at 1.0. The findings in this rare case indicate that DKC can cause severe retinal vascular occlusion, thus leading to vitreous hemorrhage and retinal detachment. Therefore, early detection with fundus examination and early treatment with photocoagulation are important.

Internal limiting membrane peel with or without finesse flex loop assistance

2020 ◽  
Vol 14 (2) ◽  
pp. 64-67
Author(s):  
Faisal Mehmood ◽  
Abdullah Irfan ◽  
Awais Afzal ◽  
Muhammad Moin ◽  
Muhammad Muneeb
Keyword(s):  
Retinal Detachment ◽  
Vitreous Hemorrhage ◽  
Internal Limiting Membrane ◽  
Retinal Hemorrhage ◽  
Ilm Peeling ◽  
Closure Rate ◽  
Cross Sectional ◽  
Retinal Tear ◽  
Significant Difference ◽  
Surface Irregularities

Background: Internal Limiting Membrane (ILM) peeling, currently, due to more successful hole closure rate and prevention of postoperative reopening, has been accepted globally but it may leads to other trivial complications like subretinal and retinal hemorrhage, vitreous hemorrhage and retinal edema etc., which may be avoided by using adjuvant instruments, like Finesse flex Loop. The aim of this study was to compare complications after ILM peel, with and without finesse loop. Patients and methods: In this comparative cross-sectional study conducted in Ophthalmology Department of Lahore General Hospital, Lahore from February 2018 to January 2019, the data of thirty (30) patients was compared after taking informed consent through self-made pro-forma. Data analysis was done on SPSS-21. Frequency / percentage table of qualitative variables like retinal hemorrhage, retinal tear, retinal detachment and surface irregularities were designed by using excel-16. Fischer’s exact test was applied to compare complications after ILM peeling with and without using Finesse loop. Confidence interval of 0.95 with α of 0.05 was taken as significant. Results: This study included thirty (30) patients (female: 13; male: 17) with mean age of 56 years and 8 months. Comparison between outcomes of ILM peeling with and without using Finesse™ Flex Loop showed that there is statistically non-significant difference in occurrence of retinal hemorrhage (p=0.245), retinal tear (p=0.224), retinal detachment (p=1.00) and surface irregularities (p=0.39). However, the prevalence of complications like surface irregularities, retinal tear, retinal hemorrhage and retinal detachment with finesse loop were less as compared to without finesse loop. Conclusion: The prevalence of complications during ILM peel with finesse loop in a macular hole surgery, were less than that in ILM peel with ILM forceps alone.

Pediatric retinal damage due to soccer-ball-related injury: Results from the last decade

2019 ◽  
pp. 112067211988233
Author(s):  
Ari Leshno ◽  
Amir Alhalel ◽  
Miri Fogel-Levin ◽  
Ofira Zloto ◽  
Joseph Moisseiev ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Blunt Trauma ◽  
Pediatric Trauma ◽  
Vitreous Hemorrhage ◽  
Posterior Segment ◽  
Medical Database ◽  
Equal Distribution ◽  
Soccer Ball ◽  
Retinal Tear ◽  
Severe Group

Objective: To outline the incidence of posterior segment injuries related to soccer-ball blunt trauma in children. Methods: Retrospective search of the computerized hospital medical database between the years 2007 and 2017. All pediatric trauma cases were reviewed and cases with blunt trauma related to direct orbital/ocular hit from a soccer-ball were included. Cases were divided into two groups (non-severe and severe) based on the presence of sight-threatening findings on presentation (e.g. retinal tear, vitreous hemorrhage, retinal detachment, and macular edema). Results: Out of 343 pediatric patients with relevant diagnoses, 14 (4.1%) were treated for injuries related to soccer-ball trauma. All patients were males at their early-to-mid teens (14.3 ± 2.1 years). The most common funduscopic finding was peripheral commotio retina (13, 93%). There was equal distribution between the two groups (seven each). Retinal injury in the severe group included retinal tear (3), vitreous hemorrhage (4), retinal detachment (1), and macular hole (1). Five patients in this group presented with visual acuity of 20/25 or better. Rate of external signs of injury were similar in both groups. Conclusion: Soccer-ball blunt trauma in children can cause significant posterior segment injuries regardless of the presence of external injury or ocular complaints. A thorough ocular exam is mandatory in all cases for the detection of vision-threatening retinal injuries.

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