Trauma ocular

Josset et al. [4] found that there were approximately 7,000 serious chemical splash injuries in France per year, with about half of these cases involving the eyes [4]. Chemical eye splashes made up about 9.9% of ocular trauma in the USA and 7.2% in a UK casualty department however, most were with rather innocuous substances such as hairsprays and shampoos [5]. Acid and base eye bums were 1.6% and 0.6%, respectively, of total eye injuries [5]. 

Ocular bums comprise about 7-18% of ocular trauma presenting to emergency departments in the USA and eye injuries account for about 3 % of total occupational injuries [6]. Most of these (approximately 84%) are chemical bums. About 15-20% of patients with facial bums also have ocular bums. The ratio of acid/alkali chemical ocular bums is 1 1-1 4 [6]. 

Clinicians should ask about past and current eye disease as well as past ocular trauma. Practitioners should inquire about a history of contact lens wear. Many topically applied medications can cause corneal complications when used in the presence of soft contact lenses. Obtaining a history of current ocular medications is essential. If their continued use is necessary, the old and... 

Topically applied anesthetics may cause corneal endothelial toxicity when used after perforating ocular trauma or when used topically for cataract extraction. When injected inttacametally, benzalkonium chloride, the primary preservative used in topical ocular anesthetics, can cause irreversible corneal edema in rabbits. 

The salicylates are beneficial for pain associated with inflammation, but their use has now been generally supplanted by other NSAIDs, largely because of gastrointestinal (GI) distress. Nevertheless, the salicylates are effective for treatment of mild to moderate pain and may produce analgesic effects comparable with those of weak narcotics such as propoxyphene hydrochloride. When used in combination with narcotics, the salicylates can be effective for severe pain accompanying acute ocular trauma or inflammation. 

A patient with a corneal abrasion typically reports a history of recent ocular trauma, such as being struck by a flying object or by a finger striking the eye. Patients with intermediate to large corneal abrasions usually seek treatment within 24 hours of the injury because of the significance of their symptoms. 

Retinal detachment associated with vitreoretinopathy is a complication of ocular trauma and vitreoretinal surgery. The mechanism leading to the detachment is not completely understood (Weller etal., 1991 McGillem and Dacheux, 1998 Valeria Canto Soler etal., 2002). Several studies suggest a role of MP, however their origin was not... 

Retinal detachment associated with vitreoretinopathy as a result of complication of ocular trauma is mediated solely by microglia. 

The use of intravitreal corticosteroids was first popularized by Machemer in 1979 (33) in an effort to halt cellular proliferation after retinal detachment surgery, and Graham (34), McCuen (35), Tano (36), and others have studied its use in both animal models and humans. In contrast to other corticosteroids with short half-lives following intravitreal injection, triamcinolone acetonide is an effective and well-tolerated (35,37) agent for intravitreal injection in conditions such as uveitis (38,39), macular edema secondary to ocular trauma or retinal vascular disease (40), proliferative diabetic retinopathy (41), intraocular proliferation such as proliferative vitreoretinopathy (42), and choroidal neovascularization from AMD (43,44). 

In cases of ocular trauma, Bacillus species are the most common cause of postoperative infection, particularly in a rural setting (6,10-12). Staphylococcal organisms are the next most common while gram-negative infections have an increased likelihood by comparison to postoperative cases. Mixed infections involving multiple bacteria are also more common than after elective surgery (5,6,13). 

Affeldt JC, Flynn HW Jr, Forster RK, Mandelbaum S, Clarkson JG, Jarus GD. Microbial endophthalmitis resulting from ocular trauma. Ophthalmology 1987 94 407-413. 

Schech JM, Alfaro DV, Laughlin RM, Sanford EG, Briggs J, Dalgetty M. Intravenous gentamicin and ceftazidime in penetrating ocular trauma a swine model. Retina 1997 17 28-32. 

Miller DM, Stegmann R (eds). Treatment of Anterior Segment Ocular Trauma. Montreal, Medicopea, 1982 Miyake K, Ota I, Ichihashi S, Miyake S, Tanaka T, Terasaki, H. New classification of capsular block syndrome. J Cataract Refract Surg 1998 24 1230-1234... 

Roper-Hall MJ. Visco elastic materials in the surgery of ocular trauma. Trans Ophthalmol Soc UK 1983 103 274-276... 

Stegmann R, Miller D. Use of sodium hyaluronate in severe penetrating ocular trauma. Ann Ophthalmol 1986 18 9-13... 

Silicone oils have been used as vitreous fluid substitute to treat difficult cases of retinal detachment, such as those complicated with proliferative vitreoretinotherapy, giant retinal tears, and penetrating ocular trauma. The incidence and cause of several visual loss following use and removal of intraocular silicone oil (SiO) after uncomplicated vitrectomy and SiO injection for primary rhegmatogenous retinal detachment (SSD) was investigated. 

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