A retrospective study of eyeball rupture in patients with or without orbital fracture

Chen, Xiang; Yao, Yi; Liu, Tiecheng; Zhao, Xiaofei

doi:10.1097/md.0000000000007109

Cited by 13 publications

(10 citation statements)

References 30 publications

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“…A correlation between ocular injuries and orbit fractures has been detected by several authors previously, especially in the case of posterior and/or lateral extension of the fracture [28,29]. Of note, final visual prognosis is reported to be worse in severe eye trauma with associated orbit fracture [30]. Moreover, frontal bone fractures are known to be closely related to posttraumatic pneumocephalus, which was also seen more commonly in VSI patients in our study [31].…”

Section: Discussionsupporting

confidence: 79%

Damage to the eye and optic nerve in seriously traumatized patients with concomitant head injury: analysis of 84,627 cases from the TraumaRegister DGU® between 2002 and 2015

Huckhagel

Regelsberger

Westphal

et al. 2020

Scand J Trauma Resusc Emerg Med

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Background: To determine the prevalence and characteristics of prechiasmatic visual system injuries (VSI) among seriously injured patients with concomitant head trauma in Europe by means of a multinational trauma registry. Methods: The TraumaRegister DGU® was searched for patients suffering from serious trauma with a Maximum Abbreviated Injury Scale (AIS) ≥ 3 between 2002 and 2015 in Europe. After excluding cases without significant head injury defined by an AIS ≥ 2, groups were built regarding the existence of a concomitant damage to the prechiasmatic optic system comprising globe and optic nerve. Group comparisons were performed with respect to demographic, etiological, clinical and outcome characteristics. Results: 2.2% (1901/84,627) of seriously injured patients with concomitant head trauma presented with additional VSI. These subjects tended to be younger (mean age 44.7 versus 50.9 years) and were more likely of male gender (74.8% versus 70.0%) compared to their counterparts without VSI. The most frequent trauma etiologies were car accidents in VSI patients (28.5%) and falls in the control group (43.2%). VSI cases were prone to additional soft tissue trauma of the head, skull and orbit fractures as well as pneumocephalus. Primary treatment duration was significantly longer in the VSI cohort (mean 23.3 versus 20.5 days) along with higher treatment costs and a larger proportion of patients with moderate or severe impairment at hospital discharge despite there being a similar average injury severity at admission in both groups. Conclusions: A substantial proportion of patients with head injury suffers from additional VSI. The correlation between VSI and prolonged hospitalization, increased direct treatment expenditures, and having a higher probability of posttraumatic impairment demonstrates the substantial socioeconomic relevance of these types of injuries.

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Section: Discussionsupporting

confidence: 79%

Damage to the eye and optic nerve in seriously traumatized patients with concomitant head injury: analysis of 84,627 cases from the TraumaRegister DGU® between 2002 and 2015

Huckhagel

Regelsberger

Westphal

et al. 2020

Scand J Trauma Resusc Emerg Med

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“…Previous research has found that trauma caused by a blunt force is a more common cause of orbital fracture than trauma caused by a sharp object. [46][47][48] Similarly, blunt trauma causes globe ruptures and is more likely to involve the posterior aspect of the globe, zones 2 and 3. 47,49 The posterior region of the globe is sequestered from the surrounding environment; for this reason, posterior ruptures may not have as high a risk of contamination as anterior scleral or corneal open wounds and thus may be at a reduced risk of developing endophthalmitis.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Post–Open-Globe Injury Endophthalmitis

Uppuluri

Zarbin

Bhagat

2020

Journal of VitreoRetinal Diseases

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Purpose: The objective of our project is to use the National Inpatient Sample Database to identify risk factors for endophthalmitis in cases of open-globe injury (OGI). Methods: This is a cross-sectional observational study of 48 627 cases of OGI from the National Inpatient Sample Database. We performed regression analysis using IBM SPSS Statistics 23. Codes from the International Classification of Disease, Ninth Revision were used to identify ocular findings and conditions. Variables with P values less than .05 on univariate analysis were included in the multivariable regression model; Bonferroni correction was applied to these results. Results: Of the 48 627 cases of OGI, 37 440 (77.0%) occurred in the adult group (21 years and older). Overall, 1018 (2.1%) cases developed posttraumatic endophthalmitis, with 74.5% cases in the adult group. Endophthalmitis developed in 293 (4.5%) eyes with an intraocular foreign body (IOFB). Results of binary logistic regression showed the clinical findings of traumatic cataracts, hypopyon, vitreous inflammation, corneal ulcers, or IOFBs were associated with an increased risk of developing endophthalmitis after OGI. Conversely, orbital fractures, rupture-type injuries, and intraocular tissue prolapse were associated with a decreased likelihood of being diagnosed with endophthalmitis. Conclusions: Endophthalmitis developed in 2.4% of pediatric OGIs and 2.0% of adult OGIs. Traumatic cataract, hypopyon, vitreous inflammation, corneal ulcer, keratitis, retinal detachment, IOFB, and diabetes increased the risk of post-open-globe endophthalmitis.

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“…In this study, about 50% of patients having rupture globe had associated multiple orbital wall fractures. In the study done by Chen X et al, 36 out of 197 eyes of a rupture globe, 32 eyes got injured due to RTA. Among them 15 eyes had rupture globe with orbital fracture.…”

Section: Clinical Profilementioning

confidence: 99%

Eye injuries in motor vehicle accidents: Epidemiology, spectrum of injury and analysis of risk factors

Maurya¹,

Singh²,

Mishra³

et al. 2021

IJOOO

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To study the epidemiology, clinico-radiological pattern and visual outcome in patients having ocular injuries following road traffic accident and also compare various risk factors associated with it. Materials and Methods: A prospective, hospital based, observational study was performed at a teaching hospital of North India. Various parameters including demographics, time, place and session of injury, type of road, vehicle & collision, type of injury, severity & location of injury, radiological findings and initial & final visual acuity were analysed. The association between ocular trauma and characteristics of the accident were evaluated. Results: Out of 402 patients of ocular trauma, 101 eyes of 95(23.63%) patients had injuries due to road traffic accidents. It was observed that males were affected predominantly (88.40%).The ratio between men and women was 7.6:1, age ranged from 1 year to 67 years. The most vulnerable age group was 21-30 year (25.30%) followed by 31-40 year (24.20%) and 11-20 year (21.10%).Maximum injury victims were illiterate (33.68%) or had primary education only (29.47%). The majority were married (68.42%) and belonged to rural background (42.10%). Most of the road traffic accidents occur in summer season (47.37%). Majority of the victims sustained injury in the afternoon between 12.00 -17.59 hrs (29.47%) and in evening between 18.00-23.59 hrs (27.33%). 57.89 % victims were not using any protective gear at the time of injury. Driving under influence of alcohol (42.11%) and sleepiness or drowsiness of victims (21.05%) were found to be an important risk factor in ocular injury. 43.61% of the accidents took place at highway. Two-wheeler occupants (30.53%) were more prone to ocular trauma than pedestrians (13.68%), three-wheelers occupants (5.26%) and car occupants (21.05%). However 29.47% victims were travelling in heavy vehicles like bus/ truck. The most common mode of road accident was collision with other stationary objects like a tree, pole, milepost and other vehicle (51.58%) followed by swerved / skidded vehicle (26.32%) and run in the ditch (13.68%). The commonest mode of injury was frontal impact or head-on collision (37.89%) followed by sideways impact (26.32%) and hit by projectile object (6.32%). However, in 29.47% cases the mode of injury was indeterminate. Conclusion: Road traffic accidents can cause severe ocular trauma. Victims are usually adult males of productive age group. Two wheeler occupants, driving under influence of alcohol and non-use of protective gear were found to be major risk factors. Frontal impacts posed the greatest risk of orbito-facial trauma. Open globe injury and multiple orbital wall fracture usually associated with poor prognosis. Use of helmet and seatbelt may reduce the frontal impact and hence vision threatening ocular trauma.

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A retrospective study of eyeball rupture in patients with or without orbital fracture

Cited by 13 publications

References 30 publications

Damage to the eye and optic nerve in seriously traumatized patients with concomitant head injury: analysis of 84,627 cases from the TraumaRegister DGU® between 2002 and 2015

Damage to the eye and optic nerve in seriously traumatized patients with concomitant head injury: analysis of 84,627 cases from the TraumaRegister DGU® between 2002 and 2015

Risk Factors for Post–Open-Globe Injury Endophthalmitis

Eye injuries in motor vehicle accidents: Epidemiology, spectrum of injury and analysis of risk factors

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