Woman With Facial Trauma

Lee, Mathew; Heerden, Anton Van

doi:10.1016/j.annemergmed.2015.10.012

Cited by 1 publication

(1 citation statement)

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“…3 Management strategies depend on the type, size of the FB, site of penetration, and hemostasis. [4][5][6][7] Ocular imaging of radiolucent FBs remains difficult: plain films detect only metallic FBs 8 and magnetic resonance imaging poses risk associated with unrecognized metal. 9 Inert FBs carry a lower risk of infection than organic FBs such as wood, 4 but still warrant broad-spectrum antibiotics to prevent infections.…”

Section: Discussionmentioning

confidence: 99%

Removal of an Impaled Intraocular Hair Comb Following Self-inflicted Trauma

Markovitz

Hamburger

Fromm

et al. 2020

Clinical Practice and Cases in Emergency Medicine

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Ocular trauma is one of the most common and vision-threatening ophthalmic presentations with a wide spectrum of complications, such as bleeding, infection, vision loss, and enucleation. A 64-year-old-male presented to the emergency department (ED) with a self-inflicted orbital penetrating injury with a hair comb. Computed tomography showed the comb traversed the medial orbit inferior to the medial rectus but did not damage the optic nerve; there were no globe or orbital wall fractures. His ocular exam was significant for a right eye afferent pupillary defect and decreased visual acuity 20/800, consistent with optic neuropathy. Primary concerns were stabilizing and removing the foreign body without causing further damage in the setting of an uncooperative patient. The comb was removed with the aid of local and systemic analgesia using gentle traction and normal saline irrigation. The patient was admitted for systemic and topical antibiotics and showed improvement in visual acuity and resolution of his optic neuropathy. This case illustrates the importance of rapid ED assessment and management of complex penetrating ocular trauma. Examination should specifically look for signs of globe rupture and optic nerve injury. Expedited foreign body removal should be managed together with an ophthalmologist with procedural sedation and broad-spectrum antibiotics to avoid further visual and infectious complications.

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Section: Discussionmentioning

confidence: 99%