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A 54-years-old man, a known case of oculocutaneous albinism (OCA) type 1, presented to us with gradual-onset diminution of vision both eyes (OU) for 5 years. The patient had no prior history of ocular trauma. There was no history of any systemic illness, especially collagen vascular disorder. The

An adult man was struck in the face by his own aerial drone. The propellers hit the upper face region leading to forehead and eyelid lacerations, a partial scleral laceration, conjunctival laceration, hyphaema, traumatic iritis and forward displacement of one haptic of the intraocular lens from a previous cataract surgery. In the last decade, drone use has significantly increased and drone-related injuries have become an emerging cause of trauma. Our case raises awareness of the risks and highlights the need for improvement in regulation of drone use.

AIM: To predict final visual acuity and analyze significant factors influencing open globe injury prognosis. METHODS: Prediction models were built using a supervised classification algorithm from Microsoft Azure Machine Learning Studio. The best algorithm was selected to analyze the predicted final visual acuity. We retrospectively reviewed the data of 171 patients with open globe injury who visited the Pusan National University Hospital between January 2010 and July 2020. We then applied cross-validation, the permutation feature importance method, and the synthetic minority over-sampling technique to enhance tool performance. RESULTS: The two-class boosted decision tree model showed the best predictive performance. The accuracy, precision, recall, F1 score, and area under the receiver operating characteristic curve were 0.925, 0.962, 0.833, 0.893, and 0.971, respectively. To increase the efficiency and efficacy of the prognostic tool, the top 14 features were finally selected using the permutation feature importance method: (listed in the order of importance) retinal detachment, location of laceration, initial visual acuity, iris damage, surgeon, past history, size of the scleral laceration, vitreous hemorrhage, trauma characteristics, age, corneal injury, primary diagnosis, wound location, and lid laceration. CONCLUSION: Here we devise a highly accurate model to predict the final visual acuity of patients with open globe injury. This tool is useful and easily accessible to doctors and patients, reducing the socioeconomic burden. With further multicenter verification using larger datasets and external validation, we expect this model to become useful worldwide.

Aim To analyze the visual acuity (VA) and the incidence of secondary glaucoma among patients with closed globe injury (CGI). To determine the correlations between the ocular trauma score (OTS) with surgery rate, and evaluate the applicability of OTS in secondary glaucoma prediction and treatment. Methods We conducted a retrospective review of 265 patients (265 eyes) with CGI admitted to Xijing Hospital between January 2014 and December 2016. The clinical characteristics; VA, IOP, injury zone, surgery, and IOP-lowering medications were collected at the initial visit and at six months. The patients with secondary glaucoma were scored and assessed by the OTS system. The correlation of the anti-glaucoma surgery with the OTS was evaluated. The difference in the number of IOP-lowering medications between the initial visit and six months was analyzed. Results The average age of the patients was 33.5 ± 20.7 years with 80.8% being males. The final VA outcome improved in its totality after treatment. 35 patients developed glaucoma, with an incident rate of 13.2% over six months. All glaucoma patients had an injury in zone I and II, and 12 of them had an injury in zone III. The severity of the OTS category showed a strong correlation with the anti-glaucoma surgery rate. After the surgical intervention, the number of IOP-lowering medications in OTS category 2, 3, and 4 significantly reduced. Conclusions The OTS has predictive value in the incidence of secondary glaucoma after CGI. A patient with a low score is more likely to develop secondary glaucoma and might require surgical intervention.

Ophthalmic trauma is a leading cause of preventable monocular blindness worldwide. The prevalence of ophthalmic trauma varies considerably based on geographic location, socio-economic status, age groups, occupation, and cultural practices such as firework celebrations. Clinical registries are known to be valuable in guiding the diagnosis, management, and prognostication of complex diseases. However, there is currently a lack of a centralized international data repository for ophthalmic trauma. We draw lessons from past and existing clinical registries related to ophthalmology and propose a new suitable international multicenter clinical registry for ophthalmic trauma: the International Globe and Adnexal Trauma Epidemiology Study (IGATES). IGATES is hosted on a secure web-based platform which exhibits user-friendly smart features, an integrated Ocular Trauma Score (OTS) prognosis calculator, efficient data collection points, and schematic graphical software. IGATES currently has 37 participating centers globally. The data collected through IGATES will be primarily used to develop a more robust and improved ophthalmic trauma prognostic classification system, the Ocular Trauma Score-2 (OTS-2), which builds on previous systems such as the Birmingham Eye Trauma Terminology System (BETTS) and Ocular Trauma Score (OTS). Furthermore, IGATES will act as a springboard for further research into the epidemiology, diagnosis, and management of ophthalmic trauma. Ultimately, IGATES serves to advance the field of ophthalmic trauma and improve the care that patients with ophthalmic trauma receive.

To compare the anatomical and functional outcomes of silicone oil (SO)-filled foldable capsular vitreous body (FCVB) and SO endotamponade in vitrectomy for patients with no light perception after ocular trauma.A total of 64 patients (64 eyes) with no light perception caused by severe ocular trauma were divided into FCVB and SO groups based on the surgical treatment. The main outcome measurements were retinal reattachment rate, intraocular pressure, best-corrected visual acuity, and number of operations.Both the FCVB group (29 eyes) and the SO group (35 eyes) showed significant improvement in postoperative best-corrected visual acuity and intraocular pressure. The two groups showed no significant differences in final intraocular pressure and the retinal reattachment rate. The postoperative vision (≥LP) in the FCVB group was significantly worse than in the SO group (FCVB [4/29] vs. SO [18/35], P = 0.003). However, the number of surgeries in the FCVB group was significantly lower than in the SO group (FCVB [1.10] vs. SO [2.23], P0.001).Vitrectomy combined with SO endotamponade shows better short-term improvement in the treatment of no light perception caused by severe ocular trauma. However, SO-filled FCVB can effectively prevent many complications caused by direct SO endotamponade, such as secondary surgeries or SO dependence.

Introduction Ocular injury is the commonest ocular emergency and can vary across geographical and socioeconomic regions. This study was conducted to determine the pattern of ocular injuries presenting to our tertiary care hospital located in Puducherry, Southern India. Methods A retrospective hospital-based study was performed and analyzed the records of the patients who presented with ocular injuries to the emergency department between January 2016 and December 2017. Data were collected using a structured format and noted the demographic profile and clinical profile of ocular injury. Results Of the 392 ocular emergencies, 318 (81.1%) were caused by ocular trauma. Mechanical trauma was most common (306; 96.2%). Males were more frequently affected (ratio; 3.7:1). Most cases of trauma belonged to the 21–30 years age group (86, 28.1%) and were caused by road traffic accidents (RTAs) (197; 64.4%). Adnexal injuries were commonest (285; 93.1%). The ocular injury was close globe type in 93 (30.4%) and the open globe in three (1.0%). Serious lid injury was present in 71 cases (23.2%). Serious injuries such as globe rupture and traumatic optic neuropathy were present in three (1.0%) and eleven (3.6%) cases, respectively. Conclusion Ocular trauma is the most common cause of ocular emergencies and RTA is the commonest cause of ocular trauma. We need to explore strategies to minimize ocular trauma as a priority.

Purpose The purpose of this report is to describe a patient who has fluorescein angiographic evidence and retinal changes suspicious for intrauterine abusive ocular trauma. Methods A case report of a premature ward of the state with no prenatal care and a presentation suspicious for intrauterine abusive ocular trauma. We performed serial ophthalmologic examinations, reviewed available prenatal history with the infant's social worker, and all relevant hospital notes, laboratory results, and imaging results. Results Following initial empiric treatment for possible viral retinitis in the setting of a positive urine CMV, repeat examinations demonstrated fluorescein angiographic evidence and clinical findings suspicious for abusive ocular trauma including neovascularization and no evidence of retinitis; therefore, the child was treated with laser photocoagulation. Conclusion At-risk newborns will benefit from an examination of the retinal periphery and wide field fluorescein angiography. Intrauterine abusive ocular trauma should be included in the differential of retinal hemorrhage and avascular retinal periphery. It is imperative for clinicians to recognize this presentation to prevent progression of associated visual morbidity.

Sympathetic ophthalmia is a rare bilateral diffuse granulomatous panuveitis that usually results from surgical or penetrating trauma to one eye. The symptoms range from impaired near vision to pain, photophobia, and loss of visual acuity. Anterior segment manifestations include bilateral acute uveitis with mutton-fat keratic precipitates and posterior segment findings include vitritis, multifocal neurosensory retinal detachment, choroiditis, optic nerve edema, and Dalen–Fuchs nodules. The diagnosis is clinical. Ancillary investigations include fundus fluorescein angiography, indocyanine green angiography, optical coherence tomography (OCT), ultrasound B scan, and autofluorescence imaging. The management options include corticosteroids (topical and systemic) as the first line along with immunomodulatory therapy started at the presentation of the disease. Recent advances include imaging with OCT-angiography, enhanced depth imaging-OCT (EDI-OCT, choroidal vascular index/CVI), targeting IL-23/IL-17 pathway, and use of biologics for the management of this rare entity. Recent advances in early diagnosis and prompt treatment has led to improved final visual outcomes in both the sympathizing and exciting eye. This review is aimed at giving a comprehensive overview of sympathetic ophthalmia along with a special emphasis on current treatment strategies and recent advances.

SIGNIFICANCE Previously, people had only recognized the discomfort of masks, and no one had ever realized the risk of ocular trauma associated with masks. We classify the causes of injuries into two categories and emphasize the importance of using masks properly. PURPOSE This study aimed to characterize and classify ocular injuries caused by masks. CASE REPORTS With the increase in the number of masks used during the coronavirus disease 2019 pandemic, we have seen a rise in mask-related ocular injuries. This is a single-center retrospective case series of patients presenting to the Peking University Third Hospital Ophthalmology Department emergency department with ocular injuries secondary to masks from February to August 2020. Nine patients (six males, three females) were reviewed. All patients had a unilateral injury (four right eyes, five left eyes). The most frequently injured site was the cornea, which was seen in five patients. Some patients were injured in more than one area. Seven patients were injured by metal nose wires or other rigid, sharp parts of masks. The other two patients were injured by elastic mask straps. CONCLUSIONS Masks can cause two types of ocular injuries that may require surgical intervention. One kind is metal nose wires or other rigid, sharp parts of masks causing lacerations or abrasions. The other is recoiling elastic mask straps snapping into the eyes and causing contusions. Our report emphasizes the importance of using masks properly.

AIM: To describe epidemiological aspects, clinical findings, and visual results in eye trauma patients requiring urgent surgery at a tertiary hospital. METHODS: Retrospective review of adult patients requiring urgent surgery for trauma to the eyeball from January 2010 and April 2020. Data was collected relative to age, gender, mechanism of the injury, type of wound, initial and final visual acuity, number and type of surgeries carried out. Injuries were classed according to the Birmingham Eye Trauma Terminology (BETT) and the Ocular Trauma Score (OTS) categories. RESULTS: The survey included 92 eyes. Mean age was 54.76±22.18y. The most frequent cause was domestic accidents (44.6%), followed by aggression (22.80%) and occupational accidents (17.4%). Trauma from aggression was more frequent in men (P=0.006) and accidents in the home more common in women (P=0.011). Patients over 65y presented an odds ratio (OR) of 10.71 for suffering a domestic accident. Patients between 15-45 and 46-65y were at higher risk of trauma from aggression (OR=17.52 and OR=10.94, respectively). As for the type of injury, 63.04% were open-globe lesions, Zone II being the most frequently affected (27.2%). In Logistic regression analysis, old age (P=0.05) and retinal involvement (P=0.001) were found to be associated with higher rate of unfavourable visual outcome. CONCLUSION: The epidemiological aspects of eye trauma are highly dependent on the area of population studied. Domestic accidents are more relevant than workplace accidents in older urban areas with high socio-economic status. A better knowledge of the epidemiological characteristics is useful for implementing specific prevention measures and appropriate treatment strategies.

Purpose: To determine the etiological spectrum of irreversible blindness in Kashmir Valley in India. Methods: Patients presenting to a tertiary care hospital in Kashmir, India, with unilateral or bilateral blindness from April 2019 to March 2020 were included in this cross-sectional study. Blindness was defined using the World Health Organization (WHO) criteria. All subjects had a complete ophthalmologic examination and information was gathered regarding their demographic profile, nature of ocular disorder whether primary or secondary and laterality, if the ocular involvement was unilateral. Results: 248 patients were enrolled in the study. The mean age of the patients was 57.17 years. The male: female ratio was 2.17:1. The commonest cause of unilateral or bilateral blindness was glaucoma (22.58%) followed by diabetic retinopathy (DR) (17.74%). Unilateral blindness was seen in 78.62% of the patients. Unilateral blindness occurred mainly due to glaucoma (16.41%), DR (14.87%), age-related macular degeneration (13.33%), and trauma (pellet injury: 10.76%, non-pellet injury: 10.25%). The major causes of bilateral blindness were glaucoma (45.28%), DR (28.30%), and hereditary/congenital retinal diseases (16.98%). Socioeconomic status and educational status were significantly associated (P < 0.05 each) while age, gender, place of residence, and occupation were not significantly associated (P > 0.05 each) with the number of eyes affected by blindness. Conclusion: Glaucoma and DR are the foremost causes of irreversible blindness in Kashmir. Public health plans aimed at encouraging good health education of patients should be developed in this region. Moreover, patients should be screened effectively for glaucoma and diabetes at the level of primary health care facilities.

Introduction : This project set out to focus on ocular (globe) and peri-ocular trauma and to describe the spectrum of injuries seen in a busy South African trauma unit and to document their management and outcome. Results : During the period November 2012 to April 2020, a total of 12 115 patients were managed by the Pietermaritzburg Metropolitan Trauma Service (PMTS) at Greys Hospital in Pietermaritzburg, South Africa. Of these 2194 (11%) sustained ocular or peri-ocular injury. Of these 2194 patients, 1069 (83%) were male. 83% of injuries (n=1076) were classified as primarily blunt injury and 17% as a primarily sharp/penetrating mechanism. A substantial number of patients required a life-saving emergency intervention. These included resuscitation in 242 cases (19%) and active airway intervention was in 290 (22%). In total 919 (71%) patients required urgent surgery to the peri-ocular region. Slightly over half (55%) of these the surgery was performed by a single discipline. The rest needed procedures by two or more disciplines. The disciplines involved included ophthalmology, maxillofacial, plastic, ENT and neurosurgery. Plastic surgery was involved in 683 cases (53%). A total of 341 distant surgeries were required - These included orthopaedic operations, laparotomy and vascular operations. Of the 1294 cases in this study, 42 (3%) died before discharge and 99 (8%) were discharged with a GCS lower than 10. The primary skill set for management of these injuries is identified. Conclusion : Although the management of immediate life and organ threatening injuries takes priority, ocular and peri-ocular trauma may damage a number of important structures and their comprehensive management requires a multi-disciplinary team of specialists or, in austere environments, a font-line medical team with a diverse skill set.

To report on the factors associated with severe vision loss from fireworks-related ocular trauma during celebrations, including festivals. Tertiary eye care hospitals in 5 countries and private ophthalmology practices in the Netherlands. Patients included received treatment for fireworks-related ocular trauma during celebrations. Demographic and clinical data for patients affected were analyzed and associations with severe vision loss reported. Of 388 patients, 71 (18.3 %) had severe vision loss (worse than 6/60) at 4-week follow-up due to fireworks-related ocular trauma. Mean age overall was 20.6 years (range 2 to 83 years), and there was a male predominance of 4:1. Clinical factors associated with severe vision loss included penetrating injury (OR 4.874 [95% CI 1.298–18.304; p = 0.02]) and lens injury (OR 7.023 [95% CI 2.378–20.736; p = 0.0004]). More patients with closed-globe injuries (CGIs) had improved vision after 4 weeks (OR 3.667, 1.096–12.27) compared to those with open-globe injuries (OGI) (p = 0.035). Eye protection use was reported by 7 patients, and 39.4% patients < 18 years were unsupervised by an adult at the time of injury. Severe vision loss from fireworks-related ocular trauma occurred during celebrations in a variety of countries and was associated with penetrating and/or lens injury and poor presenting vision. New initiatives are needed to prevent severe vision loss associated with these injuries.

Purpose: To study the mechanism and clinical features of ocular injury and its outcome associated with bungee cord related eye trauma. Materials and Methods: A retrospective review of medical records was erformed at our tertiary care centre to identify patients presented with bungee cord related eye injury between March 2016 to February 2017. Data collected from medical records were age, sex, mechanism of injury, clinical features, therapeutic intervention, presenting visual acuity, final visual acuity and length of follow up. Result: Total of thirteen patients with bungee cord related trauma were identified. Ten (77%) patients presented with closed globe injury and 3(23%) presented with open globe injury. All patients were male with mean age group of 30.157.38 years. Presenting visual acuity ranges from 6/12 to NPL. Only seven (54%) of patients were having final visual acuity of better than or equal to 6/18 in injured eye. Three patients (23.1%) with open globe injury had final visual acuity of counting fingers or worse. Main mechanism of injury being combination of blunt and high speed projectile injury due to slippage of metal or plastic hook while the cord is stretched. Conclusions: Trauma with bungee cord is usually affecting working age group male with injury resulting in loss of workable vision to loss of eye hence there is need of appropriate intervention like use of printed warning on package and modification of hook design to decrease the incidence of bungee cord related trauma. Keywords: Bungee cord, Closed globe injury, Open globe injury.

Vaidehi Bhatt,1 Deepak Bhatt,2 Rakesh Barot,1 Jay Sheth3 1Department of Ophthalmology, Rajiv Gandhi Medical College and Chhatrapati Shivaji Memorial Hospital, Thane, Maharashtra, India; 2Department of Imaging, UBM Institute, Mumbai, Maharashtra, India; 3Department of Vitreoretinal, Surya Eye Institute and Research Center, Mumbai, Maharashtra, IndiaCorrespondence: Jay ShethDepartment of Vitreoretinal, Surya Eye Institute and Research Center, Mumbai, Maharashtra, IndiaTel +91 9961167200Email drjay009@gmail.comPurpose: To evaluate the role of ultrasound biomicroscopy (UBM) in detecting zonular abnormalities in eyes with ocular trauma.Patients and Methods: Prospective study of 143 eyes of 143 patients with ocular trauma and having opaque media was evaluated using a UBM. The presence or absence of zonular damage (zonular tears and/or zonular stretching) was examined and the clock-hour involvement was noted.Results: One-hundred and one eyes had blunt trauma (70.63%; group 1), while 42 eyes had penetrating trauma (29.37%; group 2) The mean age of the patient population was 48.01± 17.93 years with a male:female ratio of 2.11:1. Group 1 had significantly greater visual acuity than group 2 (p = 0.03). Zonular damage was present in 79 (55.2%) eyes, including zonular tears (48 eyes; 33.6%) and zonular stretching (31 eyes; 21.7%). Zonular damage was seen significantly more in eyes with blunt trauma (64.28%) as compared to penetrating trauma (25.74%) (p = 0.015). On quantitative analysis, zonular damage between 3 and 6 clock hours was most frequent, both in eyes having zonular tears (70.83%) and zonular stretching (96.77%). Additionally, 3– 6 clock hours of zonular stretching was seen significantly more in blunt trauma as compared to penetrating trauma (p = 0.015).Conclusion: UBM is an effective imaging modality to diagnose zonular abnormalities in patients with ocular trauma having opaque media. The ability to detect the presence of zonular weakness and their quantification by performing a UBM is critical to formulate the optimal surgical approach and avoid any untoward surgical complications.Keywords: ultrasound biomicroscopy, ocular trauma, zonular tears, zonular stretching

Ocular repeated air blast injuries occur from low overpressure blast wave exposure, which are often repeated and in quick succession. We have shown that caspase-2 caused the death of retinal ganglion cells (RGC) after blunt ocular trauma. Here, we investigated if caspase-2 also mediates RGC apoptosis in a mouse model of air blast induced indirect traumatic optic neuropathy (b-ITON). C57BL/6 mice were exposed to repeated blasts of overpressure air (3 × 2 × 15 psi) and intravitreal injections of siRNA against caspase-2 (siCASP2) or against a control enhanced green fluorescent protein (siEGFP) at either 5 h after the first 2 × 15 psi (“post-blast”) or 48 h before the first blast exposure (“pre-blast”) and repeated every 7 days. RGC counts were unaffected by the b-ITON or intravitreal injections, despite increased degenerating ON axons, even in siCASP2 “post-blast” injection groups. Degenerating ON axons remained at sham levels after b-ITON and intravitreal siCASP2 “pre-blast” injections, but with less degenerating axons in siCASP2 compared to siEGFP-treated eyes. Intravitreal injections “post-blast” caused greater vitreous inflammation, potentiated by siCASP2, with less in “pre-blast” injected eyes, which was abrogated by siCASP2. We conclude that intravitreal injection timing after ocular trauma induced variable retinal and ON pathology, undermining our candidate neuroprotective therapy, siCASP2.

Corneal foreign bodies are commonly seen in an ophthalmology emergency. The most common cause of this condition is a workplace-related injury. In these situations, the management differs from patient to patient and depends on a wide range of variables. In this article, we aim to review the literature on corneal foreign bodies in the past 50 years and classify them based on their level of impaction and elaborately discuss all the management options described for each. Keywords: Foreign bodies, cornea, surgical techniques, ocular trauma, corneal foreign body

Introduction Ocular trauma can cause significant morbidity and is a leading cause of unilateral blindness. In multi-trauma, life- and sight-threatening injuries can co-occur causing increased complexity in the assessment and management of ocular injuries as the competing priorities in the severely injured must be balanced. We conducted a narrative review to determine how ophthalmology may be further integrated into a trauma service and/or the organisation of an ocular trauma service. Methods The literature was reviewed via EMBASE, MEDLINE, CINAHL and Google Scholar utilising comprehensive search strategies and keyword searches. Our review was conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Results The search yielded 437 articles, 30 studies met selection criteria and were included in the review. The included literature comprised guidelines, observational studies and reviews of registry data from Australia, England, the United States, Singapore, Iran and Israel. Conclusion The Australian Trauma Model has clear guidelines for referral of trauma patients to ensure appropriate care of the severely injured. However, there are no clear guidelines for the integration of ophthalmology into trauma. Therefore, early referral to ophthalmology and streamlining of referral pathways of specialist care would improve the care of patients with ocular trauma.

Zusammenfassung Hintergrund Es können 3 Gruppen an Irisprothesen zur chirurgischen Versorgung von Irisdefekten unterschieden werden: (1) segmentale Irisimplantate, (2) kombinierte Irisblenden-Intraokularlinsen (IOL) und (3) reine Irisimplantate. Die meisten Irisrekonstruktionen gehen zusätzlich mit einer Aphakiekorrektur durch sekundäre Linsenimplantation einher. Auch wenn primäre Ziele die Herstellung einer Pupille sowie die Besserung des Blendungsempfindens, der Kontrastsensitivität und der Sehschärfe sind, spielt das ästhetische Ergebnis eine nicht zu vernachlässigende Rolle. Ziel der Arbeit Dargestellt werden funktionelle und ästhetische Ergebnisse nach Austausch von Aniridie-IOL-Implantaten gegen eine individuell angefertigte künstliche Iris in Kombination mit einer IOL. Material und Methoden In dieser retrospektiven Studie mit 7 Augen von 7 Patienten wurde eine Irisblenden-IOL (Morcher GmbH, Stuttgart) aus medizinischen Gründen (Subluxation) gegen eine individuell hergestellte künstliche Iris aus Silikon (ArtificialIris, HumanOptics, Erlangen) in Kombination mit einer angenähten IOL ausgetauscht. Die Nachbeobachtungszeit betrug mindestens 3 Monate. Bestkorrigierter Fernvisus (BCVA), Endothelzellzahl (ECC), Komplikationen, Blendungsempfinden, das ästhetische Ergebnis und die Patientenzufriedenheit wurden evaluiert. Ergebnisse BCVA und ECC zeigten keine statistisch signifikante Änderung zwischen prä- und postoperativ (p > 0,05). Es zeigte sich eine Dezentrierung des Iris-IOL-Implantats von 0,27 ± 0,19 mm 3 Monate postoperativ. Auf einer visuellen Analogskala (VAS) von 1 bis 10 (1 = gar nicht bis 10 = extrem zufrieden) wurde die Zufriedenheit mit dem Gesamtergebnis mit 8,6 ± 2,5 bewertet. Das subjektive Blendungsempfinden besserte sich auf 5,6 ± 3,5 und die subjektive ästhetische Beeinträchtigung auf 2,4 ± 2,0 auf der VAS (1 = gar nicht bis 10 = extrem stark). Die postoperativen Komplikationen umfassten eine vorübergehende intraokulare Hypotonie in zwei, einen Druckanstieg in zwei, eine Netzhautablösung und eine transiente Glaskörperblutung jeweils in einem Auge. Sechs von sieben Patienten würden den Eingriff wiederholen. Schlussfolgerung Im Vergleich zu einem starren Aniridie-IOL-Implantat bietet der Austausch gegen eine individuell angefertigte künstliche Iris in Kombination mit einer IOL neben einem guten funktionellen gleichzeitig auch ein ästhetisch ansprechendes Ergebnis.

We report a case of ocular injury caused by a bombardier beetle in a young boy. Ocular injuries due to this coleoptera have not previously been reported. An 11-year-old boy experienced an eye injury while trying to place a bombardier beetle inside an anthill. The boy was diagnosed with a second-degree burn on the skin of the upper right eyelid and conjunctival and corneal erosion in the right eye. The condition resolved completely after 2 weeks of appropriate treatment. Education about the dangers of playing with insects is crucial to prevent this type of lesions.

OBJECTIVES: To determine the visual outcome of ocular trauma in patients admitted in the ophthalmology unit. METHODOLOGY: This descriptive cross sectional study was conducted after approval of ethical committee, from June 2017 till June 2019 at Ophthalmology Department, Medical Teaching Institution, Mardan Medical Complex, Mardan (MTI-MMC). A total of 501 patients of either gender having ocular trauma were enrolled in study. Following informed written consent, detailed history, ocular examination and investigations the surgical procedure was carried out. A pre-designed proforma was used to record the outcome along with demographics and type of trauma, which was analyzed using SPSS V-24.0. RESULTS: In a total of 501 patients the mean age of sample was 30.5±2.2. Among 501, males were 408 (81.44%) and female were 93 (18.56%) with ratio of 9:1. Ocular trauma was more common in age of

Purpose: To investigate outcomes and presenting characteristics for subjects undergoing pars plana vitrectomy for ocular trauma. Methods: Retrospective study of 113 patients who underwent pars plana vitrectomy for severe ocular trauma at [name deleted to maintain the integrity of the review process] between 1999 and 2018. Data were collected on age, gender, initial and final visual acuity (LogMAR), mode of injury, type of injury, number of surgeries performed, follow-up duration, type of tamponade, presence of phthisis, and retinal detachment. The Birmingham Eye Trauma Terminology System (BETTS) was employed. Results: We identified assault and contusion injuries to be the most common mode and type of ocular injury in our cohort. Furthermore, through follow-up we noted a varied number of operations required by patients presenting with ocular trauma and a statistically significant improvement in visual acuity from 1.73 (±0.86) LogMAR to 1.17 (±1.03; p

Zusammenfassung Hintergrund Patienten mit Irisdefekten leiden unter starken Sehbeeinträchtigungen, insbesondere erhöhter Blendungsempfindlichkeit, und kosmetischen Beeinträchtigungen. Dies kann eine große psychische Belastung für die betroffenen Patienten darstellen. In der jüngeren Vergangenheit bestand die Behandlung aus farbigen Iriskontaktlinsen, Sonnenbrillen und einfachen Irisprothesen. Indikationen für eine chirurgische Behandlung sind Kolobome der Iris, Aniridie, traumatische Irisdefekte und persistierende Mydriasis. Ziel dieser Übersichtsarbeit ist es, chirurgische Ansätze, funktionelle und ästhetische Ergebnisse sowie Komplikationen nach Implantation einer individuellen künstlichen Irisprothese aus Silikon zu untersuchen. Ziel der Arbeit Analyse der veröffentlichten Literatur zum Thema chirurgische Irisrekonstruktion mit einer künstlichen Iris in Kombination mit eigenen Erfahrungen über 120 vom Autor in den letzten 10 Jahren behandelter Patienten. Material und Methoden Die in dieser Übersichtsarbeit verwendete maßgefertigte, flexible Silikonirisprothese ArtificialIris (HumanOptics, Erlangen, Deutschland) ist eine innovative und vielseitige Option in der chirurgischen Behandlung von Irisdefekten. Besprochen werden die diversen Implantationstechniken, die erreichbaren Ergebnisse sowie die möglichen Komplikationen. Ergebnisse Untersucht wurden die Veränderung der bestkorrigierten Sehschärfe, der Augeninnendruck, die Pupillenöffnung, die Blendung, die Kontrastempfindlichkeit, die Endothelzellzahl, die Vorderkammertiefe, der Kammerwinkel und die Patientenzufriedenheit. Weiterhin wurden Komplikationen und die Farbanpassung an die Rest- und Partneraugeniris bewertet. Diskussion Die Implantation der künstlichen Iris ist eine effektive Therapieoption zur Behandlung ausgeprägter traumatischer Irisdefekte und führt neben einer hohen Patientenzufriedenheit zu einem individuellen, ästhetisch ansprechenden und guten funktionellen Ergebnis. Es handelt sich aber um einen nicht zu unterschätzenden Eingriff mit flacher Lernkurve, bei dem Komplikationen auftreten können.

To detail the methodology for a novel ocular trauma registry and utilize the registry to determine the demographics, nature of injury, and associations of severe visual loss for open globe injuries (OGI). Thirteen hospitals in 7 countries used International Globe and Adnexal Trauma Epidemiology Study (IGATES) platform. Patients presenting between April 2009 and 2020 with OGI (with or without) adnexal involvement or intraocular foreign body (IOFB) were included. Analyses of presenting and final VA, using “severe vision loss” (VA ≤ 6/60) and “no severe loss” (VA > 6/60), were performed. Four hundred fifty-four (64%) patients had VA

Background Intralenticular foreign body is rarely encountered in ophthalmic practice. In most cases, subsequent traumatic cataract requires cataract surgery for visual rehabilitation. Case summary A 35-year-old man was injured by iron filings in his left eye. After the injury, the patient tried to draw the object out by himself using a magnet; however, the foreign body (FB) was pushed to the equator of the lens. The FB was removed by a magnet through the anterior chamber accessed through the original capsular wound. Since most of the lens was transparent and only partially opaque after the operation, the lens was kept under close observation. After the surgery, the patient's visual acuity reached 20/20 from 2/20, visual function recovered very well, and local opacity of the lens remained stable. Conclusion For intralenticular FB in the anterior cortex under the capsule, magnet may be a more advantageous way to remove the object.

Background: Pediatric ocular trauma is a significant cause of morbidity. It is estimated that there are up to 280,000 hospital admissions worldwide due to ocular trauma in children

Background: Ocular morbidities in children can have a serious impact on development; education and quality of life in children hence require prompt attention. This study was conducted with an objective to determine the pattern of ocular morbidity. Materials & Methods: This cross sectional study was conducted at the Vedantaa Institute of Medical Sciences, Palghar between February 2021 to April 2021 were involving 55 children. Data were tabulated in Microsoft Excel and analysed by SPSS version 23.0. All children who attended the Outpatient department of Ophthalmology during the study period were included and children whose parents did not give consents for examinations were excluded. Results: The most common ocular morbidity encountered was refractive errors (30.9%) followed by Conjunctivitis (20.0%) and ocular trauma (9.1%) in the age group of 10 - 15 years. Conclusion: Majority of ocular morbidities are preventable or treatable with proper use of eye care facilities is the need of the hour. Keywords: Ocular Trauma, Morbidity, Refractive Error, Conjunctivitis.

Asad F Durrani,1 Peter Y Zhao,1 Yunshu Zhou,1 Michael Huvard,2 Lyna Azzouz,3 Jason M Keil,3 Stephen T Armenti,1 Vaidehi S Dedania,4 David C Musch,1,5 David N Zacks1 1Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA; 2Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA; 3University of Michigan Medical School, Ann Arbor, MI, USA; 4Department of Ophthalmology, NYU Grossman School of Medicine, New York, NY, USA; 5Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USACorrespondence: David N ZacksDepartment of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan, 1000 Wall Street, Ann Arbor, MI, 48105, USATel +1 734-232-8404Email Davzacks@med.umich.eduBackground/Aims: To determine the rate of endophthalmitis and assess risk factors for development of endophthalmitis following open globe injury (OGI).Methods: A retrospective chart review of all patients treated for OGI at the University of Michigan from January 2000 to July 2017 was conducted. Exclusion criteria included intravitreal injection or intraocular surgery in the 30 days prior to injury or less than 30 days of follow-up. A total of 586 out of 993 open globe injuries were included in the study. The main outcome measure was the rate of endophthalmitis.Results: In this study, 25/586 eyes (4.3%) had endophthalmitis. Of these, 12/25 eyes (48.0%) presented with endophthalmitis and 13/25 eyes (52.0%) developed endophthalmitis after globe closure. Multivariate analysis identified time to globe repair (OR 4.5, CI 1.9– 10.7, p = 0.0008), zone I injury (OR 3.6, CI 1.1– 11.0, p = 0.0282), and need for additional surgery (OR 5.5, CI 1.5– 19.7, p = 0.0092) as factors associated with increased risk of developing endophthalmitis. Subconjunctival antibiotic injection at the time of globe closure (OR 0.3, CI 0.1– 0.7, p = 0.0036) was associated with decreased risk of developing endophthalmitis.Conclusion: Prompt globe closure and subconjunctival antibiotics may reduce the risk of endophthalmitis in OGI. Furthermore, our practice of a one-time dose of systemic prophylactic antibiotics, and intravitreal antibiotics if intraocular foreign body (IOFB) removal is delayed, was not found to increase the rate of endophthalmitis.Keywords: endophthalmitis, intraocular foreign body, ocular trauma, open globe injury

A 19-year-old young man came to emergency department with a complaint of injury in the left eye with a wire, while cleaning the car engine parts in the workshop with motorized rotating wire brush. He was referred immediately to the eye clinic. On examination of the left eye, a thin steel wire was seen penetrating at the nasal limbus which was projecting forwards. The wire was removed (33 mm in length) under aseptic precautions using topical anaesthesia. Postoperatively, he was treated with ciprofloxacin eye drops. The patient had no ocular morbidity; the vision was normal, and he was asymptomatic in the left eye. Eye injuries from rotating wire brushes are caused by detached fragments. These eyes should be examined in detail for the involvement of different structures of the eye; and should be treated adequately in-time to prevent visual loss/ blindness. Wearing of safety glasses/ full face shield while working is recommended to prevent such injuries.

BACKGROUND One of the major causes of preventable blindness is ocular trauma, which also results in high socioeconomic burden. This study was done to understand the clinical profile of orbital and ocular trauma at a tertiary care centre in Kerala. METHODS A descriptive study was conducted among patients attending the casualty of a tertiary care centre in Kerala for a period of three months from August 2017 to October 2017. A semi structured proforma was filled by the ophthalmologist attending the patients. This data was analysed using appropriate software. The study included a total of 256 patients with orbital and ocular trauma. After taking a detailed history, visual acuity testing and ocular examination were conducted. Computed tomography (CT) scan of orbit was done whenever indicated. RESULTS Out of 256 patients, 60.9 % were in the age group of 21 – 60 years. Males were affected about 4 times more than the females. 40 % of trauma occurred in the afternoon between 12 and 6 pm, and 29 % happened from 6 pm to 12 midnight. Majority of trauma (47.7 %) happened at home followed by those due to road traffic accidents. Conjunctiva and cornea were the most frequently involved ocular structures. Out of 256 patients, 126 (49.2 %) had conjunctival injury while 73 (28.5 %) had corneal injury. Corneal foreign bodies were seen in 32 patients (12.5 %). Only two patients (0.8 %) had open globe injury, whereas others had closed globe injury. Eye lids were injured in 45 patients (17.6 %) and 51 patients (19.9 %) had injury in the periorbital area. Orbital bone injuries were detected in 16 patients (6.3 %) and was confirmed using CT scan. CONCLUSIONS Ocular trauma is an important cause of preventable blindness and ocular morbidity. It causes high economic burden to the individual as well as to the society. Most of the injuries were closed globe injuries and affected the younger population. KEY WORDS Ocular & Orbital Trauma, Closed Globe Injury, Open Globe Injury

Falls is a leading cause of injuries nationally and can lead to serious ophthalmic injuries. The purpose of this study is to examine the incidence and characteristics of ophthalmic trauma in patients with fall-related hospitalizations in the United States. Retrospective, cross-sectional study. National Inpatient Sample (NIS) was queried to identify all ophthalmic trauma associated with fall-related hospitalizations from 2000 to 2017. Patients were identified using relevant International Classification of Diseases (ICD) codes. National estimates, annual incidences and characteristics were produced from trend weights provided by the NIS sampling frame and population data from the US Census Bureau. There were 21,415,120 fall-related hospitalizations of which 425,725 (2.0%) had ophthalmic trauma. Ophthalmic injury incidence increased from 4.26 to 14.31 per 100,000 population (P Incidence of ophthalmic trauma in patients with fall-related hospitalizations has increased and our study provides valuable information for targeting preventive measures particularly for the elderly and falls due to tripping, stairs, and furniture related accidents. The most common associated ophthalmic injuries are contusions, orbital fractures and eyelid lacerations.

Vaping, or the use of electronic cigarettes, was initially introduced as a step toward smoking cessation, but has become an increasingly popular option for smokers. Though advertised as safer than conventional cigarettes, these devices have been found to contain carcinogenic chemicals, air pollutants, and heavy metals. The purpose of this article is to shed light on the known effects of vaping on the ocular setting and raise the discussion about additional potential effects that may call for further investigation. A comprehensive literature search was conducted for publications pertaining to the effects of vaping on the eye. Relevant studies and findings were summarized in this article. It was found that aldehydes and free radicals present in electronic cigarettes may induce a disturbance in tear film stability, and vape flavorings may damage the lipid layer through peroxidation. Corneal staining has been shown to appear following exposure to e-cigarette vapor, with nicotine and acrolein potentially inducing an inflammatory response in corneal epithelial cells. In addition, nicotine has been shown to induce nystagmus, exert vasoconstrictive effects on ocular blood flow, and may interfere with retinal light-adapted vision. Vape-related explosions, though unpredictable, may also result in decreased visual acuity along with long-term ocular trauma. Research discussing both the short-term and long-term effects of vaping on the eye is limited. However, the potential harms of substances such as nicotine and aldehydes warrant additional investigation and increased education about the detriment that electronic cigarettes may inflict on sensitive organs.

BACKGROUND Occupational ocular injuries are very common in industrial and agricultural workers. These are important and preventable causes of ocular morbidity. Objective of the study was to profile occupational ocular trauma clinicoepidemiologically. METHODS A prospective study was done by collecting data from a standardised questionnaire and complete ophthalmological examination of patients with occupational eye trauma attending VSSIMSAR, Burla, between January 2019 and October 2020. RESULTS Out of 128 cases of work related injuries, males were 85 %. 48 % of the cases were between 21 - 40 years. Out of all cases 66 % injuries were related to industrial work followed by 29 % in agricultural sector and farming. 3 % of cases were due to blast injury. Also there were 3 % cases of chemical conjunctivitis. Most injuries were closed globe (85 %), mostly involving zone 1 (91 %). Open globe injuries were 15 %, majority of them involved zone 2 (47 %). Ocular superficial foreign bodies were the most common clinical entity (60 %), majority of them being metallic in nature (37.5 %). In 4 % cases IOFBs were found. Cornea was the most common ocular structure to get injured (69 %). Out of all cases, 50 % had ocular trauma score (OTS) of 4, and 4 % cases had OTS 2. 48 % of patients presented within 6 hours of injury. 42 % patients were not aware of any eye protective gear at work and 30 % patients were aware but did not use any eye protection. CONCLUSIONS Eye trauma in workplace is an important public health concern in economically productive population. Significant proportion of these injuries is avoidable by using standardised eye protective devices. Attention need to be given for instruction, enforcement of protective eye wear use, and frequent prevention campaigns. KEYWORDS Ocular Trauma, Occupational Ocular Injuries, Eye Protective Devices, Western Odisha

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

Central retinal vein occlusions (CRVO) occurring in young patients or due to a traumatic etiology is uncommon. This paper outlines the case of a 33-year-old Asian male who presented with a chief complaint of blurry peripheral vision and photophobia in his left eye, one week after sustaining blunt ocular trauma. He was diagnosed with a traumatic CRVO based on history and exam findings.

Background. COVID-19 is a new pandemic that spread over the world in 2020, for which most countries imposed rigorous lockdown to reduce its upsurge and thus its socioeconomics’ sever effects. Global measures include isolation, social distancing, lockdown any nonemergency facilities, local and international travelling restrictions. But these rules are implacable in case of trauma in general and more with ocular trauma, which represents a serious public health problem and leading cause of visual impairment. The aim of this study was to evaluate the impact of COVID -19 lock down on number of ocular traumas acquiring surgery. Methods. A retrospective study in Aljala trauma hospital in the period from 18 March to 18 April 2020 on patients who underwent surgical intervention for non-war eye trauma. Results. A total number of patients seen in emergency department were 350 patients in 2020 with four patients needed hospital admission and surgical intervention making a 1.14% of total number. While number of patients seen at the same time in 2019 were 965 patients and three patients needed surgical intervention (0.31%). There was no statistical difference in the amount of patient acquiring surgical intervention in the two periods with the P value of >0.05 Conclusion. Although total emergency eye visits decreased during the covid-19 lockdown period, similar incidence of surgery needed ocular trauma persisted.

There is limited published data on combat ocular trauma (COT) among local nationals managed at deployed United States (US) and United Kingdom (UK) military hospitals in recent conflicts. We report the epidemiology and outcomes of COT from a deployed military hospital in Afghanistan. In this retrospective case series, consecutive injuries requiring ophthalmic surgery at a military hospital in Afghanistan where the sole US and UK ophthalmologist(s) were deployed between January 2017 and September 2019 were reviewed. The main outcomes were mean post-operative visual acuity (VA) in open and closed globe injury and the incidence of retinal detachment after open globe repair. There were 102 eyes of 84 patients who had ocular injuries and underwent ophthalmic surgery at the military hospital. Most patients were male (81 [96%]) and were local nationals (71 [85%]). Blast exposure (82 [80%]) was the most common mechanism of injury. Mean post-operative VA was 1.24 ± 2.29 logMAR (20/348 Snellen equivalent) in open globe injury and 1.59 ± 1.17 logMAR (20/778 Snellen equivalent) in closed globe injury. After open globe repair, retinal detachment developed in 8 of 18 (44%) eyes. COT injuries often resulted in poor post-operative VA and retinal detachment after open globe repair was common. The high incidence and severity of COT sustained by local civilians and combatants in this study may support programs to increase the availability and wear of combat eye protection among local nationals partnered with US and coalition troops.

Background Open globe injury (OGI) is one of the most devastating form of ocular trauma. The aim of the study is to identify the epidemiology and predict visual outcomes in traumatic open globe injuries using ocular trauma score (OTS) and correlate with final visual acuity (VA) at 3 months. Methods Patients older than 5 years, presenting to B.P. Koirala Lions Centre for Ophthalmic Studies (BPKLCOS) from March 2016- March 2017 with OGI that met inclusion criteria were evaluated. Patient profile, nature and cause of injury, and time to presentation were recorded. Patients were managed accordingly and followed up to 3 months. An OTS score for each patient was calculated and raw scores were categorized accordingly. The VA after 3 months were compared to the predicted OTS values. Results Seventy-three eyes of 72 patients were examined. 76 % were male, and the mean age was 26.17 years (median, 23.5 years). The mean time from injury to presentation was Conclusions OTS can be an accurate predictive tool for final visual acuity even with a short follow up period of 3 months; with poor presenting visual acuity, delayed presentation, posterior zones of injury, need for intravitreal injections, endophthalmitis, and globe rupture associated with poorer prognosis.

Purpose: To report the computed tomography features of a case with complete luxation of the globe after a road traffic accident. Case Report: A 35-year-old male presented with pain, loss of vision, and bleeding from the left eye 48 hr after a road traffic accident. The ophthalmic examination of the left upper and lower eyelids showed edema with subcutaneous hematoma, crepitus, and complete blepharoptosis. On retracting the eyelids, the left eyeball was not visible and the patient was not able to perceive light. The left temporal region appeared filled with a soft, palpable globular structure situated beneath the temporalis muscle. A non-contrast computed tomography (NCCT) of the head and orbits showed a comminuted and displaced fracture of the floor, medial, and lateral orbital walls in addition to a displaced tripod fracture of the left zygomatic bone. The intact left eyeball was seen below the temporalis muscle without any optic nerve or extraocular muscle attachment. The virtual reality reconstruction highlighted a contributory supero-temporal defect in the bony orbit, which appeared large enough to accommodate the intact eyeball. Conclusion: The computed tomography of the orbits provided a detailed location of the luxated eyeball and provided guidance in further management of the case.

The study objective was to assess the correlation of time outdoors in sunlight hours with spherical equivalent refraction (SER) and other variables. This was a cross-sectional study carried out in the Fauji Foundation Hospital, Rawalpindi, between January and April 2019. A total of 110 Individuals were included via convenient sampling, with myopia defined as having at least -0.5 D (SER ≤ -0.5 D). Collection of Questionnaires with interviews regarding eye care behaviour along with auto-refraction was done, followed by calculation of spherical equivalent refraction. Those having high myopia of 6 D or more (SER ≤ - 6 D), hyperopia of 0.5 D or more (SER ≥ +0.5 D), and history significant for ocular trauma and surgeries, were excluded. After data cleaning and their entry, analyses were done using SPSS version 26. The mean age data, available for 105 individuals, was 15.4 ± 3.69 years. Spearman's correlation was used for right SER with time outdoors in summers (r= +0.25, p=0.008) and winters (r= +0.243, p=0.010), indicating an inverse relationship with myopia. Females had more myopic refraction than males, but the independent sample t-test was not significant. Logistic regression was used and a protective effect was found for both summer and winter time outdoors, while education level was associated with myopia. Key Words: Myopia, Spherical equivalent refraction (SER), Sunlight exposure.

Background: The purpose was to describe the epidemiology of open-globe injury (OGI) in Palestine and identify the prognostic factors associated with profound visual loss. Material and methods: The current study is a retrospective review of hospital files for 83 consecutive patients with OGI who presented to St. John Eye Hospital, Jerusalem, within 5 years, between 2009 and 2013. Demographic details included age, gender, wound characteristics, and visual acuity (VA). The Ocular Trauma Classification Group was used for wound location, classification, and scoring for each case. Results: We identified 83 OGI that presented to St. John eye hospital. The study group included 62 males and 21 females. The mean age was 16.66 years ± 3.216. The most frequent injuries were playground injuries (59%), followed by workplace injuries (26.5%). Penetrating injuries represented 45.8% of injuries, and rupture globes occurred in 39.8% of cases. The most frequent objects causing injury were metal (31.3%) and stone (20.5%). Kinetic impact projectiles were a statistically significant poor prognostic factor for the visual outcome. Variables that were statistically significant poor prognostic factors for visual outcome included: retinal detachment, macular scar, vitreous hemorrhage. Conclusion: This study showed that the act of demonstration, street injuries, kinetic impact projectiles, zone III injuries, globe disruption, retinal detachment, vitreous hemorrhage, and a poor VA at the first visit are poor prognostic factors for OGI. Recognition of these prognostic factors will help the ophthalmologist evaluate the injury and its prognosis.

BACKGROUND Ocular injuries due to road traffic accidents (RTA) is one of the important causes of ophthalmological morbidity and cause of unilateral blindness. Some of the injuries also result in cosmetic disfigurement. Increased usage of vehicles for transport in recent times has increased the incidence of cases. The primary objective of this study was to understand the epidemiology and pattern of ocular trauma in RTA cases and their visual outcome. METHODS A total of 75 cases was included in the study following the inclusion and exclusion criteria. A detailed history was taken which included information regarding time, location, type and mechanism of injury, use of spectacles, car safety belts, and helmets. The time interval between injury and reporting was recorded. Test of visual acuity was done, ophthalmic examination included the examination of all patients with the slit lamp, 90 D examination, and indirect ophthalmoscopy were done. Ultrasound B scan was done in cases where unclear media prevented fundus examination. RESULTS Ecchymosis of the lids was the commonest type of ocular injury. Out of 15 eyelid laceration cases, 10 cases were with mild partial-thickness tears present and 5 had severe lid tears which required suturing. Most of the patients recovered with good vision in 6 months post-treatment and a few fair results. Analysis of variance (ANOVA) comparison between conservative management and surgical management at the end of 4 months post treatment was done. The P-values were > 0.05 hence, not significant. It indicated that the outcomes were independent of the method of management adopted. CONCLUSIONS The incidence of RTAs is increasing due to an increase in the number of vehicles used by the public. Ocular injuries are more often seen in young men especially those driving two-wheelers without safety devices like helmets. Open globe injuries and cases with previous ocular problems have poor outcomes. KEYWORDS Ocular Trauma, Road Traffic Accidents [RTA], Visual Outcome

Background The timely evaluation of ocular conditions in the emergency department (ED) can be difficult due to a general lack of specialized equipment, trained personnel, and the time-sensitive nature of emergent ocular conditions. Recently, the use of ocular point-of-care ultrasound (POCUS) has been shown to be particularly useful in the ED. POCUS can be used to promptly diagnose various ocular pathologies, which include ocular trauma, vitreous hemorrhage, central retinal artery occlusion, and retinal detachment. Objectives This narrative review seeks to inform the reader of current literature regarding the use of POCUS for the assessment of various ocular emergencies in the ED. The goal of this review is to provide the emergency physician with succinct and up-to-date information and instruction regarding the current uses of POCUS for patients presenting with particular ocular emergencies. Ocular pathologies that are common (ocular trauma) or for which ultrasound is particularly useful (such as retinal detachment) are discussed. Other ocular pathologies are also briefly discussed, such as central retinal artery occlusion, which is a promising new application for ultrasound evaluation. Discussion There have been many studies that provide evidence for the utility of POCUS in the evaluation of trauma and other ocular pathologies, including vitreous hemorrhage, retinal detachment, and central retinal artery occlusion. Conclusions Ocular POCUS is a useful modality in the evaluation of acute ocular complaints in the ED. Emergency physicians should be aware of these findings and feel confident in the utility of ocular POCUS in the ED.

Purpose: To assess changes in the presentation patterns of posterior segment trauma during the COVID-19 pandemic from six tertiary eye care institutes of North and Central India. Methods: A multicenter, hospital-based, retrospective comparative analysis of patients presenting with posterior segment trauma was done during the COVID-19 (Group A) (March 25, 2020 - September 30, 2020) period and the pre-COVID-19 (Group B) (March 25, 2019 - September 30, 2019) period. Results: A total of 405 patients were diagnosed with posterior segment trauma (Group A: 206, Group B: 199). The time interval between onset of trauma and presentation was higher in Group A (16.59 ± 29.87 days) as compared to Group B (9.41 ± 19.19 days) (P = 0.004). A majority of patients in Group A had a history of prior consultation before presentation (P = 0.049). In Group A, 120 (58.2%) patients sustained ocular trauma at home as compared to 80 (40.2%) patients in Group B (P < 0.0001). Patients presenting with light perception were significantly more in Group A (43.7%) as compared to Group B (30.2%) (P = 0.004). In Group B, 37.6% patients had presenting visual acuity of counting finger or better as compared to 27.6% patients in Group A (P = 0.07). Patients in Group A had a significantly higher proportion of post-traumatic endophthalmitis with delayed presentation (P = 0.011) and retinal detachment (P = 0.041). Patients undergoing surgery for foreign-body removal were significantly fewer in Group A (P = 0.05). Conclusion: Although the number of patients presenting with posterior segment trauma was comparable in Groups A and B, a greater number of patients sustained home injuries during the COVID-19 pandemic. A majority of these patients had delayed presentation with poor presenting visual acuity and a higher tendency of retinal detachment.

Introduction. Severe ocular injuries caused by fishing equipment are relatively rare. The visual prognosis for fishing-related injuries depends on the involved ocular structures, the presence of complications, and surgical techniques applied. Case outline. A 40-year-old man reported a sudden severe sharp pain and a loss of vision in his left eye while he was pulling the fishing rod during recreational fishing. At admission, his best corrected visual acuity (BCVA) of the left eye was 1/60. Clinical examination revealed a laceration in the temporal quadrant of the bulbar conjunctiva 0.2?0.3 mm in size and a dark tumefaction under the conjunctiva in the same region. It was identified during primary surgical exploration as a fishing sinker 1 cm in size lodged under the lateral rectus muscle. The bulbar wall was intact and the fishing sinker was safely removed. Phacoemulsification with the implantation of an artificial foldable intraocular lens and 23G pars plana vitrectomy were performed. During vitrectomy, subretinal hemorrhage in the macular region and large retinal dialysis in the temporal segment were revealed. Vitrectomy was finished with silicone oil tamponade. One week later, the patient?s BCVA of the left eye was 2/60. Eight months after surgery, spontaneous resorption of subretinal hemorrhage in the macular region and the attached retina was observed. The patient?s BCVA was 3/60 due to the destruction of photoreceptors and retinal pigment epithelium and the formation of epiretinal membrane. Conclusion. To our knowledge, this is the first case report of a severe blunt ocular injury associated with large retinal dialysis caused by a fishing sinker.

Purpose Posterior ocular trauma and the subsequent fibrotic retinal complication termed proliferative vitreoretinopathy (PVR) are leading causes of blindness in children and young adults. A previous study suggested that changes occurring within the first month post-trauma can lead to development of PVR later. The aim of this study was to examine the effect of dasatinib, a tyrosine kinase inhibitor clinically used to treat chronic myeloid leukemia, on fibrotic changes occurring within the first month following ocular trauma. Methods A previously established swine ocular trauma model that mimics both contusion and penetrating injuries was used. Dasatinib was administered on days 4 and 18 post-trauma via intravitreal injection of either bolus solution or suspension of a sustained release system incorporated in biodegradable poly (lactic-co-glycolic acid) (PLGA) nanoparticles. Animals were followed up to day 32, and the development of traction full-thickness fold in the posterior retina was assessed. Results A full-thickness retinal fold extending from the wound site developed in 3 out of 4 control eyes injected with PLGA nanoparticles alone at 1 month. Administration of dasatinib solution had little preventative effect with 6 out of 7 eyes developing a fold. In contrast, dasatinib-incorporated PLGA nanoparticle injection significantly reduced the incidence of fold to 1 out of 10 eyes. Conclusions Injection of dasatinib-incorporated PLGA significantly reduced early fibrotic retinal changes which eventually lead to PVR following posterior ocular trauma. Thus, our sustained dasatinib release system can potentially be used to both prevent and/or broaden the surgical treatment window for PVR.