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Aims: Ocular trauma is one of the major causes of monocular blindness in the pediatric age group, causing significant visual morbidity. The purpose of this study is to identify the causes, types, location of injuries, and clinical features due to ocular trauma in a tertiary care center. Settings and Design: It is a retrospective hospital-based observational study. Materials and Methods: Demographic details of 69 consecutive patients up to 14 years of age who were hospitalized for primary repair of penetrating ocular injuries during March 2017 to March 2019 were documented and evaluated. Results: Fifty-six (81.16%) children were male. The mean age was 8.31 ± 3.96 years. Thirty-one (44.93%) were in the 6–10-yearage group. The most common cause of injury was with wooden stick in 23 cases (33.33%). Full-thickness corneal tear was seen in 52 cases (75.36%). Associated anterior segment involvement included iris prolapse in 34 cases (49.28%), hyphemia in 11 (15.94%), and traumatic cataract in 15 (21.74%), interlamellar corneal foreign body in two cases, and associated full-thickness lid tear involving lid margin in two cases. The posterior segment involvement in the form of vitreous hemorrhage in 19 (27.53%) cases, retinal detachment involving macula in seven cases (10.14%), choroidal detachment in six cases (8.69%), endophthalmitis in five cases (7.25%), and retained intraocular foreign body in three (4.35%). Conclusions: Prevention is always considered superior to the best treatment. Parents should be educated about the devastating complications of ocular trauma, need for supervision, and need for timely referral to the eye care center.

Abstract Background Traumatic aniridia occurs when the iris is extruded from the eye and is often accompanied by lens injuries. However, traumatic aniridia due to dislocation of the iris into the vitreous cavity without lens damage has never been reported. Case presentation A 30-year-old man presented with visual loss and pain for 6 h after a thin wire injured his right eyeball. Ophthalmologic examinations manifested a 2 mm full-thickness corneal laceration and total hyphema. An intact clear lens, healthy attached retina, and almost complete iris tissue in the vitreous cavity were found after resolution of hyphema the next day. Further examination revealed that the defect in the zonule below the corneal wound was the path for the iris to enter the vitreous cavity. The patient opted for nonsurgical treatment until pigment granules and opacity were observed in the vitreous cavity after 50 days. Vitrectomy was performed to remove the dislocated iris. Conclusions The presentation of this unique case indicates that the torn iris was displaced to the vitreous cavity with an intact lens and missing local zonula instead of out the corneal laceration after a penetrating injury. The type of injury, mechanism, and force on the spot may contribute to the occurrence of this rare condition. Instead of artificial irises, tinted glasses were more appropriate treatment option for this patient. Peripheral retinal examination was essential in the management of this case. In such cases, the iris in the vitreous cavity should be resected to prevent complications.

Background: Traumatic aniridia occurs when the iris is extruded from the eye and is often accompanied by lens injuries. However, traumatic aniridia due to dislocation of the iris into the vitreous cavity without lens damage has never been reported. Case presentation: A 30-year-old man presented with visual loss and pain for 6 h after a thin wire injured his right eyeball. Ophthalmologic examinations manifested a 2 mm full-thickness corneal laceration and total hyphema. An intact clear lens, healthy attached retina, and almost complete iris tissue in the vitreous cavity were found after resolution of hyphema the next day. Further examination revealed that the defect in the zonule below the corneal wound was the path for the iris to enter the vitreous cavity. The patient opted for nonsurgical treatment until pigment granules and opacity were observed in the vitreous cavity after 50 days. Vitrectomy was performed to remove the dislocated iris. Conclusions: The presentation of this unique case indicates that the torn iris was displaced to the vitreous cavity with an intact lens and missing local zonula instead of out the corneal laceration after a penetrating injury. The type of injury, mechanism, and force on the spot may contribute to the occurrence of this rare condition. Instead of artificial irises, tinted glasses were more appropriate treatment option for this patient. Peripheral retinal examination was essential in the management of this case. In such cases, the iris in the vitreous cavity should be resected to prevent complications. [ABSTRACT FROM AUTHOR]

Introduction: Amniotic membrane (AM) is a popular treatment for external ocular diseases. First intraocular implantations in other diseases reported promising results. Here, we review three cases of intravitreal epiretinal human AM (iehAM) transplantation as an adjunct treatment for complicated retinal detachment and analyze clinical safety. Possible cellular rejection reactions against the explanted iehAM were evaluated and its influence was assessed on three retinal cell lines in vitro. Methods: Three patients with complicated retinal detachment and implanted iehAM during pars plana vitrectomy are retrospectively presented. After removal of the iehAM at subsequent surgery, tissue-specific cellular responses were studied by light microscopy and immunohistochemical staining. We investigated the influence of AM in vitro on retinal pigment epithelial cells (ARPE-19), Müller cells (Mio-M1), and differentiated retinal neuroblasts (661W). An anti-histone DNA ELISA for cell apoptosis, a BrdU ELISA for cell proliferation, a WST-1 assay for cell viability, and a live/dead assay for cell death were performed. Results: Despite the severity of the retinal detachment, stable clinical outcomes were obtained in all three cases. Immunostaining of the explanted iehAM showed no evidence of cellular immunological rejection. In vitro, there was no statistical significant change in cell death or cell viability nor were proliferative effects detected on ARPE-19, Müller cells, and retinal neuroblasts exposed to AM. Conclusion: iehAM was a viable adjuvant with many potential benefits for treatment of complicated retinal detachment. Our investigations could not detect any signs of rejection reactions or toxicity. Further studies are needed to evaluate this potential in more detail. [ABSTRACT FROM AUTHOR]

Endophthalmitis is an uncommon purulent inflammation of the intraocular fluids secondary to endogenous or exogenous causes. It is known that posttraumatic endophthalmitis had a notably poor visual outcome, and it poses therapeutic challenges. Therefore, early organism detection would be beneficial in therapeutic management and are able to reduce long-term complications. This case report describes a patient with a rare positive culture-proven Sphingomonas paucimobilis endophthalmitis due to penetrating ocular trauma by a metal brush over the right eye. A 36-year-old man presented with progressively worsening right eye redness and blurring of vision with pain for 3 days following ocular penetration by a metal brush during grinding. On initial presentation, his visual acuity was 6/12 over the right eye and 6/6 over the left eye. His visual acuity deteriorated to hand movement 5 days later with worsening of ocular infection over the right eye despite topical and oral antibiotics. B-scan revealed dense vitreous infiltration. A vitreous tap was done, and a combination of intravitreal vancomycin and ceftazidime was administered. Vitreous culture isolated Gram negative S. paucimobilis. The patient was planned for early vitrectomy; however, the patient opted for conservative treatment. Therefore, the patient received intravitreal vancomycin and intravitreal ceftazidime injections every 48–72 h. Published articles on S. paucimobilis endophthalmitis postocular penetration are extremely limited. This case report may provide a better understanding of the presentation and is able to aid with early diagnosis and treatment initiation for future reference.

Endophthalmitis is an uncommon purulent inflammation of the intraocular fluids secondary to endogenous or exogenous causes. It is known that posttraumatic endophthalmitis had a notably poor visual outcome, and it poses therapeutic challenges. Therefore, early organism detection would be beneficial in therapeutic management and are able to reduce long-term complications. This case report describes a patient with a rare positive culture-proven Sphingomonas paucimobilis endophthalmitis due to penetrating ocular trauma by a metal brush over the right eye. A 36-year-old man presented with progressively worsening right eye redness and blurring of vision with pain for 3 days following ocular penetration by a metal brush during grinding. On initial presentation, his visual acuity was 6/12 over the right eye and 6/6 over the left eye. His visual acuity deteriorated to hand movement 5 days later with worsening of ocular infection over the right eye despite topical and oral antibiotics. B-scan revealed dense vitreous infiltration. A vitreous tap was done, and a combination of intravitreal vancomycin and ceftazidime was administered. Vitreous culture isolated Gram negative S. paucimobilis. The patient was planned for early vitrectomy; however, the patient opted for conservative treatment. Therefore, the patient received intravitreal vancomycin and intravitreal ceftazidime injections every 48-72 h. Published articles on S. paucimobilis endophthalmitis postocular penetration are extremely limited. This case report may provide a better understanding of the presentation and is able to aid with early diagnosis and treatment initiation for future reference. [ABSTRACT FROM AUTHOR]

Hammouda Hamdy Ghoraba,1,2 Mahmoud Leila,3 Adel Galal Zaky,4 Sameh Mohamed Elgouhary,4 Amin Faisal Ellakwa,4 Hosam Othman Mansour,5 Mohamed Amin Heikal2,6,7 1Faculty of Medicine, Tanta University, Tanta, Egypt; 2Magrabi Eye Hospital, Tanta, Egypt; 3Retina Department, Research Institute of Ophthalmology, Giza, Egypt; 4Ophthalmology Department, Faculty of Medicine, Menoufia University, Shebin ElKom, Menoufia, Egypt; 5Ophthalmology Department, Faculty of Medicine, Al Azhar University - Damietta Branch, New Damietta, Egypt; 6Ophthalmology Department, Faculty of Medicine, Benha University, Benha, Egypt; 7Vitreoretinal Department, Magrabi Eye Hospital, Eastern province, Khober, KSACorrespondence: Mahmoud Leila 146 Street 3, 2nd Floor, Flat#8, Hadabet Al-Ahram, Giza, 12572, EgyptTel +201286644025Email mahmoudleila@yahoo.comPurpose: To report the long-term outcome of pars plana vitrectomy (PPV) for management of retained posterior segment intraocular foreign body (IOFB) secondary to gunshot injury.Methods: This is a retrospective interventional case series including consecutive patients who had PPV for retained posterior segment IOFB secondary to gunshot injury. Main outcome measures were final best-corrected visual acuity (BCVA), long-term globe survival and detection of complications. Spearman correlation analyzed relationships between numerical data. Kruskal–Wallis test compared differences in initial BCVA and final BCVA across variables. Categorical variables were tested using Chi square or Fisher’s exact test. P value is significant at 0.05.Results: The study included 103 eyes of 103 patients. Mean baseline BCVA was 0.01 decimal unit (2 logMAR). Mean duration from primary repair to PPV was 3 weeks. Mean duration of post-operative follow-up was 60 months. Mean final BCVA was 0.04 decimal unit (1.3 logMAR), p 0.001. Post-operatively, BCVA improved in 58.2% of patients. Nineteen patients (18%) gained ≥ 2 lines of vision, and 15 patients (14.5%) achieved final BCVA of 0.4 decimal unit (logMAR 0.4). All complications were related to the original injury. These included macular scar (19%), macular pucker (6%), recurrent retinal detachment (4%), subretinal fibrosis (3%), consecutive optic atrophy (3%), and PVR (3%). Phthisis bulbi or sympathetic ophthalmia did not develop in any case.Conclusion: PPV for removal of IOFB caused by gunshot injury yielded long-term favorable functional outcome with excellent globe survival. Poor initial BCVA, location of IOFB in the posterior pole, associated lens injury and retinal detachment are significant adverse prognostic factors for final BCVA but not for globe survival.Keywords: Intraocular foreign body; IOFB, ocular gunshot injury, penetrating ocular trauma, IOFB-associated endophthalmitis, pars plana vitrectomy for intraocular foreign body, PPV for IOFB

Abstract Background To evaluate the effect and prognostic factors of vitrectomy combined with intravitreal antifungal therapy for posttraumatic fungal endophthalmitis in Eastern China. Methods We retrospectively reviewed the medical records of patients who developed fungal endophthalmitis after penetrating ocular trauma at an ophthalmic center in Eastern China. All patients underwent vitrectomy and intravitreal injection of antifungal drugs. Results Thirty-five patients (35 eyes) were included. Twelve eyes suffered plant trauma, 17 eyes metal trauma, and 6 eyes other trauma. The culture results for all 35 eyes showed filamentous fungi, including Aspergillus in 26 eyes (74.3%). Twenty-three eyes underwent vitrectomy once and 12 eyes were treated twice. Four eyes were iridectomized because of a fungal lesion behind the iris. Fungal endophthalmitis was effectively controlled in 33 eyes (94.3%), whereas 2 eyes were ultimately enucleated. Visual acuity was significantly better after treatment than before treatment (P = 0.0006). According to the preoperative vision, the affected eyes were divided into two groups: group 1A (light perception) and group 1B (better than light perception). The final visual acuity in group 1B was significantly better than that in group 1A (P = 0.0289). Conclusions Vitrectomy combined with intravitreal antifungal therapy is an effective treatment for posttraumatic fungal endophthalmitis. Preoperative visual acuity is a significant factor affecting the prognosis of visual acuity.

One of the mechanisms of expulsive suprachoroidal hemorrhage is pressure to the sclera that causes stretching and rupture of posterior ciliary arteries in the presence of full thickness wounds. With this report we present a case of expulsive suprachoroidal hemorrhage in the presence of a full thickness graft–host junction wound. A 73-year-old female patient had a full thickness rupture of the graft–host junction in the 4 o’clock hour quadrants. Expulsive suprachoroidal hemorrhage occurred shortly after the initiation of continuous positive airway pressure therapy, and light perception was negative. The intraocular tissues were replaced in the globe after the drainage of the intraocular hemorrhage and the existing graft was sutured to the host under sub-Tenon’s anesthesia. Although the wounds and sutures remained stable, visual acuity did not improve.

Purpose: The purpose of this paper is to provide a meaningful literature review about the epidemiology, pathogenesis, clinical signs, imaging and treatment of ocular siderosis (OS). Methods: A computerized search from inception up to March 2020 of the online electronic database PubMed was performed using the following search strings: "ocular siderosis" and "siderosis bulbi". The reference list in each article was analysed for additional relevant publications. Results: OS is an uncommon cause of visual loss due to a retained ferrous intraocular foreign body (IOFB). It may develop from 18 days to years after a penetrating trauma that usually occurs during hammering. On average, patients are 22–25 years old, and the vast majority are male. The most common cause of OS development is delayed presentation by the patient or missed diagnosis of IOFB after trauma. The pathophysiology is not fully understood; nevertheless, iron deposition causes hydroxyl radical formation, which damages photoreceptors and retinal pigment epithelium. Moreover, iron damages retinal vessels with consequent inner retinal layers degeneration. The most frequent signs are iris heterochromia, pupillary mydriasis, cataract development and retinal arteriolar narrowing with pigmentary retinal degeneration. Electroretinogram signs, in particular, b-wave amplitude reduction, arise earlier than clinical signs. Orbital CT scans and ultrasonography play an essential role in detecting IOFBs. Treatment depends on the IOFB location and OS development. However, it is crucial to remove the IOFB after OS development because visual acuity and clinical signs may improve. Anterior segment IOFBs can be dislodged using an intraocular magnet (IOM) or forceps through limbal paracentesis. In contrast, posterior segment IOFBs require a pars plana vitrectomy and IOM or forceps to be removed through an enlarged sclerotomy or the limbus. Conclusion: Recommending the usage of protective glasses and spreading knowledge about OS may further benefit patient care. [ABSTRACT FROM AUTHOR]

Purpose The aim of this study was to evaluate the role of ultrasound biomicroscopy (UBM) in diagnosis, decision of intervention, and follow-up monitoring of secondary iris cysts. Patients and methods This case series study included 17 patients diagnosed clinically of having secondary iris cysts. History and full ophthalmological examination included visual acuity testing and slit lamp examination. UBM and B-scan ultrasound were performed for all cases. The study cases were divided into two groups according to the management plan (surgical management group and follow-up group). The follow-up period was 1 year. Results The study included 17 cases with unilateral secondary iris cysts. They were five females and 12 males, with age range from 3.0 to 44 years and a mean of 9.01±10.76 years. The clinical presentations such as blurring of vision, uveitis, red eye, ocular pain, or disfiguring intraocular swelling were insignificantly related to the different management groups (P>0.05). Angle closure and corneal touch (detected by UBM) were significantly present in the surgically managed cases, with P values of 0.003 and 0.009, respectively. The cyst size dimensions and its relation to the visual axis were detected with an insignificant difference between both groups. Conclusion UBM had a great value in the diagnosis of secondary iris cysts. Certain UBM findings were very important in deciding the different management plans and follow-up monitoring.

A 54-year-old male sustained ocular trauma with a projectile. Examination of the right eye revealed an intraocular foreign body (IOFB) adjacent to the optic nerve head, vitritis, vitreous hemorrhage, and translucent perivascular sheathing of the retinal vessels in all quadrants suggesting frosted branch angiitis (FBA). The patient underwent vitrectomy with removal of the IOFB and silicone oil tamponade under steroid cover. With continued use of systemic and topical steroids after surgery, complete resolution of FBA and improvement in vision were noted in a week. Prompt resolution of FBA after IOFB removal points toward a strong association between the presence of IOFB and FBA.

AIM:To analyze the spectrum and antibiotic sensitivity of bacteria in the aqueous humor and vitreous immediately following the occurrence of penetrating ocular trauma.METHODS: Aqueous humor or vitreous specimens were collected from 45 eyes of 45 patients with penetrating ocular trauma before operations. The specimens were prepared for bacterial culture and the associated sensitivity tests to several commonly used antibiotics.RESULTS: Fifteen eyes of all the patients were found to be positive with bacterial infection, and the most frequently identified bacteria was staphylococcus epidermidis, which accounted for 67.7%(10/15)of all identified cases. All identified bacteria were sensitive to ciprofloxacin and ofloxacin, and less sensitive to cefoperazone. Most of them were resistant to gentamycin, rifampin and chloramphenicol. Accompanying intraocular foreign body or sclera wound were associated with positive bacterial cultures(χ12=6.544, P1=0.016; χ22=4.5, P2=0.034). Causes of injury(χ2=1.667,P=0.197), lens rupture(χ2=1.125,P=0.352)or locations where the specimen was collected(χ2=1.667,P=0.197)did not contribute to the difference in the positive rates of bacterial cultures.CONCLUSION:In patients with penetrating ocular trauma, the major bacteria entering into the eye was staphylococcus epidermidis. Fluro-Quinolones can be used as the first-line antibiotics for prophylactic treatment. Cefoperazone can be taken as a second choice.

AIM: To explore the effect of early posterior approach vitrectomy in the treatment of penetrating ocular trauma with intraocular foreign body. METHODS: Totally 10 cases of penetrating ocular trauma with intraocular foreign bodies(IOFB)in the past two years were included. Emergency vitrectomy, intraocular foreign body removal and silicone oil tamponade were performed by the same surgeon. Antibiotics and steroids were given after surgeries. Retinal photocoagulation was done according to fundus conditions after surgeries. RESULTS: One patient combined with preoperation endophthalmitis and severely damaged retina failed to recover, eventually came to phthisis bulbi. Vitrectomy and IOFB removal were all successfully performed in the other patients. The postoperation follow-up time was 3-18mo. Two of the patients received secondary vitrectomy and silicone replacement surgeries due to recurrent retinal detachment. The remaining patients had no further bleeding with intraoclar pressure(IOP)8-21mmHg. At the last follow-up, three of them gained best corrected visual acuity better than 0.1, two patients had visual acuity of 0.01 to 0.1 and four patients had poor visual acuity of light perception to FC/50cm because of macular damage. The patient with phthisis bulbi had no light perception. CONCLUSION: Early vitrectomy, foreign body removal and silicone oil tamponade is an effective treatment for patients with penetrating eyeball injury with IOFB.

Background: Although posttraumatic endophthalmitis is an uncommon condition, it causes severe complications, so medical and pharmacological interventions for prevention of endophthalmitis after trauma are a major concern. The aim of this study was to evaluate the efficacy and clinical outcome of oral ciprofloxacin versus intravenous cefazolin/gentamicin for the prevention of endophthalmitis after penetrating ocular trauma. Materials and Methods: This was a retrospective, descriptive single-center study, including all cases of penetrating ocular trauma seen in the Feiz Hospital, a Tertiary Referral Eye Hospital in Isfahan, Iran, between 2011 and 2017. Data systemically recorded for each patient included clinical, ophthalmological, and demographic findings by a trained medical record abstractor or ophthalmologist reviewing patient records. Results: Six hundred and forty-five patients in cefazolin/gentamicin and 273 patients in oral ciprofloxacin groups were included in the study. Our study showed that the incidence of endophthalmitis was not significantly different between the two groups (P = 0.463). In patients with either sharp or blunt penetrating ocular trauma. Conclusion: Oral ciprofloxacin as a prophylactic treatment could prevent posttraumatic endophthalmitis as effective as injectable cefazolin/gentamicin. Due to easier consumption of oral ciprofloxacin and lower systemic complications, in all patients with penetrating eye trauma, oral administration of ciprofloxacin is preferable to intravenous or intramuscular types of antibiotics to reduce the risk of posttraumatic endophthalmitis. [ABSTRACT FROM AUTHOR]

Sympathetic Ophthalmia is a rare and potentially devastating bilateral uveitis, typically followed by penetrating ocular trauma (0.2-0.5%) or intraocular surgery (0.01%). A high index of suspicion is vital to ensure early diagnosis and treatment for a good visual outcome. Onset varies from days to decades, with 80% of cases starting before 3 months and 90% within the first year. The clinical presentation can be very variable, with the presence of conjunctival injection, mutton fat keratic precipitates, serous retinal detachments, papillary edema and the characteristic nodules of Dalen- Fuchs. The treatment is based on systemic steroids and considering immunomodulators in refractory cases. We present a case of a young man suffering from evisceration secondary to penetrating eye trauma; whom later develops sympathetic ophthalmia in the contralateral eye, with identification and early treatment. [ABSTRACT FROM AUTHOR]

Background: Although posttraumatic endophthalmitis is an uncommon condition, it causes severe complications, so medical and pharmacological interventions for prevention of endophthalmitis after trauma are a major concern. The aim of this study was to evaluate the efficacy and clinical outcome of oral ciprofloxacin versus intravenous cefazolin/gentamicin for the prevention of endophthalmitis after penetrating ocular trauma. Materials and Methods: This was a retrospective, descriptive single-center study, including all cases of penetrating ocular trauma seen in the Feiz Hospital, a Tertiary Referral Eye Hospital in Isfahan, Iran, between 2011 and 2017. Data systemically recorded for each patient included clinical, ophthalmological, and demographic findings by a trained medical record abstractor or ophthalmologist reviewing patient records. Results: Six hundred and forty-five patients in cefazolin/gentamicin and 273 patients in oral ciprofloxacin groups were included in the study. Our study showed that the incidence of endophthalmitis was not significantly different between the two groups (P = 0.463). In patients with either sharp or blunt penetrating ocular trauma. Conclusion: Oral ciprofloxacin as a prophylactic treatment could prevent posttraumatic endophthalmitis as effective as injectable cefazolin/gentamicin. Due to easier consumption of oral ciprofloxacin and lower systemic complications, in all patients with penetrating eye trauma, oral administration of ciprofloxacin is preferable to intravenous or intramuscular types of antibiotics to reduce the risk of posttraumatic endophthalmitis.

A 54-year-old male sustained ocular trauma with a projectile. Examination of the right eye revealed an intraocular foreign body (IOFB) adjacent to the optic nerve head, vitritis, vitreous hemorrhage, and translucent perivascular sheathing of the retinal vessels in all quadrants suggesting frosted branch angiitis (FBA). The patient underwent vitrectomy with removal of the IOFB and silicone oil tamponade under steroid cover. With continued use of systemic and topical steroids after surgery, complete resolution of FBA and improvement in vision were noted in a week. Prompt resolution of FBA after IOFB removal points toward a strong association between the presence of IOFB and FBA. [ABSTRACT FROM AUTHOR]

Background: To evaluate the morpho-functional outcomes and safety of transconjuctival 23-gauge pars plana vitrectomy(PPV) for removal of intraocular foreign bodies (IOFBs). Methods: A retrospective study of 36 consecutive cases (mean age; 34,2 ± 10,9 years (between 15 and 60), 27 M,9 F) of 23-G PPV for the removal of IOFBs during the period of April 2009 and December 2011 and followed 9,4 ± 6,4(2-27) months were conducted. Visual outcomes, slit lamp biomicroscopy, intraocular pressure (IOP), and posterior segment visualization by indirect ophthalmoscopy, A-B mode ultrasonography, and computed orbital tomography were performed for all cases. Main outcomes including anatomic and visual outcomes, and both intraoperative and postoperative complications were recorded. Results: Of the 36 cases available for the study, the IOFBs (size range, 3 to 12 mm) could be removed in all eyes. Mean preoperative LogMAR BCVA was 1.44 ± 138 (range, 1.00 to 0.00) and mean postoperative LogMAR BCVA at final visit was 0,78 ± 0,98 (range, 1.00 to 0.00). (P = 0,007) Anatomic success was obtained in 97.2 % of eyes. 16 patients needed primary wound repair due to the leakage in insertion sites before the PPV, however remaining 20 cases were not. Fibrin reaction was seen in 8 (22.2 %) patients in early postoperative period, intraocular pressure elevation was detected in 12 (33.3 %) patients in which the silicone oil was used as an intravitreal tamponade, one patient with silicone oil tamponade developed band keratopathy and phthisis bulbi. Conclusions: 23-Gauge PPV is a feasible, effective approach in the surgical management of the patients with posterior segment intraocular foreign bodies. [ABSTRACT FROM AUTHOR]

The case is presented of a 12-year old boy who sustained severe penetrating ocular trauma while playing on a domestic trampoline. A main spring broke under tension and the hook had struck the eye at high velocity and penetrated the sclera. Primary repair was undertaken but on review it became apparent the eye could not be salvaged. Evisceration was carried out and an orbital implant was placed. Post-operative cosmesis is acceptable. This type of injury has not been reported before. Adult supervision of children on trampolines is recommended to minimise the chance of serious injury. [ABSTRACT FROM AUTHOR]

Case Report: The case is presented of a 32 year-old male with no medical history of interest who suffered a traffic accident with mild traumatic brain injury. He had a left supraciliary incised and contused wound that extended to the left upper eyelid, with no loss of vision. After palpebral anaesthetic injection, there was a sudden visual acuity decrease in the left eye and hyposphagma located between I-III at 4mm from the limbus, with increased intraocular pressure. A whitish lesion with a central haemorrhagic focus was observed in the ocular fundus, corresponding to the area where the hyposphagma was located., Discussion: Anaesthetic injection during palpebral repair may be complicated by inadvertent penetration of the eyeball. Intravitreal mepivacaine and adrenaline could cause macular and retinal lesions., (Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.)