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Management of hyphema, repair of iridodialysis, and repair of corneoscleral lacerations
Published in A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha, Vitreoretinal Surgical Techniques, 2019
Patients with traumatic cataract or lens rupture may require lens extraction (Fig. 47.15). If the decision is made to remove the lens at the initial laceration closure, several methods are available. The technique used to remove the lens depends on the preference of the surgeon, the stability of the lens, and the age of the patient. In young patients, the lens can usually be aspirated with an automated or manual irrigation/aspiration instrument or a vitrectomy handpiece. In older patients, phacoemulsification of harder nuclei is usually necessary. Large extracapsular wounds should be avoided in acutely traumatized eyes, because there may be increased risk of expulsive choroidal hemorrhage.
Pathophysiology of Lightning Injury
Published in Christopher J. Andrews, Mary Ann Cooper, Mat Darveniza, David Mackerras, Lightning Injuries: Electrical, Medical, and Legal Aspects Editors, 1992
Christopher J. Andrews, Mary Ann Cooper, Mat Darveniza, David Mackerras
Two types of cataracts are recognized after lightning injury. One type is due to a concussion and results in minute tears of the lens capsule. This ordinary traumatic cataract is usually seen shortly after the injury. The other type of cataract is more characteristic of an injury caused by lightning or high-tension current; however, both the anterior and posterior capsules are usually affected secondary to lightning.
Ophthalmic Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
Blunt trauma may cause a sequence of injuries from the front to the back of the eye. Systematically exclude each one: Periorbital haematoma or subconjunctival haemorrhage.Corneal abrasion or laceration.Bleeding into the anterior chamber, called hyphaema. This may be microscopic or macroscopic with formation of a fluid level.A fixed pupil or torn iris, known as traumatic mydriasis and iridodialysis, respectively.A dislocated lens or subsequent traumatic cataract.Vitreous haemorrhage, causing a dull or absent red reflex and obscuring the fundus.A retinal tear, with retinal detachment seen as a dark, wrinkled, ballooned area diametrically opposite any resultant visual field defect.Retinal oedema (commotio retinae) seen as whitish areas of oedema, usually associated with haemorrhage.Optic nerve damage, causing blindness with no direct pupillary response to light.Ruptured globe, with marked visual loss, a soft eye and shallow anterior chamber.Retrobulbar haematoma, with pain, proptosis and a fixed, dilated pupil.Orbital fracture, usually a ‘blow-out’ fracture of the orbital floor (see p. 378).
Cataract in children in sub-Saharan Africa: an overview
Published in Expert Review of Ophthalmology, 2018
Annie Bronsard, Robert Geneau, Roseline Duke, Lévi Kandeke, Ssali Grace Nsibirwa, Mildred Ulaikere, Paul Courtright
Cataract in children can be classified as congenital, developmental or traumatic [4,5]. Cataracts may develop in one eye (unilateral) or both eyes (bilateral). Traumatic cataract is usually unilateral, and primarily occurs secondary to blunt or penetrating ocular trauma. ‘Developmental cataract’ often refers to the onset of cataract-related vision loss after the first year of life while the term ‘congenital cataract’ is used when clouding of the lens is present at birth or soon thereafter. Among cases for which a cause could be identified, heredity is the most common etiology of congenital cataracts [6]. Congenital and developmental cataract may be caused by mutations in specific genes [7,8]. Cataract in children may also be the result of intrauterine infection or be associated with syndromes.
Efficacy of Phacotrabeculectomy Alone versus Phacotrabeculectomy Augmented with Autologous Anterior Capsule Implantation Beneath the Sclera Flap
Published in Seminars in Ophthalmology, 2018
Gopal K. Das, P. K. Sahu, Sabitabh Kumar, Laura V. L. Biakthangi
Eighty-eight patients with primary open angle or angle closure glaucoma with coexistent cataract, posted for phacotrabeculetomy, were included in the study. Subjects with post-traumatic cataract, past uveitis, previous ocular surgery, and Grade-IV nuclear cataract were excluded. After randomization, the subjects were divided into two groups; the first group underwent phacotrabeculectomy with ALC transplantation (Group I: ALC group), and the second group underwent phacotrabeculectomy without ALC usage (Group II: non-ALC group). A detailed history was obtained and a general physical examination was carried out to rule out gross systemic disease. An ocular examination was performed with emphasis on the best-corrected visual acuity (BCVA) using Snellen’s chart, detailed slit-lamp examination including peripheral AC depth grading using the Van Herick technique,14 fundus examination (direct ophthalmoscopy and biomicroscopy using 90D lens), intraocular pressure (Goldmann applanation tonometer), gonioscopy (Golmann gonioscope), keratometry (Bausch and Lomb type Keratometer), axial length (A-scan Appasamy instruments), and pachymetry (using a specular microscope).
Anterior Segment Optical Coherence Tomography in Pediatric Ocular Pathology: Imaging Study of 115 eyes
Published in Expert Review of Medical Devices, 2023
A detailed evaluation of traumatized eyes was possible with the extent of the corneal or scleral tears demarcated; traumatic uveitis (Figure 3a and j), exudate (Figure 3a and f), synechiae, and cataracts including lens rupture were observed as well. Corneal tears were classified into lamellar or partial thickness [1(0.9%)], total thickness, self-sealing [5(4.3%)], and total thickness with iris prolapse [1(0.9%)]. Scleral tears were similarly diagnosed and classified into partial thickness and full thickness 1(0.9%)] each (Figure 1m). Iridodialysis and iris tears were observed as well 1(0.9%)]. Traumatic cataract included total white, lens rupture, and ASCO or PSCO. Traumatic lens subluxation was observed in one eye.