Materiały źródłowe

• #1 Pathophysiology of Ocular Trauma | Clinical Gate

  https://clinicalgate.com/pathophysiology-of-ocular-trauma/

  Ocular trauma is a major cause of ocular morbidity and a leading cause of monocular visual loss. It is estimated that over 2 million eye injuries occur in the USA each year. […] Different types of ocular injuries have different pathophysiologic and therapeutic ramifications; therefore, knowledge of the initial mechanism of injury to the macula or optic nerve is critical for determining visual prognosis. […] Breakdown of the bloodretina barrier after trauma is a key triggering mechanism in the wound healing sequence. The bloodretinal barrier (BRB) consists of tight junctions between the retinal capillary endothelial cells (inner BRB) and the retinal pigment epithelial (RPE) cells (outer BRB). Disruption of this highly specialized barrier system leads to migration of inflammatory cells and leakage of serum components, allowing a profound change in the biochemical milieu of the retina and vitreous.

• #2 Pathophysiology of Ocular Trauma | Ento Key

  https://entokey.com/pathophysiology-of-ocular-trauma/

  Ocular trauma is a major cause of ocular morbidity and a leading cause of monocular visual loss. […] Different types of ocular injuries have different pathophysiologic and therapeutic ramifications; therefore, knowledge of the initial mechanism of injury to the macula or optic nerve is critical for determining visual prognosis. […] Breakdown of the bloodretina barrier after trauma is a key triggering mechanism in the wound healing sequence. […] Open-globe injury results in a breakdown of the bloodretinal barrier and allows the entry of a variety of cells into the intraocular milieu, causing the expression of a variety of chemokines, inflammatory cytokines, and growth factors that affect the adjacent RPE, fibroblasts, and glial cells. […] This wound healing process is central to the final common pathway that leads to traction retinal detachment and posttraumatic PVR in open globe injury. […] The RPE cell is central to the pathophysiological response seen in posttraumatic PVR. […] Fibroblastic proliferation is critical to the progression of post-traumatic proliferative response.

• #3 Eye injury

  https://www.rch.org.au/trauma-service/manual/eye-injury/

  Children account for between 20 and 59% of all eye injuries. […] They are more predisposed to eye injury due to their developing physical coordination, limited ability to detect environmental risks and a more vulnerable facial morphology. […] The outcome of paediatric eye injuries is worse than that of adults due to their visual immaturity, increased years of visual loss and potential for amblyopia. […] Most paediatric eye injuries (66.2%) occur during play predominantly whilst at home under supervision of parents / caregivers (47.7%), but often whilst at school / nursery (24.4%). […] Sharp instruments are the most common cause of injury, followed by plants, animals, toys or sports equipment. […] In the Australian context, it has been estimated that sports-related eye injuries make up 11% of all paediatric eye injuries.

• #4 Eye injuries: Understanding ocular trauma

  https://www1.racgp.org.au/ajgp/2022/july/eye-injuries

  Ocular trauma may result in pathology of the ocular surface and adnexa, extraocular muscles, orbital walls, eye and optic nerve. […] Ocular trauma can lead to serious sight and eye-threatening consequences. Accurate history-taking and astute observation are paramount for timely treatment or referral that may prevent blindness. […] The modified Birmingham Eye Trauma Terminology (BETT) classification should be used to ensure language is consistent when describing mechanical eye and periocular injuries across general practice, emergency departments and ophthalmology services. […] Causes of ocular injuries vary according to the patients age and occupation. […] The presence of white infiltrate or anterior chamber reaction should be noted, as this may indicate secondary bacterial infection.

• #5 Ocular Penetrating and Perforating Injuries – EyeWiki

  https://eyewiki.org/Ocular_Penetrating_and_Perforating_Injuries

  Ocular penetrating and perforating injuries (commonly referred to as open globe injuries) can result in severe vision loss or loss of the eye. Penetrating injuries by definition are caused by a sharp object that penetrates into the eye (i.e. laceration) but not through and through–there is no exit wound. Perforating injuries go 'through and through’ the eye and therefore have both an entrance and an exit wound. Typically, to constitute one of these injuries, a full-thickness wound through the cornea and/or sclera must be present. Open globe rupture, in contrast, refers to blunt injury of the eye causing sudden increase in intraocular pressure resulting in eye wall dehiscence and ultimately globe collapse. […] The injury is further classified based on three zones: I, II, and III (see Zone of Injury). Zone I involves the cornea up to the limbus, Zone II involves the sclera from the limbus back to 5mm beyond the limbus, which anatomically is anterior to the ora serrata and therefore does not extend into the retina, and Zone III refers to any injury greater than 5mm beyond the limbus, which results in anatomic injuries posterior to the ora serrata that involve the retina.

• #6 Penetrating eye injury

  https://www.rch.org.au/clinicalguide/guideline_index/Penetrating_eye_injury/

  An open globe, or penetrating eye injury is a serious threat to vision […] In penetrating eye injury, avoid any pressure on the eyeball through examination or padding, as eye contents may be extruded […] An open globe injury is defined as a full thickness injury to the cornea or sclera resulting in either globe rupture or laceration […] Globe rupture is more common in blunt injury, and laceration as a result of trauma from a sharp object or high velocity projectile […] Open globe injuries are associated with poor visual outcomes […] Open globe injuries may accompany multiple trauma or serious head injury […] Avoid pressure on the globe if perforation is suspected and examine with the utmost care […] In young children examination facilitated by procedural sedation or general anaesthesia should be performed by an ophthalmologist whenever the mechanism of injury is highly suggestive of an open globe

• #7 Eye Injury: Types, Causes, Prevention & Treatment

  https://my.clevelandclinic.org/health/diseases/eye-injury

  A penetrating injury is when a sharp object punctures your eye, or when a high-speed projectile goes into your eye. Fishhooks, darts, sharp tools, BB guns and paintball guns can cause penetrating injuries. Penetrating objects might get stuck in your eye and need a specialist to remove them. They can cause bleeding and damage to the structures of your eye. […] Open globe injuries penetrate the wall of your eye, the white part (sclera) or the clear part (cornea). Your sclera protects the delicate inner parts of your eye. If blunt or sharp eye trauma injures these inner parts, it’s more likely to cause long-term damage and vision loss. A closed globe injury doesn’t penetrate the eye wall. Black eyes, blunt trauma and corneal scratches are examples of closed globe injuries. […] Eye injuries are so painful because there are so many nerve endings in your eyeball. These nerves help maintain your eyes protective reflexes, movements and visual processing. They also make your eye extremely sensitive to sensory input. Even a surface-layer eye injury, like a scratch on your cornea or conjunctiva, can be intensely painful because it exposes the nerve endings.

• #8 Open Access Macedonian Journal of Medical Sciences (OAMJMS).

  https://oamjms.eu/index.php/mjms/article/view/6862

  Objectives: To identify ocular trauma trends and to analyze how initial uncorrected visual acuity (VA) is associated with mechanism of injury (MOI) in a referral hospital in Indonesia. […] Results: A total of 953 patients consisted of 80.3% males and 19.9% females. Ocular trauma predominantly occurred in 2130 years age group (20.9%). […] Closed globe injuries (80.3%) were more prevalent than open globe injuries (17.7%). The most frequent MOIs were sharp objects (311; 32.6%), followed by blunt objects (236; 24.8%). […] Compared to road dust, blunt object, sharp object and traffic accident were significantly associated with poor initial VA, with adjusted ORs (95% CIs) of 5.24 (2.27-12.10), 4.03 (1.76-9.25) and 8.17 (3.31-20.15), respectively. […] Conclusions: Initial uncorrected VA and MOI provide earlier information regarding the prognosis. Traffic accident showed a greater tendency to cause a poor initial uncorrected VA. Most ocular trauma is preventable by educating people at risk to avoid common MOIs and to use protection.

• #9 Ocular Penetrating and Perforating Injuries – EyeWiki

  https://eyewiki.org/Ocular_Penetrating_and_Perforating_Injuries

  Ocular penetrating and perforating injuries (commonly referred to as open globe injuries) can result in severe vision loss or loss of the eye. Penetrating injuries by definition are caused by a sharp object that penetrates into the eye (i.e. laceration) but not through and through–there is no exit wound. Perforating injuries go 'through and through’ the eye and therefore have both an entrance and an exit wound. Typically, to constitute one of these injuries, a full-thickness wound through the cornea and/or sclera must be present. Open globe rupture, in contrast, refers to blunt injury of the eye causing sudden increase in intraocular pressure resulting in eye wall dehiscence and ultimately globe collapse. […] The injury is further classified based on three zones: I, II, and III (see Zone of Injury). Zone I involves the cornea up to the limbus, Zone II involves the sclera from the limbus back to 5mm beyond the limbus, which anatomically is anterior to the ora serrata and therefore does not extend into the retina, and Zone III refers to any injury greater than 5mm beyond the limbus, which results in anatomic injuries posterior to the ora serrata that involve the retina.

• #10 Blunt Eye Trauma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470379/

  Blunt eye trauma can result in various intrinsic eye injuries. […] Blunt trauma can result in open and closed globe injuries. The closed globe injuries are further classified as contusion and lamellar lacerations. Open globe injuries can be laceration and globe rupture. […] The mechanism of blunt eye trauma can be due to coup, countercoup, and anteroposterior compression or horizontal expansion of the tissue. The mode of injury can be a direct blow to the eyeball or accidental blunt trauma. […] Globe rupture occurs when there is a defect in the cornea, sclera, or both structures. Global rupture often occurs after direct penetrating trauma; however, if sufficient blunt force is applied to the eye, the intraocular pressure can increase enough to rupture the sclera. […] A retrobulbar hematoma occurs when blood is accumulated in the retrobulbar space. As blood collects behind the eye, there is increased intraocular pressure, which can subsequently cause stretching of the optic nerve. Within several hours, decreased ocular perfusion can lead to permanent blindness. […] The rupture site is most commonly near the globe’s equator posterior to the insertion of the rectus muscles, which is where the sclera is weakest and thinnest.

• #11 Traumatic eye injuries – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/traumatic-eye-injuries/

  Trauma to the eye may be caused by blunt or penetrating impact or a chemical, thermal, or radiation burn. […] The initial diagnostic approach aims to identify red flags of serious eye injury and involves an external eye examination, slit lamp examination with fluorescein stain, and testing of visual fields and visual acuity. […] If an open globe injury is suspected, the examination should be stopped, an eye shield should be placed, and systemic antibiotics administered. […] Complications of ocular trauma include traumatic cataracts, endophthalmitis, and loss of vision. […] Energy from an external object involved in blunt trauma is transferred to the eye. […] Clinical features are injury-specific and include pain, foreign body sensation, photophobia, decreased visual acuity, monocular diplopia, and ecchymosis, periorbital edema.

• #12 EPIDEMIOLOGY

  https://www.aao.org/education/topic-detail/trauma–europe

  Blunt force causes peripheral volume displacement with increased wedge pressure that causes damage to area of least resistance along the lens, iris root, and trabecular meshwork. […] Lens subluxation, retinal dialysis, optic nerve avulsion and vitreous hemorrhage may also occur. […] Sheering of vessels causes hyphema and force may cause scleral ruptures most likely at thinnest points posterior to the muscle insertion and limbus.

• #13 EPIDEMIOLOGY

  https://www.aao.org/education/topic-detail/trauma–europe

  Blunt force causes peripheral volume displacement with increased wedge pressure that causes damage to area of least resistance along the lens, iris root, and trabecular meshwork. […] Lens subluxation, retinal dialysis, optic nerve avulsion and vitreous hemorrhage may also occur. […] Sheering of vessels causes hyphema and force may cause scleral ruptures most likely at thinnest points posterior to the muscle insertion and limbus.

• #14 EPIDEMIOLOGY

  https://www.aao.org/education/topic-detail/trauma–europe

  Blunt force causes peripheral volume displacement with increased wedge pressure that causes damage to area of least resistance along the lens, iris root, and trabecular meshwork. […] Lens subluxation, retinal dialysis, optic nerve avulsion and vitreous hemorrhage may also occur. […] Sheering of vessels causes hyphema and force may cause scleral ruptures most likely at thinnest points posterior to the muscle insertion and limbus.

• #15 Blunt Eye Trauma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470379/

  Blunt eye trauma can result in various intrinsic eye injuries. […] Blunt trauma can result in open and closed globe injuries. The closed globe injuries are further classified as contusion and lamellar lacerations. Open globe injuries can be laceration and globe rupture. […] The mechanism of blunt eye trauma can be due to coup, countercoup, and anteroposterior compression or horizontal expansion of the tissue. The mode of injury can be a direct blow to the eyeball or accidental blunt trauma. […] Globe rupture occurs when there is a defect in the cornea, sclera, or both structures. Global rupture often occurs after direct penetrating trauma; however, if sufficient blunt force is applied to the eye, the intraocular pressure can increase enough to rupture the sclera. […] A retrobulbar hematoma occurs when blood is accumulated in the retrobulbar space. As blood collects behind the eye, there is increased intraocular pressure, which can subsequently cause stretching of the optic nerve. Within several hours, decreased ocular perfusion can lead to permanent blindness. […] The rupture site is most commonly near the globe’s equator posterior to the insertion of the rectus muscles, which is where the sclera is weakest and thinnest.

• #16 Ocular Penetrating and Perforating Injuries – EyeWiki

  https://eyewiki.org/Ocular_Penetrating_and_Perforating_Injuries

  Ocular penetrating and perforating injuries (commonly referred to as open globe injuries) can result in severe vision loss or loss of the eye. Penetrating injuries by definition are caused by a sharp object that penetrates into the eye (i.e. laceration) but not through and through–there is no exit wound. Perforating injuries go 'through and through’ the eye and therefore have both an entrance and an exit wound. Typically, to constitute one of these injuries, a full-thickness wound through the cornea and/or sclera must be present. Open globe rupture, in contrast, refers to blunt injury of the eye causing sudden increase in intraocular pressure resulting in eye wall dehiscence and ultimately globe collapse. […] The injury is further classified based on three zones: I, II, and III (see Zone of Injury). Zone I involves the cornea up to the limbus, Zone II involves the sclera from the limbus back to 5mm beyond the limbus, which anatomically is anterior to the ora serrata and therefore does not extend into the retina, and Zone III refers to any injury greater than 5mm beyond the limbus, which results in anatomic injuries posterior to the ora serrata that involve the retina.

• #17 Ocular Penetrating and Perforating Injuries – EyeWiki

  https://eyewiki.org/Ocular_Penetrating_and_Perforating_Injuries

  Penetrating or perforating ocular injuries can be due to injury from any sharp or high velocity object. […] The most common blunt objects reported by May et al from the United States Eye injury Registry were rocks, fists, baseballs, lumber and fishing weights. […] When one of these objects becomes lodged in the eye, it is referred to as an intraocular foreign body (IOFB), which occurs in up to 40% of ocular penetrating or perforating injuries. […] The Ocular Trauma Score (OTS) was developed in 2002 from a cohort of 2500 eye injuries and visual recovery as a way to assess prognosis of visual recovery post injury. […] Risk of endophthalmitis should be assessed (higher risk with rural settings, IOFB), and prophylaxis given with systemic, topical, and/or intravitreal broad spectrum antibiotics covering both Gram positive and negative organisms.

• #18 Open Access Macedonian Journal of Medical Sciences (OAMJMS).

  https://oamjms.eu/index.php/mjms/article/view/6862

  Objectives: To identify ocular trauma trends and to analyze how initial uncorrected visual acuity (VA) is associated with mechanism of injury (MOI) in a referral hospital in Indonesia. […] Results: A total of 953 patients consisted of 80.3% males and 19.9% females. Ocular trauma predominantly occurred in 2130 years age group (20.9%). […] Closed globe injuries (80.3%) were more prevalent than open globe injuries (17.7%). The most frequent MOIs were sharp objects (311; 32.6%), followed by blunt objects (236; 24.8%). […] Compared to road dust, blunt object, sharp object and traffic accident were significantly associated with poor initial VA, with adjusted ORs (95% CIs) of 5.24 (2.27-12.10), 4.03 (1.76-9.25) and 8.17 (3.31-20.15), respectively. […] Conclusions: Initial uncorrected VA and MOI provide earlier information regarding the prognosis. Traffic accident showed a greater tendency to cause a poor initial uncorrected VA. Most ocular trauma is preventable by educating people at risk to avoid common MOIs and to use protection.

• #19 Ocular Penetrating and Perforating Injuries – EyeWiki

  https://eyewiki.org/Ocular_Penetrating_and_Perforating_Injuries

  Penetrating or perforating ocular injuries can be due to injury from any sharp or high velocity object. […] The most common blunt objects reported by May et al from the United States Eye injury Registry were rocks, fists, baseballs, lumber and fishing weights. […] When one of these objects becomes lodged in the eye, it is referred to as an intraocular foreign body (IOFB), which occurs in up to 40% of ocular penetrating or perforating injuries. […] The Ocular Trauma Score (OTS) was developed in 2002 from a cohort of 2500 eye injuries and visual recovery as a way to assess prognosis of visual recovery post injury. […] Risk of endophthalmitis should be assessed (higher risk with rural settings, IOFB), and prophylaxis given with systemic, topical, and/or intravitreal broad spectrum antibiotics covering both Gram positive and negative organisms.

• #20 Eye Injury: Types, Causes, Prevention & Treatment

  https://my.clevelandclinic.org/health/diseases/eye-injury

  A penetrating injury is when a sharp object punctures your eye, or when a high-speed projectile goes into your eye. Fishhooks, darts, sharp tools, BB guns and paintball guns can cause penetrating injuries. Penetrating objects might get stuck in your eye and need a specialist to remove them. They can cause bleeding and damage to the structures of your eye. […] Open globe injuries penetrate the wall of your eye, the white part (sclera) or the clear part (cornea). Your sclera protects the delicate inner parts of your eye. If blunt or sharp eye trauma injures these inner parts, it’s more likely to cause long-term damage and vision loss. A closed globe injury doesn’t penetrate the eye wall. Black eyes, blunt trauma and corneal scratches are examples of closed globe injuries. […] Eye injuries are so painful because there are so many nerve endings in your eyeball. These nerves help maintain your eyes protective reflexes, movements and visual processing. They also make your eye extremely sensitive to sensory input. Even a surface-layer eye injury, like a scratch on your cornea or conjunctiva, can be intensely painful because it exposes the nerve endings.

• #21 Traumatic eye injuries – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/traumatic-eye-injuries/

  Trauma to the eye may be caused by blunt or penetrating impact or a chemical, thermal, or radiation burn. […] The initial diagnostic approach aims to identify red flags of serious eye injury and involves an external eye examination, slit lamp examination with fluorescein stain, and testing of visual fields and visual acuity. […] If an open globe injury is suspected, the examination should be stopped, an eye shield should be placed, and systemic antibiotics administered. […] Complications of ocular trauma include traumatic cataracts, endophthalmitis, and loss of vision. […] Energy from an external object involved in blunt trauma is transferred to the eye. […] Clinical features are injury-specific and include pain, foreign body sensation, photophobia, decreased visual acuity, monocular diplopia, and ecchymosis, periorbital edema.

• #22 Ophthalmologic Approach to Chemical Burns: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1215950-overview

  Chemical injuries to the eye constitute a critical ophthalmic emergency, demanding immediate and decisive action. […] The severity of this injury is related to chemical composition, pH, volume, concentration, duration of exposure, and the degree of penetration of the chemical. The mechanism of injury differs slightly between acids and alkali. […] Acids dissociate into hydrogen ions in the cornea. This usually occurs when a strong acid has a pH of less than 4. The hydrogen molecule damages the ocular surface by altering the pH, whereas the anion causes protein denaturation, precipitation, and coagulation. […] Alkaline substances are lipophilic and can penetrate cell membranes. They dissociate into a hydroxyl ion and a cation in the ocular surface. The hydroxyl ion saponifies cell membrane fatty acids, whereas the cation interacts with stromal collagen and glycosaminoglycans.

• #23 Ophthalmologic Approach to Chemical Burns: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1215950-overview

  Chemical injuries to the eye constitute a critical ophthalmic emergency, demanding immediate and decisive action. […] The severity of this injury is related to chemical composition, pH, volume, concentration, duration of exposure, and the degree of penetration of the chemical. The mechanism of injury differs slightly between acids and alkali. […] Acids dissociate into hydrogen ions in the cornea. This usually occurs when a strong acid has a pH of less than 4. The hydrogen molecule damages the ocular surface by altering the pH, whereas the anion causes protein denaturation, precipitation, and coagulation. […] Alkaline substances are lipophilic and can penetrate cell membranes. They dissociate into a hydroxyl ion and a cation in the ocular surface. The hydroxyl ion saponifies cell membrane fatty acids, whereas the cation interacts with stromal collagen and glycosaminoglycans.

• #24 Ophthalmologic Approach to Chemical Burns: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1215950-overview

  Chemical injuries to the eye constitute a critical ophthalmic emergency, demanding immediate and decisive action. […] The severity of this injury is related to chemical composition, pH, volume, concentration, duration of exposure, and the degree of penetration of the chemical. The mechanism of injury differs slightly between acids and alkali. […] Acids dissociate into hydrogen ions in the cornea. This usually occurs when a strong acid has a pH of less than 4. The hydrogen molecule damages the ocular surface by altering the pH, whereas the anion causes protein denaturation, precipitation, and coagulation. […] Alkaline substances are lipophilic and can penetrate cell membranes. They dissociate into a hydroxyl ion and a cation in the ocular surface. The hydroxyl ion saponifies cell membrane fatty acids, whereas the cation interacts with stromal collagen and glycosaminoglycans.

• #25 Chemical eye injury: pathophysiology, assessment and management | Eye

  https://www.nature.com/articles/s41433-020-1026-6

  Chemical eye injury (CEI) is an acute emergency which can threaten sight and life. […] Major workplace accidents involve other parts of the body and can be associated with inhalation or ingestion of the chemical. […] Alkali injuries cause damage by saponification of tissue and deeper penetration as a consequence. Acid injuries cause rapid coagulation of tissue, which impedes penetration and limits damage. […] Severe chemical insult can affect all anterior segment structures causing iris, pupil and lens abnormalities. […] The severity of ocular surface chemical injury is determined by the causative agent, the duration of contact, treatment given and the time from injury to initiation of treatment. […] The main causative agents are alkalis, acids and irritants like alcohols. […] Alkalis are hydrophilic and lipophilic causing dissolution of tissues by release hydroxyl ions which induce saponification of fatty acids in cell membranes.

• #26 Ophthalmologic Approach to Chemical Burns: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1215950-overview

  Chemical injuries to the eye constitute a critical ophthalmic emergency, demanding immediate and decisive action. […] The severity of this injury is related to chemical composition, pH, volume, concentration, duration of exposure, and the degree of penetration of the chemical. The mechanism of injury differs slightly between acids and alkali. […] Acids dissociate into hydrogen ions in the cornea. This usually occurs when a strong acid has a pH of less than 4. The hydrogen molecule damages the ocular surface by altering the pH, whereas the anion causes protein denaturation, precipitation, and coagulation. […] Alkaline substances are lipophilic and can penetrate cell membranes. They dissociate into a hydroxyl ion and a cation in the ocular surface. The hydroxyl ion saponifies cell membrane fatty acids, whereas the cation interacts with stromal collagen and glycosaminoglycans.

• #27 Chemical eye injury: pathophysiology, assessment and management | Eye

  https://www.nature.com/articles/s41433-020-1026-6

  Chemical eye injury (CEI) is an acute emergency which can threaten sight and life. […] Major workplace accidents involve other parts of the body and can be associated with inhalation or ingestion of the chemical. […] Alkali injuries cause damage by saponification of tissue and deeper penetration as a consequence. Acid injuries cause rapid coagulation of tissue, which impedes penetration and limits damage. […] Severe chemical insult can affect all anterior segment structures causing iris, pupil and lens abnormalities. […] The severity of ocular surface chemical injury is determined by the causative agent, the duration of contact, treatment given and the time from injury to initiation of treatment. […] The main causative agents are alkalis, acids and irritants like alcohols. […] Alkalis are hydrophilic and lipophilic causing dissolution of tissues by release hydroxyl ions which induce saponification of fatty acids in cell membranes.

• #28 Eye Trauma | Doctor

  https://patient.info/doctor/eye-injuries

  Intraocular foreign bodies (IOFBs) result from sharp or high-velocity injures. Symptoms typically include decreased or double vision. However, in some cases patients may have no symptoms and the FB may remain undetected for years. […] Blunt injuries to the globe can be caused in a variety of ways (eg, sports balls (especially squash balls), elastics snapping back, champagne corks, etc) or through fight injuries from, for example, a punch. A worrying development has been an increasing level of trauma due to paintball injuries, usually during unsupervised play. […] These can be ocular emergencies. They can be so severe as to damage the pluripotent limbal stem cell, leading to opacification and neo-vascularisation of the cornea and to extensive scarring. […] Alkali burns are generally more severe and cause penetrating eye injuries. They cause corneal damage by pH change, ulceration, proteolysis and collagen synthesis defects. Alkalis are lipophilic and penetrate the eye much more rapidly than acids. […] Chemical burns can lead to significant eye injury.

• #29 Eye Trauma | Doctor

  https://patient.info/doctor/eye-injuries

  Intraocular foreign bodies (IOFBs) result from sharp or high-velocity injures. Symptoms typically include decreased or double vision. However, in some cases patients may have no symptoms and the FB may remain undetected for years. […] Blunt injuries to the globe can be caused in a variety of ways (eg, sports balls (especially squash balls), elastics snapping back, champagne corks, etc) or through fight injuries from, for example, a punch. A worrying development has been an increasing level of trauma due to paintball injuries, usually during unsupervised play. […] These can be ocular emergencies. They can be so severe as to damage the pluripotent limbal stem cell, leading to opacification and neo-vascularisation of the cornea and to extensive scarring. […] Alkali burns are generally more severe and cause penetrating eye injuries. They cause corneal damage by pH change, ulceration, proteolysis and collagen synthesis defects. Alkalis are lipophilic and penetrate the eye much more rapidly than acids. […] Chemical burns can lead to significant eye injury.

• #30 Explosive eye injuries: characteristics, traumatic mechanisms, and prognostic factors for poor visual outcomes | Military Medical Research | Full Text

  https://mmrjournal.biomedcentral.com/articles/10.1186/s40779-022-00438-4

  Explosions can produce blast waves, high-speed medium, thermal radiation, and chemical spatter, leading to complex and compound eye injuries. […] Mechanical ocular trauma accounted for 94.00% of explosion-related eye injuries, among which intraocular foreign bodies (IOFBs) resulted in 55.17% of open globe injuries (OGIs) and contusion caused 60.22% of close globe injuries (CGIs). […] Poor presenting vision [odds ratio (OR)=5.789], full-thickness laceration of the eyeball 5 mm (OR=3.665), vitreous hemorrhage (OR=3.474), IOFB (OR=3.510), non-mechanical eye injury (NMEI, OR=2.622, P0.001), rupture (OR=2.362), traumatic optic neuropathy (OR=2.102), retinal detachment (RD, OR=2.033), endophthalmitis (OR=3.281, P0.01), contusion (OR=1.679), ciliary body detachment (OR=6.592), zone III OGI (OR=1.940), and PVR (OR=1.615, P0.05) were significant negative predictors for poor visual outcomes.

• #31 Explosive eye injuries: characteristics, traumatic mechanisms, and prognostic factors for poor visual outcomes | Military Medical Research | Full Text

  https://mmrjournal.biomedcentral.com/articles/10.1186/s40779-022-00438-4

  Explosions can produce blast waves, high-speed medium, thermal radiation, and chemical spatter, leading to complex and compound eye injuries. […] Mechanical ocular trauma accounted for 94.00% of explosion-related eye injuries, among which intraocular foreign bodies (IOFBs) resulted in 55.17% of open globe injuries (OGIs) and contusion caused 60.22% of close globe injuries (CGIs). […] Poor presenting vision [odds ratio (OR)=5.789], full-thickness laceration of the eyeball 5 mm (OR=3.665), vitreous hemorrhage (OR=3.474), IOFB (OR=3.510), non-mechanical eye injury (NMEI, OR=2.622, P0.001), rupture (OR=2.362), traumatic optic neuropathy (OR=2.102), retinal detachment (RD, OR=2.033), endophthalmitis (OR=3.281, P0.01), contusion (OR=1.679), ciliary body detachment (OR=6.592), zone III OGI (OR=1.940), and PVR (OR=1.615, P0.05) were significant negative predictors for poor visual outcomes.

• #32 Explosive eye injuries: characteristics, traumatic mechanisms, and prognostic factors for poor visual outcomes | Military Medical Research | Full Text

  https://mmrjournal.biomedcentral.com/articles/10.1186/s40779-022-00438-4

  Explosion ocular trauma has complex mechanisms, with multiple eyes involved and poor prognosis. […] In lethal level I explosion injuries, eyeball rupture is a serious condition, whereas contusion is more likely to improve. […] In level II injuries, IOFBs are more harmful than penetrating injuries, and level IV represents burn-related eye injuries. […] PVR is more associated with penetrating mechanisms than with OGI. […] Identifying the risk predictors for visual prognosis can guide clinicians in the evaluation and treatment of ocular blast injuries.

• #33 Explosive eye injuries: characteristics, traumatic mechanisms, and prognostic factors for poor visual outcomes | Military Medical Research | Full Text

  https://mmrjournal.biomedcentral.com/articles/10.1186/s40779-022-00438-4

  Explosion ocular trauma has complex mechanisms, with multiple eyes involved and poor prognosis. […] In lethal level I explosion injuries, eyeball rupture is a serious condition, whereas contusion is more likely to improve. […] In level II injuries, IOFBs are more harmful than penetrating injuries, and level IV represents burn-related eye injuries. […] PVR is more associated with penetrating mechanisms than with OGI. […] Identifying the risk predictors for visual prognosis can guide clinicians in the evaluation and treatment of ocular blast injuries.

• #34 Corneal Laceration: Background, Epidemiology, Pathophysiology

  https://emedicine.medscape.com/article/798005-overview

  A corneal laceration is a partial- or full-thickness injury to the cornea that can occur from trauma to the eye. A partial-thickness injury does not violate the globe of the eye (abrasion). A full-thickness injury penetrates through all the layers of the cornea, resulting in ruptured globe. These lacerations vary in size, shape, and severity. This article will focus on full-thickness injury. […] When evaluating eye trauma with evidence of corneal injury, it is important to assess for full-thickness laceration and the resulting ruptured globe. With a ruptured globe, aqueous humor escapes the anterior chamber, which can result in a flat-appearing cornea, air bubbles under the cornea, or an asymmetric pupil secondary to the iris protruding through the corneal defect. […] The human cornea comprises the following 6 layers: epithelium, Bowman’s layer, stroma, Dua’s layer, Descemet’s membrane, and endothelium. An injury and defect to the epithelium leaves the eye susceptible to infection. Injury involving the Bowman’s and deeper layers are likely to result in corneal scarring and consequently limit visual clarity. The non-regenerating cells of the endothelium house the sodium-potassium channels that keeps the cornea dry and clear. Violation of the endothelium results in a cloudy edematous cornea.

• #35 Corneal Laceration: Background, Epidemiology, Pathophysiology

  https://emedicine.medscape.com/article/798005-overview

  A corneal laceration is a partial- or full-thickness injury to the cornea that can occur from trauma to the eye. A partial-thickness injury does not violate the globe of the eye (abrasion). A full-thickness injury penetrates through all the layers of the cornea, resulting in ruptured globe. These lacerations vary in size, shape, and severity. This article will focus on full-thickness injury. […] When evaluating eye trauma with evidence of corneal injury, it is important to assess for full-thickness laceration and the resulting ruptured globe. With a ruptured globe, aqueous humor escapes the anterior chamber, which can result in a flat-appearing cornea, air bubbles under the cornea, or an asymmetric pupil secondary to the iris protruding through the corneal defect. […] The human cornea comprises the following 6 layers: epithelium, Bowman’s layer, stroma, Dua’s layer, Descemet’s membrane, and endothelium. An injury and defect to the epithelium leaves the eye susceptible to infection. Injury involving the Bowman’s and deeper layers are likely to result in corneal scarring and consequently limit visual clarity. The non-regenerating cells of the endothelium house the sodium-potassium channels that keeps the cornea dry and clear. Violation of the endothelium results in a cloudy edematous cornea.

• #36 Chemical eye injury: pathophysiology, assessment and management | Eye

  https://www.nature.com/articles/s41433-020-1026-6

  Retinal damage is rarely due to the direct effect of the chemical agent. […] Anterior segment tissues i.e. the ocular surface, iris, ciliary body and lens act as buffers for intraocular penetration by reacting with the chemicals leading to their deactivation. […] In severe chemical injuries, the entire limbus across 360 degrees is damaged and sloughs. […] The corneal stroma is predominantly formed of regularly arranged collagen fibrils (I, III, V), of which type I is the major constituent. […] Following chemical injury, the keratocytes are mobilised to repopulate the cornea starting from the most posterior part of the stroma. […] In severe chemical injury fibrovascular pannus can grow to cover the ocular surface with development of subepithelial fibrosis, superficial and deep scaring, tenons fibrosis and contracture, corneal vascularisation, nerve damage and progressive symblepharon with cicatrising lid deformities. […] The key factor in determining outcome is the rapidity with which treatment was commenced and the treatment measures initiated.

• #37 Chemical eye injury: pathophysiology, assessment and management | Eye

  https://www.nature.com/articles/s41433-020-1026-6

  Retinal damage is rarely due to the direct effect of the chemical agent. […] Anterior segment tissues i.e. the ocular surface, iris, ciliary body and lens act as buffers for intraocular penetration by reacting with the chemicals leading to their deactivation. […] In severe chemical injuries, the entire limbus across 360 degrees is damaged and sloughs. […] The corneal stroma is predominantly formed of regularly arranged collagen fibrils (I, III, V), of which type I is the major constituent. […] Following chemical injury, the keratocytes are mobilised to repopulate the cornea starting from the most posterior part of the stroma. […] In severe chemical injury fibrovascular pannus can grow to cover the ocular surface with development of subepithelial fibrosis, superficial and deep scaring, tenons fibrosis and contracture, corneal vascularisation, nerve damage and progressive symblepharon with cicatrising lid deformities. […] The key factor in determining outcome is the rapidity with which treatment was commenced and the treatment measures initiated.

• #38 Pathophysiology of Ocular Trauma | Clinical Gate

  https://clinicalgate.com/pathophysiology-of-ocular-trauma/

  Ocular trauma is a major cause of ocular morbidity and a leading cause of monocular visual loss. It is estimated that over 2 million eye injuries occur in the USA each year. […] Different types of ocular injuries have different pathophysiologic and therapeutic ramifications; therefore, knowledge of the initial mechanism of injury to the macula or optic nerve is critical for determining visual prognosis. […] Breakdown of the bloodretina barrier after trauma is a key triggering mechanism in the wound healing sequence. The bloodretinal barrier (BRB) consists of tight junctions between the retinal capillary endothelial cells (inner BRB) and the retinal pigment epithelial (RPE) cells (outer BRB). Disruption of this highly specialized barrier system leads to migration of inflammatory cells and leakage of serum components, allowing a profound change in the biochemical milieu of the retina and vitreous.

• #39 Pathophysiology of Ocular Trauma | Clinical Gate

  https://clinicalgate.com/pathophysiology-of-ocular-trauma/

  Ocular trauma is a major cause of ocular morbidity and a leading cause of monocular visual loss. It is estimated that over 2 million eye injuries occur in the USA each year. […] Different types of ocular injuries have different pathophysiologic and therapeutic ramifications; therefore, knowledge of the initial mechanism of injury to the macula or optic nerve is critical for determining visual prognosis. […] Breakdown of the bloodretina barrier after trauma is a key triggering mechanism in the wound healing sequence. The bloodretinal barrier (BRB) consists of tight junctions between the retinal capillary endothelial cells (inner BRB) and the retinal pigment epithelial (RPE) cells (outer BRB). Disruption of this highly specialized barrier system leads to migration of inflammatory cells and leakage of serum components, allowing a profound change in the biochemical milieu of the retina and vitreous.

• #40 Pathophysiology of Ocular Trauma | Clinical Gate

  https://clinicalgate.com/pathophysiology-of-ocular-trauma/

  Ocular trauma is a major cause of ocular morbidity and a leading cause of monocular visual loss. It is estimated that over 2 million eye injuries occur in the USA each year. […] Different types of ocular injuries have different pathophysiologic and therapeutic ramifications; therefore, knowledge of the initial mechanism of injury to the macula or optic nerve is critical for determining visual prognosis. […] Breakdown of the bloodretina barrier after trauma is a key triggering mechanism in the wound healing sequence. The bloodretinal barrier (BRB) consists of tight junctions between the retinal capillary endothelial cells (inner BRB) and the retinal pigment epithelial (RPE) cells (outer BRB). Disruption of this highly specialized barrier system leads to migration of inflammatory cells and leakage of serum components, allowing a profound change in the biochemical milieu of the retina and vitreous.

• #41 Pathophysiology of Ocular Trauma | Clinical Gate

  https://clinicalgate.com/pathophysiology-of-ocular-trauma/

  Open-globe injury results in a breakdown of the bloodretinal barrier and allows the entry of a variety of cells into the intraocular milieu, causing the expression of a variety of chemokines, inflammatory cytokines, and growth factors that affect the adjacent RPE, fibroblasts, and glial cells. […] This wound healing process is central to the final common pathway that leads to traction retinal detachment and posttraumatic PVR in open globe injury. […] The RPE cell is central to the pathophysiological response seen in posttraumatic PVR. The RPE cells have critical characteristics, including migration and proliferation. […] Several growth factors appear to play critical roles, including platelet-derived growth factor (PDGF), hepatocyte growth factor (HGF), transforming growth factor- (TGF-), connective tissue growth factor (CTGF) and vascular endothelial growth factor (VEGF). The association of these growth factors with cells in the membranes suggests that they are produced locally during the wound healing response. […] The stage specificity of growth factor expression during PVR development has been described, where PDGF-AA is expressed uniformly throughout all stages of PVR, while HGF expression peaks during mid stage, and CTGF expression is highest during late stage PVR.

• #42 Pathophysiology of Ocular Trauma | Clinical Gate

  https://clinicalgate.com/pathophysiology-of-ocular-trauma/

  Open-globe injury results in a breakdown of the bloodretinal barrier and allows the entry of a variety of cells into the intraocular milieu, causing the expression of a variety of chemokines, inflammatory cytokines, and growth factors that affect the adjacent RPE, fibroblasts, and glial cells. […] This wound healing process is central to the final common pathway that leads to traction retinal detachment and posttraumatic PVR in open globe injury. […] The RPE cell is central to the pathophysiological response seen in posttraumatic PVR. The RPE cells have critical characteristics, including migration and proliferation. […] Several growth factors appear to play critical roles, including platelet-derived growth factor (PDGF), hepatocyte growth factor (HGF), transforming growth factor- (TGF-), connective tissue growth factor (CTGF) and vascular endothelial growth factor (VEGF). The association of these growth factors with cells in the membranes suggests that they are produced locally during the wound healing response. […] The stage specificity of growth factor expression during PVR development has been described, where PDGF-AA is expressed uniformly throughout all stages of PVR, while HGF expression peaks during mid stage, and CTGF expression is highest during late stage PVR.

• #43 Pathophysiology of Ocular Trauma | Ento Key

  https://entokey.com/pathophysiology-of-ocular-trauma/

  Ocular trauma is a major cause of ocular morbidity and a leading cause of monocular visual loss. […] Different types of ocular injuries have different pathophysiologic and therapeutic ramifications; therefore, knowledge of the initial mechanism of injury to the macula or optic nerve is critical for determining visual prognosis. […] Breakdown of the bloodretina barrier after trauma is a key triggering mechanism in the wound healing sequence. […] Open-globe injury results in a breakdown of the bloodretinal barrier and allows the entry of a variety of cells into the intraocular milieu, causing the expression of a variety of chemokines, inflammatory cytokines, and growth factors that affect the adjacent RPE, fibroblasts, and glial cells. […] This wound healing process is central to the final common pathway that leads to traction retinal detachment and posttraumatic PVR in open globe injury. […] The RPE cell is central to the pathophysiological response seen in posttraumatic PVR. […] Fibroblastic proliferation is critical to the progression of post-traumatic proliferative response.

• #44 Chemical eye injury: pathophysiology, assessment and management | Eye

  https://www.nature.com/articles/s41433-020-1026-6

  Retinal damage is rarely due to the direct effect of the chemical agent. […] Anterior segment tissues i.e. the ocular surface, iris, ciliary body and lens act as buffers for intraocular penetration by reacting with the chemicals leading to their deactivation. […] In severe chemical injuries, the entire limbus across 360 degrees is damaged and sloughs. […] The corneal stroma is predominantly formed of regularly arranged collagen fibrils (I, III, V), of which type I is the major constituent. […] Following chemical injury, the keratocytes are mobilised to repopulate the cornea starting from the most posterior part of the stroma. […] In severe chemical injury fibrovascular pannus can grow to cover the ocular surface with development of subepithelial fibrosis, superficial and deep scaring, tenons fibrosis and contracture, corneal vascularisation, nerve damage and progressive symblepharon with cicatrising lid deformities. […] The key factor in determining outcome is the rapidity with which treatment was commenced and the treatment measures initiated.

• #45 Chemical eye injury: pathophysiology, assessment and management | Eye

  https://www.nature.com/articles/s41433-020-1026-6

  Retinal damage is rarely due to the direct effect of the chemical agent. […] Anterior segment tissues i.e. the ocular surface, iris, ciliary body and lens act as buffers for intraocular penetration by reacting with the chemicals leading to their deactivation. […] In severe chemical injuries, the entire limbus across 360 degrees is damaged and sloughs. […] The corneal stroma is predominantly formed of regularly arranged collagen fibrils (I, III, V), of which type I is the major constituent. […] Following chemical injury, the keratocytes are mobilised to repopulate the cornea starting from the most posterior part of the stroma. […] In severe chemical injury fibrovascular pannus can grow to cover the ocular surface with development of subepithelial fibrosis, superficial and deep scaring, tenons fibrosis and contracture, corneal vascularisation, nerve damage and progressive symblepharon with cicatrising lid deformities. […] The key factor in determining outcome is the rapidity with which treatment was commenced and the treatment measures initiated.

• #46 Pathophysiology of Ocular Trauma | Clinical Gate

  https://clinicalgate.com/pathophysiology-of-ocular-trauma/

  Open-globe injury results in a breakdown of the bloodretinal barrier and allows the entry of a variety of cells into the intraocular milieu, causing the expression of a variety of chemokines, inflammatory cytokines, and growth factors that affect the adjacent RPE, fibroblasts, and glial cells. […] This wound healing process is central to the final common pathway that leads to traction retinal detachment and posttraumatic PVR in open globe injury. […] The RPE cell is central to the pathophysiological response seen in posttraumatic PVR. The RPE cells have critical characteristics, including migration and proliferation. […] Several growth factors appear to play critical roles, including platelet-derived growth factor (PDGF), hepatocyte growth factor (HGF), transforming growth factor- (TGF-), connective tissue growth factor (CTGF) and vascular endothelial growth factor (VEGF). The association of these growth factors with cells in the membranes suggests that they are produced locally during the wound healing response. […] The stage specificity of growth factor expression during PVR development has been described, where PDGF-AA is expressed uniformly throughout all stages of PVR, while HGF expression peaks during mid stage, and CTGF expression is highest during late stage PVR.

• #47 Pathophysiology of Ocular Trauma | Ento Key

  https://entokey.com/pathophysiology-of-ocular-trauma/

  Ocular trauma is a major cause of ocular morbidity and a leading cause of monocular visual loss. […] Different types of ocular injuries have different pathophysiologic and therapeutic ramifications; therefore, knowledge of the initial mechanism of injury to the macula or optic nerve is critical for determining visual prognosis. […] Breakdown of the bloodretina barrier after trauma is a key triggering mechanism in the wound healing sequence. […] Open-globe injury results in a breakdown of the bloodretinal barrier and allows the entry of a variety of cells into the intraocular milieu, causing the expression of a variety of chemokines, inflammatory cytokines, and growth factors that affect the adjacent RPE, fibroblasts, and glial cells. […] This wound healing process is central to the final common pathway that leads to traction retinal detachment and posttraumatic PVR in open globe injury. […] The RPE cell is central to the pathophysiological response seen in posttraumatic PVR. […] Fibroblastic proliferation is critical to the progression of post-traumatic proliferative response.

• #48 Pathophysiology of Ocular Trauma | Clinical Gate

  https://clinicalgate.com/pathophysiology-of-ocular-trauma/

  Open-globe injury results in a breakdown of the bloodretinal barrier and allows the entry of a variety of cells into the intraocular milieu, causing the expression of a variety of chemokines, inflammatory cytokines, and growth factors that affect the adjacent RPE, fibroblasts, and glial cells. […] This wound healing process is central to the final common pathway that leads to traction retinal detachment and posttraumatic PVR in open globe injury. […] The RPE cell is central to the pathophysiological response seen in posttraumatic PVR. The RPE cells have critical characteristics, including migration and proliferation. […] Several growth factors appear to play critical roles, including platelet-derived growth factor (PDGF), hepatocyte growth factor (HGF), transforming growth factor- (TGF-), connective tissue growth factor (CTGF) and vascular endothelial growth factor (VEGF). The association of these growth factors with cells in the membranes suggests that they are produced locally during the wound healing response. […] The stage specificity of growth factor expression during PVR development has been described, where PDGF-AA is expressed uniformly throughout all stages of PVR, while HGF expression peaks during mid stage, and CTGF expression is highest during late stage PVR.

• #49 Pathophysiology of Ocular Trauma | Clinical Gate

  https://clinicalgate.com/pathophysiology-of-ocular-trauma/

  Open-globe injury results in a breakdown of the bloodretinal barrier and allows the entry of a variety of cells into the intraocular milieu, causing the expression of a variety of chemokines, inflammatory cytokines, and growth factors that affect the adjacent RPE, fibroblasts, and glial cells. […] This wound healing process is central to the final common pathway that leads to traction retinal detachment and posttraumatic PVR in open globe injury. […] The RPE cell is central to the pathophysiological response seen in posttraumatic PVR. The RPE cells have critical characteristics, including migration and proliferation. […] Several growth factors appear to play critical roles, including platelet-derived growth factor (PDGF), hepatocyte growth factor (HGF), transforming growth factor- (TGF-), connective tissue growth factor (CTGF) and vascular endothelial growth factor (VEGF). The association of these growth factors with cells in the membranes suggests that they are produced locally during the wound healing response. […] The stage specificity of growth factor expression during PVR development has been described, where PDGF-AA is expressed uniformly throughout all stages of PVR, while HGF expression peaks during mid stage, and CTGF expression is highest during late stage PVR.

• #50 Pathophysiology of Ocular Trauma | Clinical Gate

  https://clinicalgate.com/pathophysiology-of-ocular-trauma/

  Open-globe injury results in a breakdown of the bloodretinal barrier and allows the entry of a variety of cells into the intraocular milieu, causing the expression of a variety of chemokines, inflammatory cytokines, and growth factors that affect the adjacent RPE, fibroblasts, and glial cells. […] This wound healing process is central to the final common pathway that leads to traction retinal detachment and posttraumatic PVR in open globe injury. […] The RPE cell is central to the pathophysiological response seen in posttraumatic PVR. The RPE cells have critical characteristics, including migration and proliferation. […] Several growth factors appear to play critical roles, including platelet-derived growth factor (PDGF), hepatocyte growth factor (HGF), transforming growth factor- (TGF-), connective tissue growth factor (CTGF) and vascular endothelial growth factor (VEGF). The association of these growth factors with cells in the membranes suggests that they are produced locally during the wound healing response. […] The stage specificity of growth factor expression during PVR development has been described, where PDGF-AA is expressed uniformly throughout all stages of PVR, while HGF expression peaks during mid stage, and CTGF expression is highest during late stage PVR.

• #51 Pathophysiology of Ocular Trauma | Clinical Gate

  https://clinicalgate.com/pathophysiology-of-ocular-trauma/

  Open-globe injury results in a breakdown of the bloodretinal barrier and allows the entry of a variety of cells into the intraocular milieu, causing the expression of a variety of chemokines, inflammatory cytokines, and growth factors that affect the adjacent RPE, fibroblasts, and glial cells. […] This wound healing process is central to the final common pathway that leads to traction retinal detachment and posttraumatic PVR in open globe injury. […] The RPE cell is central to the pathophysiological response seen in posttraumatic PVR. The RPE cells have critical characteristics, including migration and proliferation. […] Several growth factors appear to play critical roles, including platelet-derived growth factor (PDGF), hepatocyte growth factor (HGF), transforming growth factor- (TGF-), connective tissue growth factor (CTGF) and vascular endothelial growth factor (VEGF). The association of these growth factors with cells in the membranes suggests that they are produced locally during the wound healing response. […] The stage specificity of growth factor expression during PVR development has been described, where PDGF-AA is expressed uniformly throughout all stages of PVR, while HGF expression peaks during mid stage, and CTGF expression is highest during late stage PVR.

• #52 Corneal Laceration: Background, Epidemiology, Pathophysiology

  https://emedicine.medscape.com/article/798005-overview

  The prognosis after corneal laceration depends on the extent of the injury. Factors to consider include but are not limited to location, length, depth, and complexity of laceration, as well as the degree of scarring. Extensive corneal scarring may affect vision, requiring corneal transplant in the future. Laceration involving deeper globe structures such as the lens, retina, and uveal tissue may have a guarded prognosis.

• #53 Corneal Laceration: Background, Epidemiology, Pathophysiology

  https://emedicine.medscape.com/article/798005-overview

  The prognosis after corneal laceration depends on the extent of the injury. Factors to consider include but are not limited to location, length, depth, and complexity of laceration, as well as the degree of scarring. Extensive corneal scarring may affect vision, requiring corneal transplant in the future. Laceration involving deeper globe structures such as the lens, retina, and uveal tissue may have a guarded prognosis.

• #54 Ocular Trauma: Acute Evaluation, Cataract, Glaucoma – EyeWiki

  https://eyewiki.org/Ocular_Trauma:_Acute_Evaluation,_Cataract,_Glaucoma

  Cataract and glaucoma resulting from ocular trauma can occur in the setting of both penetrating and blunt injuries, thus both open and closed globe injuries. […] Management of post-traumatic cataract and glaucoma will depend upon time interval between injury and presentation of patient as well as clarity of ocular media, presence and morphology of cataract, and degree of IOP elevation if glaucoma is present. […] Angle recession glaucoma: occurs due to a tear between the longitudinal and circular muscle fibers, both of which make up the ciliary body, and often includes the trabecular meshwork. The development of glaucoma can occur soon after ocular trauma or may develop over the course of months to years. Glaucoma is chronic, typically unilateral and has some of the following gonioscopic findings: brown-colored broad angle recess, torn or absent iris processes, white scleral spur, PAS at the border of the recession, and depression in the overlying trabecular meshwork. Initial treatment is medical, although incisional glaucoma surgery may be needed.

• #55 Ocular Trauma: Acute Evaluation, Cataract, Glaucoma – EyeWiki

  https://eyewiki.org/Ocular_Trauma:_Acute_Evaluation,_Cataract,_Glaucoma

  Cataract and glaucoma resulting from ocular trauma can occur in the setting of both penetrating and blunt injuries, thus both open and closed globe injuries. […] Management of post-traumatic cataract and glaucoma will depend upon time interval between injury and presentation of patient as well as clarity of ocular media, presence and morphology of cataract, and degree of IOP elevation if glaucoma is present. […] Angle recession glaucoma: occurs due to a tear between the longitudinal and circular muscle fibers, both of which make up the ciliary body, and often includes the trabecular meshwork. The development of glaucoma can occur soon after ocular trauma or may develop over the course of months to years. Glaucoma is chronic, typically unilateral and has some of the following gonioscopic findings: brown-colored broad angle recess, torn or absent iris processes, white scleral spur, PAS at the border of the recession, and depression in the overlying trabecular meshwork. Initial treatment is medical, although incisional glaucoma surgery may be needed.

• #56 Ocular Trauma: Acute Evaluation, Cataract, Glaucoma – EyeWiki

  https://eyewiki.org/Ocular_Trauma:_Acute_Evaluation,_Cataract,_Glaucoma

  Lens particle glaucoma: can occur during the setting of surgical trauma, accidental trauma, or capsulotomy. Lens cortex particles obstruct the trabecular meshwork and can often be seen floating in the anterior chamber. This results in elevated IOP, anterior chamber reaction, microcystic corneal edema, and development of synechiae. This usually occurs within weeks of initial surgery or trauma, but can occur months to years later. […] Phacoantigenic glaucoma: occurs after surgical or accidental trauma, patients become sensitized to their own lens proteins resulting in granulomatous inflammation. Clinical signs include anterior chamber reaction with keratic precipitates on both the corneal endothelium and the anterior lens surface. Treatment is initially with corticosteroids and aqueous suppressants if this is not successful, the lens material can be surgically removed.

• #57 Ocular Trauma: Acute Evaluation, Cataract, Glaucoma – EyeWiki

  https://eyewiki.org/Ocular_Trauma:_Acute_Evaluation,_Cataract,_Glaucoma

  Lens particle glaucoma: can occur during the setting of surgical trauma, accidental trauma, or capsulotomy. Lens cortex particles obstruct the trabecular meshwork and can often be seen floating in the anterior chamber. This results in elevated IOP, anterior chamber reaction, microcystic corneal edema, and development of synechiae. This usually occurs within weeks of initial surgery or trauma, but can occur months to years later. […] Phacoantigenic glaucoma: occurs after surgical or accidental trauma, patients become sensitized to their own lens proteins resulting in granulomatous inflammation. Clinical signs include anterior chamber reaction with keratic precipitates on both the corneal endothelium and the anterior lens surface. Treatment is initially with corticosteroids and aqueous suppressants if this is not successful, the lens material can be surgically removed.

• #58 Ocular Trauma: Acute Evaluation, Cataract, Glaucoma – EyeWiki

  https://eyewiki.org/Ocular_Trauma:_Acute_Evaluation,_Cataract,_Glaucoma

  Hemolytic or ghost cell glaucoma: may develop after vitreous hemorrhage. In hemolytic glaucoma, trabecular flow is blocked by hemoglobin-laden macrophages, while in ghost cell glaucoma, degenerated red blood cells gain access to the anterior chamber by bypassing a disrupted hyaloid face and obstruct the trabecular meshwork. Glaucoma clears once hemorrhage has resolved.

• #59 Eye injuries. Eye contusions, perforations and blows in the eye.

  https://icrcat.com/en/eye-health/eye-injuries/

  Eye injuries may be of different types: closed globe injuries (blow or contusion caused by a blunt object) or penetrating injuries (caused by a perforating object). […] Eye contusions may lead to cataracts, glaucoma, inflammations, haemorrhages, and retinal or choroid tears or ruptures. In up to 5% of the cases, an eye contusion causes a retinal detachment. […] In case of perforations, there is a risk of infection, as a foreign body may remain inside the eye, thus leading to a worse prognosis. […] A penetrating eye injury is what we known as an eye perforation. In such cases, there is a loss of continuity of the eye globe, that may cause its content to leak out. These are very serious cases that require urgent interventions, and in which foreign bodies may even be present within the eye. Therefore, the infection risk is very high.

• #60 Toxic External Exposure Leading to Ocular Surface Injury

  https://www.mdpi.com/2411-5150/7/2/32

  The EpiOcular™ Eye Irritation Test (EIT), an in vitro 3D epithelial model, is commercially available from the MatTek Corporation. […] A greater speed and depth of injury or decline in cell viability from a substance denotes greater cytotoxicity. […] The ocular surface, consisting of the cornea, limbus, conjunctiva, and tear film, is subject to unceasing contact with the environment. […] Toxicity to the eye surface can cause various types of tissue damage that may include edema, inflammation, and denudation of corneal or conjunctival epithelium. […] Although the eye surface can often self-repair when the toxin is removed, severe injury can lead to dry eye disease, corneal ulcers, cataracts, glaucoma, and even blindness.

• #61 Toxic External Exposure Leading to Ocular Surface Injury

  https://www.mdpi.com/2411-5150/7/2/32

  The EpiOcular™ Eye Irritation Test (EIT), an in vitro 3D epithelial model, is commercially available from the MatTek Corporation. […] A greater speed and depth of injury or decline in cell viability from a substance denotes greater cytotoxicity. […] The ocular surface, consisting of the cornea, limbus, conjunctiva, and tear film, is subject to unceasing contact with the environment. […] Toxicity to the eye surface can cause various types of tissue damage that may include edema, inflammation, and denudation of corneal or conjunctival epithelium. […] Although the eye surface can often self-repair when the toxin is removed, severe injury can lead to dry eye disease, corneal ulcers, cataracts, glaucoma, and even blindness.

• #62 Researchers identify mechanism of retina damage following chemical eye burns | Harvard Medical School Department of Ophthalmology

  https://eye.hms.harvard.edu/news/researchers-identify-mechanism-retina-damage-following-chemical-eye-burns

  Chemical eye burns caused by alkali agents not only injure the front of the eye the cornea, where the contact takes place but also cause widespread damage to the light-sensitive tissue at the back of the eye (the retina) as well, often leading to optic nerve damage and glaucoma. […] A research team from Schepens Eye Research Institute of Massachusetts Eye and Ear has identified an inflammatory factor, tumor necrosis factor alpha (TNF-alpha), as the mechanism responsible for causing retinal damage from alkali eye burns. […] The teams findings are the first to show that the pH or pressure is not the mediator of retinal damage and that TNF-alpha mediated inflammation is a key driver of neurodegeneration. […] Our finding suggests that if we can neutralize the TNF-alpha inflammatory response shortly after the injury, perhaps we can stop the whole process and rescue the retina.

• #63 Ocular Penetrating and Perforating Injuries – EyeWiki

  https://eyewiki.org/Ocular_Penetrating_and_Perforating_Injuries

  A plan for prompt surgical repair within 24 hours of the injury is crucial whenever possible, as this has been shown to have a lower risk of endophthalmitis compared to delayed repair. […] In cases with a high suspicion for penetrating or perforating eye trauma, globe exploration should be performed with possible vitrectomy if vitreous hemorrhage with an intraocular foreign body or retinal detachment is present. […] One important consideration is the risk of retinal detachment, both in the immediate timeframe and following presentation. […] Eyes must also be assessed for wound leak post operatively. […] There are a number of risk factors on initial presentation that can be used to predict ultimate visual prognosis following an ocular penetrating or perforating injury. […] Sympathetic ophthalmia, a bilateral diffuse granulomatous uveitis that often follows ocular trauma due to violation of the eye’s immune privilege, is an important though rare consequence to consider.

• #64 Explosive eye injuries: characteristics, traumatic mechanisms, and prognostic factors for poor visual outcomes | Military Medical Research | Full Text

  https://mmrjournal.biomedcentral.com/articles/10.1186/s40779-022-00438-4

  Explosions can produce blast waves, high-speed medium, thermal radiation, and chemical spatter, leading to complex and compound eye injuries. […] Mechanical ocular trauma accounted for 94.00% of explosion-related eye injuries, among which intraocular foreign bodies (IOFBs) resulted in 55.17% of open globe injuries (OGIs) and contusion caused 60.22% of close globe injuries (CGIs). […] Poor presenting vision [odds ratio (OR)=5.789], full-thickness laceration of the eyeball 5 mm (OR=3.665), vitreous hemorrhage (OR=3.474), IOFB (OR=3.510), non-mechanical eye injury (NMEI, OR=2.622, P0.001), rupture (OR=2.362), traumatic optic neuropathy (OR=2.102), retinal detachment (RD, OR=2.033), endophthalmitis (OR=3.281, P0.01), contusion (OR=1.679), ciliary body detachment (OR=6.592), zone III OGI (OR=1.940), and PVR (OR=1.615, P0.05) were significant negative predictors for poor visual outcomes.

• #65 Eye Injury: Types, Causes, Prevention & Treatment

  https://my.clevelandclinic.org/health/diseases/eye-injury

  A penetrating injury is when a sharp object punctures your eye, or when a high-speed projectile goes into your eye. Fishhooks, darts, sharp tools, BB guns and paintball guns can cause penetrating injuries. Penetrating objects might get stuck in your eye and need a specialist to remove them. They can cause bleeding and damage to the structures of your eye. […] Open globe injuries penetrate the wall of your eye, the white part (sclera) or the clear part (cornea). Your sclera protects the delicate inner parts of your eye. If blunt or sharp eye trauma injures these inner parts, it’s more likely to cause long-term damage and vision loss. A closed globe injury doesn’t penetrate the eye wall. Black eyes, blunt trauma and corneal scratches are examples of closed globe injuries. […] Eye injuries are so painful because there are so many nerve endings in your eyeball. These nerves help maintain your eyes protective reflexes, movements and visual processing. They also make your eye extremely sensitive to sensory input. Even a surface-layer eye injury, like a scratch on your cornea or conjunctiva, can be intensely painful because it exposes the nerve endings.

• #66 Eye Injury: Types, Causes, Prevention & Treatment

  https://my.clevelandclinic.org/health/diseases/eye-injury

  The outlook for people with eye injuries varies. Early evaluation by an eye doctor and treatment can significantly improve the prognosis and help avoid permanent vision loss. The outlook depends on several factors, including: Amount of time before treatment, Severity of the injury, Type of eye injury.

• #67 Eye trauma – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/961

  Eye trauma is an important cause of monocular visual impairment and blindness that most commonly affects working age males. […] Eye injuries may be due to mechanical trauma (blunt or penetrating), chemical agents, thermal burns, or exposure to ultraviolet or ionizing radiation. […] Refers to any injury to the eye. The injury may have been due to mechanical trauma (blunt or penetrating), chemical or thermal burns, or exposure to radiation (ultraviolet or ionizing).

• #68 Eye Injury: Causes, Prevention, and Treatment

  https://www.verywellhealth.com/eye-injury-8677813

  Eye injuries can occur due to many causes, including accidents (flying debris, falls, or vehicle collisions), chemicals, or radiation. […] Eye injuries can involve bruises, punctures, burns, and scratches. Even if they don’t seem severe, any of these can be very painful and some can cause permanent vision loss. […] A blow to the area of the eye can cause bleeding under the skin and a black eye. It may also lead to swelling in the area, particularly of the lid, which can create pressure on the eye and cause damage. Blunt trauma may also cause bleeding in the eye (hyphema). […] Burns to the eyes can result from chemicals, heat, and high-intensity light. […] If flushed out quickly and thoroughly enough, they may not cause permanent damage to the eye. However, with some substances, such as bleach, oven cleaner, or battery acid, it may take a day or so to determine how extensive the damage is to the eye.

• #69 Traumatic eye injuries – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/traumatic-eye-injuries/

  An open globe injury is a full thickness perforation or laceration of the ocular globe. […] Penetrating trauma (globe laceration) and high-velocity blunt trauma (globe rupture) are common causes. […] Always consider the possibility of open globe injury in patients with eye trauma; occult rupture may be difficult to diagnose. […] Administer antibiotics, as endophthalmitis from the injury can be more severe than the injury itself, resulting in loss of vision and necessitating enucleation. […] Retrobulbar hemorrhage can lead to orbital compartment syndrome, which can result in permanent vision loss within 12 hours if not decompressed with lateral canthotomy and cantholysis.

• #70 Traumatic eye injuries – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/traumatic-eye-injuries/

  An open globe injury is a full thickness perforation or laceration of the ocular globe. […] Penetrating trauma (globe laceration) and high-velocity blunt trauma (globe rupture) are common causes. […] Always consider the possibility of open globe injury in patients with eye trauma; occult rupture may be difficult to diagnose. […] Administer antibiotics, as endophthalmitis from the injury can be more severe than the injury itself, resulting in loss of vision and necessitating enucleation. […] Retrobulbar hemorrhage can lead to orbital compartment syndrome, which can result in permanent vision loss within 12 hours if not decompressed with lateral canthotomy and cantholysis.

• #71 Eye injury

  https://www.rch.org.au/trauma-service/manual/eye-injury/

  Boys are twice as likely to sustain a significant eye injury compared to girls. […] Serious eye injuries can be under-appreciated when children present with a painful, blurred vision or an extensive subconjunctival haemorrhage. […] Where an open globe injury is suspected it is important to minimise child distress as crying can raise ocular pressure leading to extrusion of intraocular contents. […] The key diagnoses to seek and identify are: Open globe injury ruptured globe or penetrating laceration, Foreign body corneal or intra-ocular, Large hyphaema, Retinal detachment, Corneal burns chemical or thermal. […] Risk of high velocity penetrating injury small projectiles at high velocity have a higher risk of penetration – eg playing with air-rifle, near lawn-mowers, using metal grinders or other power tools, hammering.

• #72 Eye injury

  https://www.rch.org.au/trauma-service/manual/eye-injury/

  Boys are twice as likely to sustain a significant eye injury compared to girls. […] Serious eye injuries can be under-appreciated when children present with a painful, blurred vision or an extensive subconjunctival haemorrhage. […] Where an open globe injury is suspected it is important to minimise child distress as crying can raise ocular pressure leading to extrusion of intraocular contents. […] The key diagnoses to seek and identify are: Open globe injury ruptured globe or penetrating laceration, Foreign body corneal or intra-ocular, Large hyphaema, Retinal detachment, Corneal burns chemical or thermal. […] Risk of high velocity penetrating injury small projectiles at high velocity have a higher risk of penetration – eg playing with air-rifle, near lawn-mowers, using metal grinders or other power tools, hammering.

• #73 A blow to the eye: Ocular and orbital trauma – Mayo Clinic

  https://www.mayoclinic.org/medical-professionals/trauma/news/a-blow-to-the-eye-ocular-and-orbital-trauma/mac-20429287

  Blunt trauma to the eye […] In addition to energy transfer, mechanism of injury largely dictates risk and the severity of ocular and orbital injuries. Due to high velocity, the most destructive types of ocular or orbital injuries are high-speed motor vehicle collisions or ballistic injuries. […] Long-term functional effects of ocular or orbital injury are infrequent when appropriate treatment is rendered in the acute phase, or within the first three to four weeks of injury.

• #74 Work-Related Eye Injuries and Illnesses | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/0401/p1017.html

  More than 65,000 work-related eye injuries and illnesses, causing significant morbidity and disability, are reported in the United States annually. […] Eye patching does not improve cornea reepithelialization or discomfort from corneal abrasions. […] Sudden eye pain after working with a chisel, hammer, grinding wheel, or saw suggests a penetrating globe injury. […] Chemical eye burns require immediate copious irrigation. […] The patient’s history of eye injury guides the diagnosis. […] Primary prevention and patient counseling on proper eye protection is essential because over 90 percent of injuries can be avoided with the use of eye protection. […] As laser use increases in industry and medical settings, adequate personal protection is needed to prevent cataracts. […] Ninety percent of work-related eye injuries are preventable with adequate eye protection.

Zobacz więcej