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F Kuhn, V Mester, R Morris; Serious Eye Injuries Caused By Blunt Objects: Contusion . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4492.
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Purpose: Only occasional studies have analyzed the consequences of closed globe injuries caused by blunt objects. Methods: We have performed a retrospective review on all 706 inpatient cases of severe eye injury in the Hungarian Eye Injury Registry collected between January 1989 and December 1997. Results: One hundred fifty-two eyes (22%) with contusion were identified. Most patients (78%) were males with an average age of 40 (3-81) years. Wood such as tree branches was the primary object (23%); 74% of these patients were chopping wood. Assault, most commonly by fist, was responsible for 19% of the cases, followed by explosion (12%) and rubber cords (11%). Only 18% of eyes sustained injury confined to the anterior segment; 59% of eyes had trauma to both the anterior and posterior segments. Thirty-four percent of the eyes developed hyphema, 42% had sub/luxation of the lens, 36% vitreous hemorrhage, 35% presented with retinal detachment, and 20% with a retinal break. Seventy-five percent of eyes underwent surgery; 13% of eyes had three or more surgeries. Only one eye was removed. The follow-up was three to 84 (average, 16) months; 14 eyes (9%) were lost to follow-up. The vision improved in 68% of eyes, remained unchanged in 18% and deteriorated in 25%. One eye became phthisical, 14% developed contusion maculopathy, and 10% had PVR/retinal detachment. Sympathetic ophthalmia occurred in one patient. Conclusions: Our data confirm that contusion may lead to serious intraocular damage: 14% of eyes in this series had no light perception final vision. With extensive reconstructive efforts including modern vitreoretinal surgery, over two-thirds of eyes showed visual improvement.
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