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Huy Vu Nguyen, Katherine E Talcott, Alice Lorch, Yewlin Chee, Carolyn Kloek, Dean Eliott, Seanna R Grob; Bilateral Open Globe Injuries at a Tertiary Care Center. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5950.
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© ARVO (1962-2015); The Authors (2016-present)
Bilateral open globe injuries are a rare subset of patients presenting with ocular trauma, yet the visual implications are severe. We performed a retrospective clinical study to evaluate the clinical characteristics, outcomes, and complications related to bilateral open globe injuries.
390 consecutive open globes were reviewed at the Massachusetts Eye and Ear Infirmary (MEEI), a single large tertiary ophthalmology trauma hospital, between the years of 2013 and 2016. 7 patients presented with bilateral open globe injury. Visual acuity, mechanism of injury, secondary injuries, initial and secondary operative reports, and complications were recorded and reviewed.
390 open globes presented to MEEI between the years of 2013 and 2016. 7 patients (14 eyes) presented with bilateral open globe injury, which comprise 3.6% of all open globes. Of the patients presenting with bilateral open globes, 14% were female and 86% were male. Average age at presentation was 41.9 years. Visual acuity on presentation ranged from light perception (LP) to no light perception (NLP). 7 out of 14 eyes were NLP on presentation, 3 eyes were LP, and 4 eyes did not have preoperative visual acuity measurements since they presented intubated and sedated. Mechanism of injury included blunt trauma in 4 patients, gunshot wound in 2 patients, and penetrating injury in 1 patient. 3 eyes presented with traumatic evisceration of intraocular contents. Associated injuries included facial and body lacerations and trauma to the trunk and extremities from assault or gunshot wounds. All eyes underwent initial exploration and 11 out of 14 eyes could be primarily closed. 5 eyes underwent secondary vitrectomy surgery. 9 out of 14 eyes had a final vision of NLP and 3 eyes were LP only. One eye eventually did achieve 20/20 vision. Patients were followed for an average of 5.3 months.
Bilateral open globe injuries are a rare subgroup of ocular traumas that present to MEEI. Often they are associated with severe traumatic accidents or intentional assault injuries. Visual acuity on presentation is commonly LP or NLP and the visual prognosis is often poor due to the severity of the trauma. The lifetime effects of these injuries are devastating since these patients experience sudden significant loss of vision bilaterally.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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