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Albert Lin, Cassie Confait, Suzanne Hoadley, Madiha Ahmad, Ching Chen; Severe Ocular Trauma In The Emergency Room. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4434.
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To assess the nature, severity, and mechanisms of severe ocular trauma in the emergency room at an academic teaching hospital.
Individual patient records involving ocular trauma in the emergency room were reviewed as a retrospective case review series. Severe intraocular trauma in this study was defined as any injury that required intraocular surgery immediately or in the future, any traumatic optic neuropathy, or total destruction of the eye. Injuries were classified per the Birmingham Eye Trauma Terminology.
Of 519 patients in 2010 seen in the emergency room for ocular trauma, 52 patients (10%) had severe intraocular trauma as defined previously. Of these 52 patients, contusions (n=17) were the most common traumatic injury, followed closely by penetrating lacerations (n=16) and ruptures (n=16). Other injuries included perforating lacerations (n=1), traumatic optic neuropathy (n=1), and complete destruction of the eye (n=1). In addition, 33 of these 52 patients (63.5%) were considered to have a full-thickness open eyewall globe injury. Of these full-thickness open eyelid wall injuries, 11 patients had confirmed physical assault, 4 fell, 2 suffered firearm injury (either accidental or intentional), 3 were involved in a motor vehicle crash, and the rest (13) suffered some type of workplace or outdoor environmental injury that did not fall into the etiologies above.
The most common types of severe intraocular traumas seen in the emergency room were contusions, penetrating lacerations, and ruptures, making up 94.2% of severe ocular traumas. Penetrating lacerations (48.5%) and ruptures (48.5%) were the most common types of full-thickness open eyewall injuries with a variety of etiologies, with physical assault and workplace or outdoor environmental injury being the most common. Characterizing the most common types and etiologies of these injuries will not only help with medical education and treatment regarding these injuries, but also help assist in ways to address these injuries from a public health viewpoint.
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