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Daniel Straka, Sumeer Thinda, Mark Melson, Louise Mawn; Periorbital and Ocular Injury from Industrial Hooks. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5340.
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The industrial work environment exposes its employees to a unique set of potential medically and surgically hazardous events ranging from chemical exposures and thermal burns, to corneal foreign bodies and other traumatic injuries. In this case series of patients we specifically discuss the periocular and orbital trauma induced by industrial hook injuries, the surgical interventions required, and their anatomical and functional outcomes.
Retrospective review of all patients presenting to the Vanderbilt University Medical Center and the Vanderbilt Eye Institute with periorbital and ocular injuries from industrial hook trauma from 2009-2011.
Five cases were identified; all subjects were males with an average age of 36 (SD 14.95). In each of these cases, the patients were without eye protection. In no cases did patients suffer open globe injuries. Similarly, there was no effect on the patients’ final visual acuity. In three of the five cases (60%), the canalicular system was involved. In two of the five cases (40%), the levator aponeurosis was transected, in one case the extraocular muscles were involved (10%), and in every case the eyelid lacerations were full thickness and involved the eyelid margin. All of the patients obtained excellent anatomical success using various surgical techniques. In only one case did the patient suffer permanent visual morbidity (diplopia) due to a completely transected abducens nerve; however this was only with attempted left gaze.
We present the largest case series of industrial hook trauma to the periorbital region. These cases highlight the importance of wearing sturdy eye protection for workers in the manufacturing fields, especially those exposed to industrial hooks. In addition, after ensuring there is no penetrating globe injury, it is important for the clinician to have a high index of suspicion for orbital trauma and perform a complete ocular exam to exclude this possibility. If one cannot be certain based on physical exam alone, then in cases where the mechanism of the injury is quite dramatic, it may be prudent to obtain an imaging modality to further delineate the extent of the trauma.
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