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R. A. Shah, M. A. Zarbin, N. Bhagat; A Series of Ruptured Globe Injuries Sustained in Motor Vehicle Accidents. Invest. Ophthalmol. Vis. Sci. 2007;48(13):714.
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. To review the presentation, management and outcomes of ruptured globe (RG) injuries sustained in motor vehicle accidents (MVAs) and identify features salient to ocular trauma in this setting.
. Medical records of patients who suffered RGs as a result of MVAs that presented to New Jersey Medical School between 1999 and 2005 were reviewed to collect the following information: demographics, etiology of the injury, type of laceration, surgeries, anatomic and functional outcome.
. 24 eyes that sustained RG due to MVAs were identified. Of 24 eyes, 10 suffered only corneal lacerations, 6 scleral, and 4 had combined corneoscleral lacerations. Four (4) eyes had intraocular foreign bodies (IOFB). Two of these foreign bodies were located in the posterior segment and were removed during pars plana vitrectomy. These foreign bodies were apparent either on clinical ophthalmic exam, computed tomography, or ophthalmic ultrasonography. 5 (five) eyes presented with vitreous hemorrhage initially, and 6 eyes presented with retinal detachment. In at least 5 eyes, the mechanism of injury was clearly attributable to penetrating ocular injury from shattered glass. The remaining injuries were presumably related to blunt trauma, and in at least one case due to an airbag injury. In eyes with a measurable pre-operative Snellen visual acuity (VA) (14/24 eyes), the mean pre-operative VA was 20/300. VA in the remaining eyes was either less than hand motion (HM) or not able to be measured due to non-cooperation. Eyes with quantifiable post-operative VA (18/24 eyes) had a mean Snellen VA of 20/160. The remaining 6 eyes had VA that ranged from light perception to HM . Five (5) eyes had best final VA of 20/40 or better. Eight (8) eyes had a final VA between 20/40-20/200. Eleven (11) eyes had a final recorded VA worse than 20/200. 4 eyes with no light perception were ultimately enucleated.
The most commonly specified mechanism of injury in MVA related RG injuries is penetrating trauma from shattered glass. 17% (seventeen percent) of the eyes in our study had an intraocular foreign body. In each of these cases the foreign body was glass. At least one RG injury was related to airbag deployment. Corneal laceration represents the most common type of RG injury in MVAs. Overall, the prognosis for visual acuity in many of these patients remains poor.
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