Conservative management of penetrating ocular trauma caused by a nail gun

Carral-Santander, Irving Enrique; Acón-Ramírez, Dhariana; Soberon, Vidal; Peñaranda-Henao, Carlos Felipe; Wheelock-Gutierrez, Lorena; García-Aguirre, Gerardo

doi:10.1016/j.ajoc.2018.06.010

Cited by 3 publications

(2 citation statements)

References 8 publications

(9 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…3 Management strategies depend on the type, size of the FB, site of penetration, and hemostasis. [4][5][6][7] Ocular imaging of radiolucent FBs remains difficult: plain films detect only metallic FBs 8 and magnetic resonance imaging poses risk associated with unrecognized metal. 9 Inert FBs carry a lower risk of infection than organic FBs such as wood, 4 but still warrant broad-spectrum antibiotics to prevent infections.…”

Section: Discussionmentioning

confidence: 99%

Removal of an Impaled Intraocular Hair Comb Following Self-inflicted Trauma

Markovitz

Hamburger

Fromm

et al. 2020

Clinical Practice and Cases in Emergency Medicine

View full text Add to dashboard Cite

Ocular trauma is one of the most common and vision-threatening ophthalmic presentations with a wide spectrum of complications, such as bleeding, infection, vision loss, and enucleation. A 64-year-old-male presented to the emergency department (ED) with a self-inflicted orbital penetrating injury with a hair comb. Computed tomography showed the comb traversed the medial orbit inferior to the medial rectus but did not damage the optic nerve; there were no globe or orbital wall fractures. His ocular exam was significant for a right eye afferent pupillary defect and decreased visual acuity 20/800, consistent with optic neuropathy. Primary concerns were stabilizing and removing the foreign body without causing further damage in the setting of an uncooperative patient. The comb was removed with the aid of local and systemic analgesia using gentle traction and normal saline irrigation. The patient was admitted for systemic and topical antibiotics and showed improvement in visual acuity and resolution of his optic neuropathy. This case illustrates the importance of rapid ED assessment and management of complex penetrating ocular trauma. Examination should specifically look for signs of globe rupture and optic nerve injury. Expedited foreign body removal should be managed together with an ophthalmologist with procedural sedation and broad-spectrum antibiotics to avoid further visual and infectious complications.

show abstract

Section: Discussionmentioning

confidence: 99%

Removal of an Impaled Intraocular Hair Comb Following Self-inflicted Trauma

Markovitz

Hamburger

Fromm

et al. 2020

Clinical Practice and Cases in Emergency Medicine

View full text Add to dashboard Cite

show abstract

“…Metallic foreign bodies can enter the eye during use of hammer and nail, nail gun, or stapler [ 175 , 176 , 177 , 178 ]. Metallic foreign body removal is key in order to avoid consequences such as infection, swelling, inflammation, astigmatism, and opacification of the cornea [ 179 ].…”

Section: Workplace Ocular Injuriesmentioning

confidence: 99%

Toxic External Exposure Leading to Ocular Surface Injury

Rauchman

Locke

Albert

et al. 2023

Vision

View full text Add to dashboard Cite

The surface of the eye is directly exposed to the external environment, protected only by a thin tear film, and may therefore be damaged by contact with ambient particulate matter, liquids, aerosols, or vapors. In the workplace or home, the eye is subject to accidental or incidental exposure to cleaning products and pesticides. Organic matter may enter the eye and cause infection. Ocular surface damage can trigger a range of symptoms such as itch, discharge, hyperemia, photophobia, blurred vision, and foreign body sensation. Toxin exposure can be assessed clinically in multiple ways, including via measurement of tear production, slit-lamp examination, corneal staining, and conjunctival staining. At the cellular level, environmental toxins can cause oxidative damage, apoptosis of corneal and conjunctival cells, cell senescence, and impaired motility. Outcomes range from transient and reversible with complete healing to severe and sight-compromising structural changes. Classically, evaluation of tolerance and safety was carried out using live animal testing; however, new in vitro and computer-based, in silico modes are superseding the gold standard Draize test. This review examines how environmental features such as pollutants, temperature, and seasonality affect the ocular surface. Chemical burns to the eye are considered, and approaches to protect the ocular surface are detailed.

show abstract