Etiologic Causes and Epidemiological Characteristics of Patients with Intraocular Foreign Bodies: Retrospective Analysis of 1340 Cases over Ten Years

Wang

Journal of Ophthalmology

et al. 2019

Aim. To describe epidemiologic and clinical characteristics and prognostic factors influencing visual outcome after intraocular foreign bodies (IOFBs) injury. Methods. Medical records of 370 patients (373 eyes) with IOFBs were reviewed to identify the factors influencing visual acuity by univariate and multivariate analyses. Results. The majority of patients (97.0%) were men, with a mean age of 38.1 years. The most common cause of ocular injury was hammering (52.6%); magnetic IOFBs occurred in 84.7% of these cases. Factors associated with poor visual outcome (defined as <1.3 logMAR) included the following: age ≥50 years (P=0.046); worse presenting visual acuity (P<0.001); complications of retinal breaks (P=0.006) and endophthalmitis (P=0.032); vitrectomy (P=0.035); and intraocular C3F8 gas tamponade (P=0.038). Excellent visual outcome (defined as ≥0.5 logMAR) was associated with age <50 years (P=0.003); better presenting visual acuity (PVA) (P<0.001); wound length <4 mm (P=0.005); absence of vitreous hemorrhage (P=0.026) and retinal breaks (P<0.001); nonvitrectomy surgery (P=0.043); and use of balanced saline (P=0.029). Conclusions. Multiple prognostic factors were identified that may predict visual outcome and globe survival after IOFBs injury. Age, initial presenting visual acuity, wound length, complications (vitreous hemorrhage, retinal breaks, and endophthalmitis), surgical approach, and intraocular tamponade were significant predictors of visual outcome.

Section: Discussionmentioning

confidence: 90%

Intraocular Foreign Bodies: Clinical Characteristics and Prognostic Factors Influencing Visual Outcome and Globe Survival in 373 Eyes

Wang

Journal of Ophthalmology

et al. 2019

“…15 16 Li et al also reported that fireworks injury accounted for the majority of patients with IOFB aged 0-9 years in China. 17 Fireworks-related eye trauma mainly occurs in children, and is frequently severe and visually devastating. 15 18 The accidents involving fireworks diminished after children aged <18 years were prohibited from setting off fireworks in Finland.…”

Section: Discussionmentioning

confidence: 99%

“…Lin reported that fireworks (41.6%) and splashing of foreign body (49.1%) injuries dominate in retained patients with IOFB aged 0-9 and 10-19 years, respectively, similar to our findings. 17 Older children have increased security awareness and an expanded range of independent activities, resulting in different causes of injury. In addition, male patients were more prone to injury with fireworks, while females were more likely to be injured by plant branches, likely reflecting the different activities of males and females when they were injured.…”

Section: Discussionmentioning

confidence: 99%

Intraocular foreign body injury in children: clinical characteristics and factors associated with endophthalmitis

Yang

Zhao

et al. 2019

Br J Ophthalmol

Background/AimsTo analyse the clinical characteristics of intraocular foreign body (IOFB) injury in children and evaluate factors associated with endophthalmitis development.MethodsPatients aged <18 years with IOFB attending Zhongshan Ophthalmic Center between January 2003 and July 2016 were included retrospectively. Demographic features, clinical characteristics and factors associated with endophthalmitis development were analysed.ResultsConsecutive subjects (n=484, 484 eyes) were included: mean age 10.12±4.54 years, 86.4% male. Fireworks (28.5%) were the most common cause of injury. Injury of uncertain cause (17.5%), fireworks (36.7%) and metal splatter (31.7%) accounted for most injuries in the 0–3, 4–12 and 13–17 years age groups, respectively. Plant branches (16.7%) and fireworks (31.1%) were the most common causes of injuries in females and males, respectively. Endophthalmitis occurred in 116 patients (24.0%), with metallic IOFB (OR=0.338, p=0.001), intraocular haemorrhage (OR=0.100, p<0.001) and uveal tissue prolapse (OR=0.206, p<0.001) conferring lower risk, while zone II wound (OR=4.336, p<0.001) and traumatic lens rupture (OR=2.567, p=0.028) were associated with higher risk.ConclusionClinical characteristics of children with IOFB injury differ from those of adults. Fireworks are the most common cause of injury, indicating a ban on children igniting fireworks should be advocated. Safety education and protective measures should vary by age and sex. Endophthalmitis is associated with zone II wound, traumatic lens rupture, IOFB material, intraocular haemorrhage and uveal tissue prolapse, which has clinical relevance.

“…Most of the studies published for epidemiological characteristics and management outcomes of IOFBs are retrospective. 6,11,12 In our study design, data was also collected in retrospective manner. Majority of injuries (81.81%) occurred in male group.…”

Section: Discussionmentioning

confidence: 99%

Pattern of Intra Ocular Foreign Bodies in a Tertiary Care Hospital of Punjab

et al. 2020

Purpose: To describe the epidemiological characteristics, management strategies and outcomes of intraocular foreign bodies (IOFB) presented in a tertiary care setup of Punjab. Study Design: Descriptive retrospective study. Place and Duration: Department of ophthalmology, Gujranwala medical college/teaching hospital, from January 2017 to December 2019. Methods: A retrospective review, of all the patients who had IOFB removal, was performed. Information regarding the nature and circumstances of injury, types of IOFB, operative procedure performed and patient’s pre-operative and post-operative Best Corrected Visual Acuity (BCVA) were analyzed. Descriptive statistics were used for analysis of data. Results: Record of 22 patients was retrieved. Out of which 18 (81.81%) were male and 4 (18.18%) were female. Mean age was 27.95 ± 9.325 years. Occupational trauma was the leading cause of injury (66.6%). Metallic objects were among the most common type of IOFB (66.6%) followed by glass, concrete stone (each 13.3%) and lead pencil (6.6%). Serious complications seen due to retained IOFB were phthisis bulbi (9.09%), retinal detachment (13.63%) and endophthalmitis (9.09%). On follow-up, 10 patients had BCVA less than hand movement (HM). 5 patients had BCVA of CF to 6/60, 3 patients had BCVA of 6/60-6/24 and 4 patients had better than 6/18. Conclusion: Most common cause of IOFB was occupational trauma and young age group of working class was the most common population affected. Treatment delay and complications contributed to poor prognosis. Ocular safety measures during high-risk work can reduce the risk of trauma. Key Words: Intra-ocular foreign Bodies, Retinal Detachment, Phthisis Bulbi.