Spectrum of intra-ocular foreign bodies and the outcome of their management in Brunei Darussalam

Abstract

To review the etiologies, prognostic factors and treatment outcomes of intraocular foreign bodies (IOFBs) occurring in the population of Brunei Darussalam, and provide guidelines to prevent and manage such injuries. A retrospective review was performed for all cases of traumatic IOFBs managed in our centre during a 3-year period between May 2008 and April 2011. The mechanism of injury, management, complications and visual outcomes were analyzed. Majority of the patients were males (93 %) and the mean age was 36 years. The main causes of trauma were metal hammering and grass cutting (43 % each). Other causes include road traffic accidents and firecracker explosion (7 % each). The visual outcome was ≥6/18 in 50 % and 'No perception of light' in 29 %. Causes of poor visual outcome were retinal detachment with proliferative vitreoretinopathy (21 %), endophthalmitis (21 %) and globe maceration (7 %). Prognostic factors associated with significantly worse final visual outcome included posterior location of the IOFB (p = 0.05) and larger IOFB size (p < 0.001). The time from injury to surgery did not correlate with a worse visual prognosis. In Brunei Darussalam, the commonest causes of IOFBs are hammering metal and cutting grass using power tools. The visual outcome varies between 6/6 and NPL. Poor visual outcome is related to the severity of the initial ocular injury, posterior segment IOFB and endophthalmitis.

Posterior Segment Intraocular Foreign Bodies: The Effect of Weight and Size, Early versus Late Vitrectomy, and Outcomes

“…This male predominance has been attributed to occupational exposure, dangerous sports and hobbies, alcohol use, and risk-taking behavior. [9][10][11] In our population, the most common cause of injuries was work related (67%), as in previous reports.…”

Intraocular Foreign Body: Diagnostic Protocols and Treatment Strategies in Ocular Trauma Patients

“…Various factors have been suggested to be associated with the final visual outcomes in patients with IOFBs. These factors include the initial visual acuity [ 7 , 8 , 9 , 10 , 11 , 12 , 13 ], size and location of the IOFB [ 9 , 11 , 12 , 13 , 14 , 15 , 16 ], size and location of the IOFB entry wound [ 7 , 12 , 14 , 17 ], presence of relative afferent pupillary defect (RAPD) [ 8 , 18 ], intraocular hemorrhage [ 8 , 12 , 18 ], retinal detachment [ 9 , 11 , 12 , 14 , 16 , 17 , 18 ], and endophthalmitis [ 10 , 12 , 15 ].…”

Predictors for Visual Outcomes in Eye Injuries with Intraocular Foreign Body

“…This problem was similar to some previous studies. 3,14 These trimmer-induced eye injuries are therefore a significant cause of eye injuries with IOFBs and result in serious visual impairment. However, these eye injuries are preventable with proper eye protection and education.…”

“…[3][4][5][6] Previous studies demonstrated a variety of prognostic factors to be associated with final visual outcomes following management of ocular injuries with IOFBs. 1,3,[5][6][7][8][9][10][11][12][13][14][15][16][17] However, there was no consensus on these predictive factors and most studies had sample sizes that were too limited to draw definite conclusions. There was only one study which evaluated prognostic factors in a large number of patients with ocular injuries and retained IOFBs in China.…”

“…Various factors have been shown to be associated with a final visual outcome following management of ocular injuries with IOFBs. These factors included presenting visual acuity, [5][6][7][8][9][10][11][12] size and location of IOFB, 7,[10][11][12][13][14][15] intraocular hemorrhage, 1,6,11,16 retinal detachment 1,8,10,11,[15][16][17] and endophthalmitis. 9,11,12 Some studies revealed that size and location of wound entry affected a final visual acuity, 3,5,[10][11][12][13]17 whereas other studies showed that presence of relative afferent pupillary defect (RAPD) was related to the final visual outcome.…”