#55. Penetrating injuries of the eyeball and adnexa with or without foreign body. Principles of treatment

Question 1

What are PENETRATING Injuries of the Eyeball known as?

Answer 1

OPEN GLOBE Injuries

Question 2

What is the EPIDEMIOLOGY of PENETRATING Injuries of the Eyeball?

Answer 2

• MORE COMMON in MALES&raquo_space; Females
• Occurs in YOUNGER People

Question 3

What are the CAUSES of PENETRATING Injuries of the Eyeball?

Answer 3

• SHARP / FOREIGN Bodies, via:
  a. Domestic / Occupational Accidents
  b. Sports

** EXTENT of Damage DEPENDS on the KINETIC ENERGY of the Object

Question 4

What are the RISK FACTORS of PENETRATING Injuries of the Eyeball?

Answer 4

• DELAY in PRIMARY Repair
• RUPTURED Lens Capsule
• DIRTY Wound

Question 5

What are the 3 TYPES of PENETRATING Injuries to the Eyeball?

Answer 5

1) Corneal

2) Scleral

3) Retinal Detachment

Question 6

What are the INJURIES to the CORNEA?

Answer 6

• PEAKING of Pupil
• SHALLOW Anterior Chamber
• FULL-THICKNESS Penetration

Question 7

What are the WOUND EXTENTS of the CORNEA?

Answer 7

1) SMALL SHELVING Wounds
- Formed Anterior Chamber

2) MEDIUM SIZED Wounds
- REQUIRE Suturing IF Anterior Chamber is SHALLOW or FLAT

• POST-OP Bandage is Applied

3) IRIS INVOLVEMENT
- EXCISION of PROLAPSED PORTION
- TO AVOID RISK of Necrosis / Contamination

4) LENS DAMAGE
a. SUTURE Laceration
b. Lens REMOVAL via VITREOUS CUTTER

Question 8

What are the 2 INJURIES to the SCLERA?

Answer 8

1) ANTERIOR Scleral Lacerations
- BETTER Prognosis than Posterior
- Lead to IRIDOCILIARY PROLAPSE
- Lead to VITREOUS INCARCERATION

2) POSTERIOR Scleral Lacerations
- Associated with RETINAL Damage
- Treatment = RESTORE Globe Integrity

Question 9

What are the CAUSES of RETINAL DETACHMENT?

Answer 9

0 DUE to PENETRATING Injury

• Leading to VITREOUS INCARCERATION of the Wound
• Resulting in FIBROBLASTIC PROLIFERATION
• May PROGRESS INTO Anterior Tractional Retinal Detachment