Download PDF
Facial Plast Surg 2015; 31(04): 345-350
DOI: 10.1055/s-0035-1563600
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Emergency Treatment of Ocular Trauma

Klaus J. Lipke
1   Department of Ophthalmology, Ulm Bundeswehr Hospital, Ulm, Germany
,
Hermann O.C. Gümbel
1   Department of Ophthalmology, Ulm Bundeswehr Hospital, Ulm, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
15 September 2015 (online)

    Permissions and Reprints

Abstract

Injuries to the eye and its adnexa are common in head and neck trauma centers. An ophthalmologist experienced in ocular traumatology is not always available. Therefore, every emergency physician should be familiar with the basic evaluation, triage, and management of ocular trauma. Above all, the identification of a need for immediate treatment should be implemented in the algorithm of an emergency room, especially in a head and neck trauma center, to reduce the risk of a devastating loss of vision. This article formulates the different types of ocular trauma and their required first-line therapy.

Keywords

orbital compartment - retrobulbar hematoma - cantholysis - open-globe injury - eyelid injury
 

  • References

  • 1 Kuhn F. Ocular traumatology and the ocular trauma specialist. Graefes Arch Clin Exp Ophthalmol 2008; 246 (2) 169-174
    CrossrefPubMedGoogle Scholar
  • 2 Kuhn HS. [Ocular injuries in industry]. Med Deporte Trab 1951; 16 (107) 4636-4718
    PubMedGoogle Scholar
  • 3 May DR, Kuhn FP, Morris RE , et al. The epidemiology of serious eye injuries from the United States Eye Injury Registry. Graefes Arch Clin Exp Ophthalmol 2000; 238 (2) 153-157
    CrossrefPubMedGoogle Scholar
  • 4 Kuhn F, Maisiak R, Mann L, Mester V, Morris R, Witherspoon CD. The ocular trauma score (OTS). Ophthalmol Clin North Am 2002; 15 (2) 163-165 , vi
    CrossrefPubMedGoogle Scholar
  • 5 Kuhn F, Morris R, Witherspoon CD, Mester V. The Birmingham Eye Trauma Terminology system (BETT). J Fr Ophtalmol 2004; 27 (2) 206-210
    CrossrefPubMedGoogle Scholar
  • 6 Herr RD, White Jr GL, Bernhisel K, Mamalis N, Swanson E. Clinical comparison of ocular irrigation fluids following chemical injury. Am J Emerg Med 1991; 9 (3) 228-231
    CrossrefPubMedGoogle Scholar
  • 7 Kompa S, Redbrake C, Hilgers C, Wüstemeyer H, Schrage N, Remky A. Effect of different irrigating solutions on aqueous humour pH changes, intraocular pressure and histological findings after induced alkali burns. Acta Ophthalmol Scand 2005; 83 (4) 467-470
    CrossrefPubMedGoogle Scholar
  • 8 Brucoli M, Arcuri F, Giarda M, Benech R, Benech A. Surgical management of posttraumatic intraorbital hematoma. J Craniofac Surg 2012; 23 (1) e58-e61
    CrossrefPubMedGoogle Scholar
  • 9 Teng CC, Reddy S, Wong JJ, Lisman RD. Retrobulbar hemorrhage nine days after cosmetic blepharoplasty resulting in permanent visual loss. Ophthal Plast Reconstr Surg 2006; 22 (5) 388-389
    CrossrefPubMedGoogle Scholar
  • 10 Mejia JD, Egro FM, Nahai F. Visual loss after blepharoplasty: incidence, management, and preventive measures. Aesthet Surg J 2011; 31 (1) 21-29
    CrossrefPubMedGoogle Scholar
  • 11 Sun MT, Chan WO, Selva D. Traumatic orbital compartment syndrome: importance of the lateral canthomy and cantholysis. Emerg Med Australas 2014; 26 (3) 274-278
    CrossrefPubMedGoogle Scholar
  • 12 Rowh AD, Ufberg JW, Chan TC, Vilke GM, Harrigan RA. Lateral canthotomy and cantholysis: emergency management of orbital compartment syndrome. J Emerg Med 2015; 48 (3) 325-330
    CrossrefPubMedGoogle Scholar
  • 13 Yung CW, Moorthy RS, Lindley D, Ringle M, Nunery WR. Efficacy of lateral canthotomy and cantholysis in orbital hemorrhage. Ophthal Plast Reconstr Surg 1994; 10 (2) 137-141
    CrossrefPubMedGoogle Scholar
  • 14 Haubner F, Jägle H, Nunes DP , et al. Orbital compartment: effects of emergent canthotomy and cantholysis. Eur Arch Otorhinolaryngol 2015; 272 (2) 479-483
    CrossrefPubMedGoogle Scholar
  • 15 Feng K, Wang CG, Hu YT , et al. Clinical features and prognosis of eyeball rupture: eye injury vitrectomy study. Clin Experiment Ophthalmol 2015;
    PubMedGoogle Scholar
  • 16 Agrawal R, Wei HS, Teoh S. Predictive factors for final outcome of severely traumatized eyes with no light perception. BMC Ophthalmol 2012; 12: 16
    CrossrefPubMedGoogle Scholar
  • 17 Savar A, Andreoli MT, Kloek CE, Andreoli CM. Enucleation for open globe injury. Am J Ophthalmol 2009; 147 (4) 595-600.e1
    CrossrefPubMedGoogle Scholar
  • 18 Manandhar A. Sympathetic ophthalmia: enucleation or evisceration?. Nepal J Ophthalmol 2011; 3 (2) 181-187
    CrossrefPubMedGoogle Scholar
  • 19 du Toit N, Motala MI, Richards J, Murray AD, Maitra S. The risk of sympathetic ophthalmia following evisceration for penetrating eye injuries at Groote Schuur Hospital. Br J Ophthalmol 2008; 92 (1) 61-63
    CrossrefPubMedGoogle Scholar
  • 20 Colyer MH, Weber ED, Weichel ED , et al. Delayed intraocular foreign body removal without endophthalmitis during Operations Iraqi Freedom and Enduring Freedom. Ophthalmology 2007; 114 (8) 1439-1447
    CrossrefPubMedGoogle Scholar
  • 21 Lipke KJ. Possibilities in the surgical management of eyelid trauma [in German]. HNO 2011; 59 (8) 783-790
    CrossrefPubMedGoogle Scholar
  • 22 Collin JR. Immediate management of lid lacerations. Trans Ophthalmol Soc UK 1982; 102 (Pt 2) 214-215
    PubMedGoogle Scholar
  • 23 Fanta H. Injuries of the lids [in German]. Klin Monatsbl Augenheilkd 1968; 153 (2) 163-169
    PubMedGoogle Scholar