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Bale BI, Zeppieri M, Idogen OS, Okechukwu CI, Ojo OE, Femi DA, Lawal AA, Adedeji SJ, Manikavasagar P, Akingbola A, Aborode AT, Musa M. Seeing the unseen: The low treatment rate of eye emergencies in Africa. World J Methodol 2025; 15:102477. [DOI: 10.5662/wjm.v15.i3.102477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2024] [Revised: 01/11/2025] [Accepted: 01/21/2025] [Indexed: 03/06/2025] Open
Abstract
BACKGROUND Emergency medical care is essential in preventing morbidity and mortality, especially when interventions are time-sensitive and require immediate access to supplies and trained personnel.
AIM To assess the treatment rates of eye emergencies in Africa. Ocular emergencies are particularly delicate due to the eye’s intricate structure and the necessity for its refractive components to remain transparent.
METHODS This review examines the low treatment rates of eye emergencies in Africa, drawing on 96 records extracted from the PubMed database using predetermined search criteria.
RESULTS The epidemiology of ocular injuries, as detailed in the studies, reveals significant relationships between the incidence and prevalence of eye injuries and factors such as age, gender, and occupation. The causes of eye emergencies range from accidents to gender-based violence and insect or animal attacks. Management approaches reported in the review include both surgical and non-surgical interventions, from medication to evisceration or enucleation of the eye. Preventive measures emphasize eye health education and the use of protective eyewear and facial protection. However, inadequate healthcare infrastructure and personnel, cultural and geographical barriers, and socioeconomic and behavioral factors hinder the effective prevention, service uptake, and management of eye emergencies.
CONCLUSION The authors recommend developing eye health policies, enhancing community engagement, improving healthcare personnel training and retention, and increasing funding for eye care programs as solutions to address the low treatment rate of eye emergencies in Africa.
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Affiliation(s)
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
| | | | | | | | | | | | | | - Pirakalai Manikavasagar
- Public Health for Eye Care, London School for Hygiene and Tropical Medicine, London CB21TN, United Kingdom
| | - Adewunmi Akingbola
- Department of Public Health, University of Cambridge, Cambridge CB2 1TN, Cambridgeshire, United Kingdom
| | | | - Mutali Musa
- Department of Optometry, University of Benin, Benin 300283, Nigeria
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Khan MMH, Akhlaq A, Khan MJ, Ali M, Joseph E, Justin GA, Woreta F. Impact of social determinants of health on causes of ophthalmic trauma: A narrative review. Surv Ophthalmol 2025:S0039-6257(25)00091-8. [PMID: 40419165 DOI: 10.1016/j.survophthal.2025.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2024] [Revised: 05/13/2025] [Accepted: 05/19/2025] [Indexed: 05/28/2025]
Abstract
Ophthalmic trauma (OT) is a leading cause of monocular vision loss that preferentially affects certain populations. In this narrative review, we aim to discuss the impact of social determinants of health (SDOH) on the prevalence and outcomes of OT. We conducted literature search to identify studies published between 2019 and 2024 that discuss the impact of SDOH on OT. A total of 92 studies were included. Overall, males, particularly those of younger and working age groups, are most commonly affected with OT, with assault, firearm, and occupation-related injuries being most common types of injuries encountered. In comparison, falls and intimate partner violence are the most common causes in women. Children are more prone to toys, sports, and firework-related injuries, while falls represent the leading cause in the elderly frequently resulting in open globe injury. Black and Hispanic individuals suffer disproportionately from assault and firearm-related injuries. Unemployed individuals and those of rural residence and low socioeconomic status have higher rates of OT. Our review underscores the impact of demographic, social, and economic factors on the risk and outcomes of OT and its subtypes. Only by understanding the patterns, targeted interventions and policy changes can be undertaken to address these disparities.
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Affiliation(s)
| | - Anam Akhlaq
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA.
| | - Muhammad Jehanzeb Khan
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA.
| | - Muhammad Ali
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA.
| | - Emily Joseph
- Informationist Services, Welch Medical Library, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA.
| | - Grant A Justin
- Department of Ophthalmology, Walter Reed National Medical Center, 8901 Rockville Pike, Bethesda, MD 20889, USA.
| | - Fasika Woreta
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA.
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Nygaard J, Hoggard C, Centner A, Amin S, Den Beste K. Open Globe Injuries in the United States: Analysis of National Trauma Data. Ophthalmic Epidemiol 2025:1-9. [PMID: 40025628 DOI: 10.1080/09286586.2025.2473721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 08/29/2024] [Accepted: 02/24/2025] [Indexed: 03/04/2025]
Abstract
PURPOSE Open Globe Injuries are one of the leading causes of preventable, trauma-related blindness. There is some literature studying the effects of demographic factors as they relate to hospital outcomes. This study characterises trends of Open Globe Injury (OGI) and hospital outcomes based on demographic information utilising the National Trauma Data Bank (NTDB). METHODS Using Python programming software, the NTDB was queried for International Classification of Diseases 9th Revision diagnosis codes related to OGI based on the Birmingham Eye Trauma Terminology system. Descriptive statistics were calculated utilising chi-square tests, multivariable adjusted logistic regressions, and ANOVA to process adjusted odds ratio (OR) and means of comparison groups. RESULTS The final analysis included 21,481 patients. Mean age of OGI was lower for Black (40.01 [40.53-41.49]), American Indian (39.08 [37.15-41.00]), and Hispanic (38.24 [37.70-38.77]) populations. OR for Black patients was lower for work-related OGI (0.36 [0.30-0.44]), but higher for drug-positive OGI (1.51 [1.35-1.69]). Black and American Indian patients had increased odds for assault-related injuries and decreased odds for accident-related injuries. Race and ethnicity had little to no effect on mortality, or discharge to home with service, ICU, or step-down unit. Mean age of fall on the same level injuries was (71.28 [70.49-72.07]); all other mechanisms of injury had a mean age < 42. CONCLUSIONS Our research offers a unique perspective on OGI utilising the NTDB. The trends identify at-risk populations not previously reported and suggests potential racial effects of public safety, work safety and precautions for open globe injuries.
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Affiliation(s)
- Joseph Nygaard
- Department of Medical Education, University of Central Florida College of Medicine, Orlando, Florida, USA
| | - Collin Hoggard
- Department of Medical Education, University of Central Florida College of Medicine, Orlando, Florida, USA
| | - Aliya Centner
- Department of Medical Education, University of Central Florida College of Medicine, Orlando, Florida, USA
| | - Sarina Amin
- Department of Ophthalmology, University of Central Florida College of Medicine, Orlando, Florida, USA
| | - Kyle Den Beste
- Department of Ophthalmology, University of Central Florida College of Medicine, Orlando, Florida, USA
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Mir A, Baseri MM, Farmanfarma KK. Factors affecting ocular trauma in Iran: A systematic review study. Health Sci Rep 2024; 7:e2281. [PMID: 39221056 PMCID: PMC11362837 DOI: 10.1002/hsr2.2281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 05/15/2024] [Accepted: 06/26/2024] [Indexed: 09/04/2024] Open
Abstract
Background and Aims Ocular trauma (OT) is a a major cause of ocular morbidity and blindness. This study was systematically conducted to determine the factors contributing to OT in Iran. Methods In this study, a systematic review of all published articles in Persian and English languages from 2000 to 2023 was conducted to investigate the factors affecting OT in Iran. The included studies encompassed cross-sectional, cohort, and case-control designs. Articles were selected from internationally recognized databases, including PubMed, Web of Science, Scopus, and Google Scholar, as well as Persian databases such as SID and Magiran. The search strategy involved using keywords aligned with the (MeSH) terms, such as "oculars," "trauma," and "Iran." Initially, 403 articles were identified, and ultimately, 14 articles met the inclusion criteria. To ensure the prevention of bias and assess the quality of the selected articles, the Newcastle-Ottawa Scale was utilized. Result In the present study, the majority of individuals in the reviewed articles were categorized as having mild eye injuries (13.8%). A higher percentage of injuries was observed in males compared to females, and a higher prevalence of injuries was also observed in the age group of over 30 years compared to other age groups. Among the mechanical causes, sharp trauma had the highest prevalence rate (72.5%), while falls had the lowest prevalence rate (14%), followed by sport-related injuries (29%). Non-mechanical injuries were mentioned in only one article and had a prevalence rate of 1.5. Conclusion The results of the current research have shown that among the mechanical injuries, accidents involving motorcycles and sharp objects are the leading causes of OT in Iranians. Therefore, the use of protective equipment such as goggles and adherence to traffic laws play a particularly important role, especially in men higher the age of 30. These findings highlight the necessity for targeted educational and preventive measures to reduce OT in Iran.
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Affiliation(s)
- Atefeh Mir
- Department of Nursing, Clinical Research Center of Sabzevar Vasei HospitalSabzevar University of Medical SciencesSabzevarIran
| | - Maryam Moradi Baseri
- Department of Enviromental HealthPars Hospital Shiraz University of Medical SciencesShirazIran
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Farag AA, Amer AAA, Bayomy HE, Youssef GH, Hassan NH, Ismail NS, Anwer OM, Elroby FA. Pattern of eye trauma among pediatric ophthalmic patients in upper and lower Egypt: A prospective two-center medicolegal study. J Public Health Res 2024; 13:22799036241278474. [PMID: 39324119 PMCID: PMC11423364 DOI: 10.1177/22799036241278474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 08/12/2024] [Indexed: 09/27/2024] Open
Abstract
Background Ocular trauma is the leading cause of monocular blindness in children. This study aimed to identify and compare pediatric ocular injuries at two national university hospitals: Benha University Hospital (BUH) and South Valley University Hospital (SVUH) while evaluating the predictive utility of the Ocular Trauma Score (OTS) for post-traumatic permanent visual infirmity. Design and methods This multicenter observational study enrolled children under 18 years at BUH and SVUH Ophthalmology Departments from May 31 to December 31, 2022. Comprehensive medical histories and detailed data on eye trauma were obtained, with each undergoing thorough eye examinations at the initial presentation and during the 6-month follow-up period. The final visual outcome was permanent visual infirmity that was defined as the Best Corrected Visual Acuity in the better eye worse than 3/60 or near vision worse than N6 according to the International Classification of Diseases 11. Results The study included 120 cases evenly distributed between the two hospitals, with a mean age of 10.03 (±3.30) years, 74.17% male and 51.67% urban residents. Blunt, sharp, and foreign objects were the most common causes (39.17%, 33.33%, and 11.67%, respectively). Closed-globe injuries prevailed at BUH (83.33%) than SVUH (40.0%). Most injuries were accidental and outdoors, with an average interval of 9.93 (±23.57) hours to seek medical care. Lack of education, open-globe injuries, poor initial visual acuity, longer intervals from admission to intervention, and lower OTS were associated with visual impairment.
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Affiliation(s)
- Amina A Farag
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Benha University, Benha, Egypt
| | - Ahmed Ali Ahmed Amer
- Department of Ophthalmology, Qena Faculty of Medicine, South Valley University, Qena, Egypt
| | - Hanaa E Bayomy
- Department of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Benha University, Benha, Egypt, and the Department of Family and Community Medicine, Faculty of Medicine, Northern Border University, Arar, Saudi Arabia
| | - Gehad H Youssef
- Department of Ophthalmology, Faculty of Medicine, Benha University, Benha, Egypt
| | - Nader Hf Hassan
- Department of Ophthalmology, Faculty of Medicine, Benha University, Benha, Egypt
| | - Nesma S Ismail
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Benha University, Benha, Egypt
| | - Omnia M Anwer
- Department of Community, Environmental, and Occupational Medicine, Benha Faculty of Medicine, Benha University, Benha, Egypt
| | - Fadwa A Elroby
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
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Ramachandran S, Chavan K, Padhi TR, Takkar B, Karande S, Kelgaonkar A, Panda KG, Padhy SK. Central retinal artery occlusion following pediatric blunt ocular trauma. Indian J Ophthalmol 2023; 71:3626-3632. [PMID: 37991294 PMCID: PMC10788753 DOI: 10.4103/ijo.ijo_3337_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 06/27/2023] [Accepted: 07/07/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND To analyze the clinical profile, presentation, possible pathophysiology, and outcomes of central retinal artery occlusion (CRAO) following blunt trauma in pediatric subjects. METHODOLOGY The medical charts of subjects aged 18 years or less with a diagnosis of CRAO following blunt ocular trauma were analyzed retrospectively for demography, details of the trauma, ocular findings, additional imaging reports if any, and final outcome. A Medline search was done (key words like central retinal artery occlusion, blunt trauma, children, pediatric subjects, and adolescents) to gather information available in the literature on the subject. RESULTS A total of 11 patients (11 eyes), mean age of 14.3 ± 3.4 years, and 100% male preponderance, with an average time duration from trauma to presentation to the hospital of 8.1 days were included. Visual acuity ranged from no light perception (four eyes) to finger count at a 1 m distance. Intraocular pressure was raised in three patients, of which two were suffering from sickle cell disease. In two eyes, the CRAO coexisted with optic nerve avulsion and the cilioretinal artery was spared. Disk pallor was seen in six eyes as early as 12 days from the trauma. None of the cases revealed any bony fracture in the CT scan. CONCLUSION CRAO was observed to be an important primary or contributory cause of visual loss in children following blunt trauma, reflex vasospasm being the most common etiology. Early onset disk pallor could suggest an underlying vascular compromise of both retinal and optic disk circulation in addition to direct disk damage.
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Affiliation(s)
- Sivaranjan Ramachandran
- Vitreoretina Services, Anant Bajaj Retina Institute, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Kasturi Chavan
- Vitreoretina Services, Anant Bajaj Retina Institute, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Tapas R Padhi
- Vitreoretina Services, Anant Bajaj Retina Institute, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Brijesh Takkar
- Vitreoretina Services, Anant Bajaj Retina Institute, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sayali Karande
- Vitreoretina Services, Anant Bajaj Retina Institute, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Anup Kelgaonkar
- Vitreoretina Services, Anant Bajaj Retina Institute, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Krushna G Panda
- Vitreoretina Services, Anant Bajaj Retina Institute, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Srikanta K Padhy
- Vitreoretina Services, Anant Bajaj Retina Institute, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
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Basnet A, Dhakal G, Ghising K, Pathak SB, Shrestha T. Ocular Trauma among Patients Visiting the Outpatient Department of Ophthalmology in a Tertiary Care Centre. JNMA J Nepal Med Assoc 2023; 61:907-910. [PMID: 38289755 PMCID: PMC10792712 DOI: 10.31729/jnma.8368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction Ocular trauma is an important cause of blindness and ocular morbidity worldwide. Knowledge of the cause of eye injuries can guide preventive strategies and optimize management capacity. The aim of the study was to find out the prevalence of ocular trauma among patients visiting the outpatient Department of Ophthalmology in a tertiary care centre. Methods A descriptive cross-sectional study was conducted among patients with ocular trauma from 10 January 2023 to 5 July 2023 after obtaining ethical approval from the Institutional Review Committee. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results Among 4,959 patients, 107 (2.16%) (1.76-2.56, 95% Confidence Interval) had ocular trauma. Among them, 24 (22.43%) had occular trauma due to fall injuries. Ocular trauma was observed in 82 (76.64%) males and the common agent was blunt objects seen in 56 (52.34%). Conclusions The prevalence of ocular trauma among patients was lower than in other studies done in similar settings. Keywords blunt injuries; injury; ophthalmology; prevalence.
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Affiliation(s)
- Anjila Basnet
- Department of Ophthalmology, KIST Medical College and Teaching Hospital, Mahalaxmi, Lalitpur, Nepal
| | - Grish Dhakal
- KIST Medical College and Teaching Hospital, Mahalaxmi, Lalitpur, Nepal
| | - Kiran Ghising
- KIST Medical College and Teaching Hospital, Mahalaxmi, Lalitpur, Nepal
| | | | - Trishna Shrestha
- Department of General Practice and Emergency Medicine, KIST Medical College and Teaching Hospital, Mahalaxmi, Lalitpur, Nepal
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Mishra K, Roybal CN, Mahajan VB. Simultaneous Bilateral Open-Globe Repair and Vitreoretinal Surgery for Explosive-Related Ocular Injury. JOURNAL OF VITREORETINAL DISEASES 2023; 7:540-544. [PMID: 37974922 PMCID: PMC10649449 DOI: 10.1177/24741264231202073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Purpose: To report an approach to explosive injuries with simultaneous, co-surgeon bilateral ruptured globe repair and pars plana vitrectomy for bilateral intraocular foreign bodies (IOFBs). Methods: A case and its findings were analyzed. Results: A 31-year-old man had bilateral vision loss after an air compressor malfunction that caused a high-pressure explosion to his face. An examination showed bilateral open-globe injuries and IOFBs, necessitating urgent repair. Given the risk for endophthalmitis and the need for expeditious repair, open-globe repair surgery was performed in both eyes simultaneously by co-surgeons followed by pars plana lensectomy, vitrectomy with IOFB removal, and silicone oil placement. The final visual acuity after bilateral scleral-fixated intraocular lens implantation was 20/20 OD and 20/25 OS. Conclusions: This case of bilateral open-globe injuries and IOFBs required expeditious repair with bilateral, simultaneous surgery that ultimately resulted in excellent visual outcomes. Simultaneous surgery may be an option for bilateral ocular trauma.
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Affiliation(s)
- Kapil Mishra
- Molecular Surgery Laboratory, Byers Eye Institute, Stanford University, Palo Alto, CA, USA
| | - C. Nathaniel Roybal
- Eye Associates of New Mexico, Albuquerque, NM, USA
- Department of Surgery, University of New Mexico, Albuquerque, NM, USA
| | - Vinit B. Mahajan
- Molecular Surgery Laboratory, Byers Eye Institute, Stanford University, Palo Alto, CA, USA
- Veterans Administration Palo Alto Health Campus, Palo Alto, CA, USA
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Ashenef B, Diress M, Yeshaw Y, Dagnew B, Gela YY, Akalu Y, Abdurahman A, Abebaw K. Visual Impairment and Its Associated Factors Among Hypertensive Patients in Amhara Region Referral Hospitals, Ethiopia. Clin Ophthalmol 2023; 17:3149-3161. [PMID: 37881781 PMCID: PMC10597370 DOI: 10.2147/opth.s408171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/04/2023] [Indexed: 10/27/2023] Open
Abstract
Background Visual impairment is one of the most common long-term effects of high blood pressure. It affects one's quality of life, independence, and mobility. There is a paucity of information regarding the prevalence of visual impairment due to hypertension in Ethiopia. Therefore, this study aimed to determine the prevalence of visual impairment and its associated factors among hypertensive patients in referral hospitals of the Amhara region, Ethiopia, 2021. Methods An institution-based cross-sectional study was conducted among 423 study participants, which were selected by systematic random sampling technique. Data were collected by using an interviewer-administered structured questionnaire and physical measurements. The collected data were entered into Epi-data version 4.6. Then, exported into SPSS Version 26 for analysis. The crude and adjusted odds ratios and 95% Confidence intervals were calculated. Both bivariable and multivariable logistic regression analyses were done. Variables with a p-value of ≤0.05 were stated as significantly associated with visual impairment. Results The overall prevalence of visual impairment among hypertensive patients was 32.4% (95% CI: 27.9-37.9). Duration of hypertension ≥ 5 years (AOR =3.06, 95% CI: 1.86-4.95), history of ocular trauma (AOR =2.50, 95% CI: 1.3-4.73), and ever alcohol drinking (AOR = 2.72, 95% CI: 1.32-5.62) were significantly associated with visual impairment. Conclusion Nearly one-third of hypertensive patients were visually impaired from the study participants. Duration of hypertension ≥5 years, history of ocular trauma, and ever alcohol drinking was significantly associated with visual impairment among hypertensive patients. Therefore, in addition to providing medical care and follow-up services for hypertension patients, health education is needed for early and proper management of visual impairment, and to decrease their level of alcohol consumption. Furthermore, better to do this study by prospective cohort study design to identify cause-and-effect relationships.
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Affiliation(s)
- Baye Ashenef
- Department of Human Physiology, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Mengistie Diress
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Yigizie Yeshaw
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Baye Dagnew
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Yibeltal Yismaw Gela
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Yonas Akalu
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Abdulhenan Abdurahman
- Department of Human Physiology, School of Medicine, Madda Walabu University, Bale Goba, Ethiopia
| | - Kassa Abebaw
- Department of Human Physiology, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
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Arora A, Priyadarshini SR, Das S, Mohanty A, Shanbhag SS, Sahu SK. Carbide Gun-Related Ocular Injuries: A Case Series. Cornea 2023; 42:726-730. [PMID: 35867658 DOI: 10.1097/ico.0000000000003095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 05/23/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to report a case series of sight-threatening ocular injuries caused by calcium carbide guns used as fire crackers. METHODS Medical records of 15 eyes of 14 patients with ocular injuries caused while using carbide guns, visiting the Institute, from January 2021 to January 2022, were retrospectively reviewed. The collected data included patients' demography (age, sex), presenting ophthalmic features, management, and outcome. Grade I and II ocular injuries were managed medically. All grade III-V injuries were managed using Amniotic Membrane Transplantation. RESULTS All patients were male. The mean age of the patients was 23.57 ± 11.76 years. According to the Dua classification, 5 eyes (33.3%) had Grade I-II ocular surface burns, 3 eyes (20%) had grade III burns, and 7 eyes (46.6%) had grade IV-VI burns. Presenting visual acuity ranged between hand movements to 20/50, and in 6 eyes (40%), the visual acuity was ≤20/200. Five eyes were managed medically alone, and 10 (66.6%) eyes needed surgical intervention (Amniotic Membrane Transplantation). After a mean follow-up of 14.23 ± 11.92 weeks, complete epithelization was seen in 10 eyes (66.6%). Partial limbal stem cell deficiency and its sequelae such as conjunctivalization of the cornea were noted in 7 eyes (46.6%). CONCLUSIONS Calcium carbide-related ocular injuries can result in corneal blindness secondary to limbal stem cell deficiency in young individuals. Loss of vision in this age group can lead to loss of economic productivity and cosmetic disfigurement. More advocacy efforts are thus needed to prevent these injuries.
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Affiliation(s)
- Anchal Arora
- Cornea and Anterior Segment Services, Mithu Tulsi Chanrai Campus, LV Prasad Eye Institute, Bhubaneshwar; and
| | - Smruti Rekha Priyadarshini
- Cornea and Anterior Segment Services, Mithu Tulsi Chanrai Campus, LV Prasad Eye Institute, Bhubaneshwar; and
| | - Sujata Das
- Cornea and Anterior Segment Services, Mithu Tulsi Chanrai Campus, LV Prasad Eye Institute, Bhubaneshwar; and
| | - Amrita Mohanty
- Cornea and Anterior Segment Services, Mithu Tulsi Chanrai Campus, LV Prasad Eye Institute, Bhubaneshwar; and
| | - Swapna S Shanbhag
- Cornea and Anterior Segment Services, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad.Funded by the Hyderabad Eye Research Foundation
| | - Srikant Kumar Sahu
- Cornea and Anterior Segment Services, Mithu Tulsi Chanrai Campus, LV Prasad Eye Institute, Bhubaneshwar; and
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Nowomiejska K, Adamczyk K, Haszcz D, Preys N, Rejdak R. Case report: Bilateral eye injuries in members of one family due to a cluster munition in Ukraine. Front Med (Lausanne) 2023; 10:1171954. [PMID: 37275384 PMCID: PMC10232851 DOI: 10.3389/fmed.2023.1171954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/24/2023] [Indexed: 06/07/2023] Open
Abstract
The aim of the study was to report the effects of surgical treatment of three victims of a cluster munition in Ukraine. A 32-year-old woman and her sons-6-year-old male twins-presented in Poland after 18 days of delay in treatment. All ocular injuries were bilateral. One of the boys presented with total retinal detachment and a post-traumatic cataract as well as corneal sutures in one eye and a post-traumatic cataract in the other eye. The other boy had already developed atrophy in one eye and a vitreous hemorrhage in the other eye. The woman suffered from bilateral post-traumatic cataract with multiple glass intraocular foreign bodies (IOFBs). The surgical treatment included cataract surgery with intraocular lens implantation in three eyes, removal of IOFBs in one eye, and enucleation of the atrophic eye with implantation of an ocular prosthesis preventing constriction of face tissues. The eye with retinal detachment underwent pars plana vitrectomy, and the vitreous hemorrhage resolved itself. Postoperatively, visual acuity improved significantly in four of six eyes. Only in the eye with an open-globe injury and persistent retinal detachment, the final visual acuity was still poor. In conclusion, cluster munition may lead to bilateral ocular trauma with IOFBs, open-and close-globe injuries, and severe vision loss if left untreated. Modern ophthalmic surgery leads to vision with IOL improvement and solving the eyes after severe combat injury.
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Affiliation(s)
- Katarzyna Nowomiejska
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, Lublin, Poland
| | - Katarzyna Adamczyk
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, Lublin, Poland
| | - Dariusz Haszcz
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, Lublin, Poland
| | | | - Robert Rejdak
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, Lublin, Poland
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Explosive eye injuries: characteristics, traumatic mechanisms, and prognostic factors for poor visual outcomes. Mil Med Res 2023; 10:3. [PMID: 36631894 PMCID: PMC9835351 DOI: 10.1186/s40779-022-00438-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 12/21/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Explosions can produce blast waves, high-speed medium, thermal radiation, and chemical spatter, leading to complex and compound eye injuries. However, few studies have comprehensively investigated the clinical features of different eye injury types or possible risk factors for poor prognosis. METHODS We retrospectively reviewed all consecutive records of explosive eye injuries (1449 eyes in 1115 inpatients) in 14 tertiary referral hospitals in China over 12 years (between January 2008 and December 2019). Data on demographics, eye injury types, ocular findings, treatments, and factors affecting visual prognosis were extracted from a standardized database of eye injuries and statistically analyzed. RESULTS Mechanical ocular trauma accounted for 94.00% of explosion-related eye injuries, among which intraocular foreign bodies (IOFBs) resulted in 55.17% of open globe injuries (OGIs) and contusion caused 60.22% of close globe injuries (CGIs). Proliferative vitreous retinopathy (PVR) was more common in perforating (47.06%) and IOFB (26.84%) than in penetrating (8.79%) injuries, and more common with laceration (24.25%) than rupture (9.22%, P < 0.01). However, no difference was observed between rupture and contusion. Ultimately, 9.59% of eyes were removed and the final vision was ≤ 4/200 in 45.82% of patients. Poor presenting vision [odds ratio (OR) = 5.789], full-thickness laceration of the eyeball ≥ 5 mm (OR = 3.665), vitreous hemorrhage (OR = 3.474), IOFB (OR = 3.510), non-mechanical eye injury (NMEI, OR = 2.622, P < 0.001), rupture (OR = 2.362), traumatic optic neuropathy (OR = 2.102), retinal detachment (RD, OR = 2.033), endophthalmitis (OR = 3.281, P < 0.01), contusion (OR = 1.679), ciliary body detachment (OR = 6.592), zone III OGI (OR = 1.940), and PVR (OR = 1.615, P < 0.05) were significant negative predictors for poor visual outcomes. CONCLUSIONS Explosion ocular trauma has complex mechanisms, with multiple eyes involved and poor prognosis. In lethal level I explosion injuries, eyeball rupture is a serious condition, whereas contusion is more likely to improve. In level II injuries, IOFBs are more harmful than penetrating injuries, and level IV represents burn-related eye injuries. PVR is more associated with penetrating mechanisms than with OGI. Identifying the risk predictors for visual prognosis can guide clinicians in the evaluation and treatment of ocular blast injuries.
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The Predictive Value of Computed Tomography Findings for Poor Visual Outcome in Traumatic Eye Injury. J Ophthalmol 2022; 2022:4995185. [PMID: 36091574 PMCID: PMC9458393 DOI: 10.1155/2022/4995185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/15/2022] [Accepted: 07/28/2022] [Indexed: 11/17/2022] Open
Abstract
Background. The prognosis of visual outcome is important for patients and healthcare providers and guides proper decision-making in traumatic eye injury. In this study, we have evaluated the predictive value of computed tomography (CT) scan findings for poor visual outcomes in patients with traumatic eye injuries. Methods. In a retrospective survey, documents of 200 patients with traumatic eye injury who underwent a diagnostic orbital CT scan were reviewed. Disorganized or collapsed globe, intraocular foreign body or gas, increased or decreased anterior chamber size, hemorrhage in the anterior or posterior chamber, crystalline or intraocular lens dislocation, posterior sclera thickening, globe borders haziness, orbital fracture, orbital hemorrhage, and foreign body, optic canal, and optic nerve injuries are the diagnostic clues for eye injury in CT scan. The predictive value of CT scan findings for poor visual outcome was calculated by sensitivity, specificity, accuracy, predictive values, hazard ratios, and binary logistic regression model. Results. The sensitivity, specificity, accuracy, and positive predictive values showed to be high. However, there was a low negative predictive value of CT findings for the prediction of poor vision. Among the investigated factors, disorganized/collapsed globe (HR 47.72, CI 6.13–371.62), increased/decreased anterior chamber size (HR 5.04, CI 2.57–9.88), hemorrhage in anterior/posterior chamber (HR 3.58, CI 1.900–6.774/3.62, CI 1.90–6.89), globe borders haziness (HR 3.06, CI 1.33–7.01), orbital foreign body (HR 3.66, CI 1.11–12.05), and optic canal/nerve injury (HR 21.62, CI 4.73–98.78) reached the statistical significance for increasing the hazard ratio for poor visual outcome in patients with a traumatic eye injury. Logistic regression analysis showed only evidence for disorganized/collapsed globe and optic canal/nerve injury in orbital CT scan as independent predictive factors for poor visual outcome. Conclusion. CT scan findings can be used as prognostic factors for visual outcomes in patients with a traumatic eye injury.
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