Atlas of Ophthalmology

Work-related Open-globe Injury with a Rupture of the Crystalline Lens and an Intraocular Foreign Body (Colour Photography, cCT)

Cornea -> Trauma (Injury), Toxic Keratopathies, Radiation
Patient: 22 years of age, male, BCVA light perception. General Medical History: empty. Ocular Medical History: injury of the eye during work. Main complaint: sudden loss of vision and pain. Methods: Colour photography, cranial Computer Tomography. Findimgs: (1) Colour photography: Colour image reveals a corneal opening, a flat anterior chamber, an iris injury, and a rupture of the crystalline lens. (2) Cranial Computer Tomography: CCT showed an intraocular foreign body (arrow). Discussion: Work-related injuries can cause significant morbidity in a young population of patients. Occupational injuries are common. In 2004 in the United States there were 1.3 million injuries that resulted in at least 1 day of missed work. Of these work-related injuries, 36 680 involved the eye. The lifetime prevalence of work-related eye injuries among US workers is 4.4% (1). Bauza et al. (2) analyzed the clinical characteristics of a total of 183 eyes with work-related open globe injuries. He found that the majority of injuries occurred in men (96.7%), and the most common cause was nail gun use (47.0%). Intraocular foreign bodies were found in 21%. Presenting visual acuity (VA) was worse than 20/200 in 66% and no light perception in 6%. Final visual acuity worse than 20/200 occurred in 37%. Significant prognostic factors for a final visual acuity of no light perception were rupture injury, and initial visual acuity of no light perception. Literature: (1) K.Y.Z. Forrest, J.M. Cali. Epidemiology of lifetime work-related eye injuries in the U.S. population associated with one or more lost days of work. Ophthalmic Epidemiol, 16 (3) (2009), pp. 156–162 (2) Bauza, AM; Emami, P; Son, JH; Langer, P; Zarbin, M; Bhagat, N. Work-related open-globe injuries: demographics and clinical characteristics. Eur J Ophthalmol, vol. 23(2) pp. 242-8

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