A 24-month review of globe rupture in a tertiary referral hospital

Abstract

Background

Globe rupture is a full thickness penetration of the ocular wall. It is a sight-threatening injury and requires emergent ophthalmic management. Prognosis for vision is dependent on the nature of the rupture, as well as clinical and intraoperative exam findings.

Aims

To identify the outcomes of globe rupture in the University Hospital Galway, a tertiary ophthalmic surgery referral unit, over a 24-month period.

Methods

A retrospective review in all cases of globe rupture was undertaken. The nature of the injury, vision, and exam findings at presentation, and intraoperative findings were recorded. Outcomes included vision at most recent follow-up, the development of complications, and the need for further surgery.

Results

A total of 12 cases were identified: 9 blunt injuries (assault, mechanical fall, workplace accident, self-inflicted) and 3 due to penetration with a sharp object (glass fragment, hammering). Globe rupture was almost twice as common in males under 40 years of age, compared with all patients over 40. All eyes with perception of light vision or less at presentation developed phthisis. Further surgery was required in a minority of cases.

Conclusions

Globe rupture after a mechanical fall was most common in the over-75 age group. Globe rupture from assault, followed by workplace injury, was the most common injury in young males under 40. In an Irish setting, this represents a change in the aetiology of globe ruptures in young males compared with rates reported 20 years ago when workplace injuries were more common. The preventable nature of these injuries is highlighted.

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References

  1. 1.

    Mulvihill A, Eustace P (2000) The pattern of perforating eye injuries in Ireland. Ir J Med Sci 169(1):47–49

    CAS  Article  Google Scholar 

  2. 2.

    Hassett PD, Kelleher CC (1994) The epidemiology of occupational penetrating eye injuries in Ireland. Occup Med (Lond) 44(4):209–211

    CAS  Article  Google Scholar 

  3. 3.

    Negrel AD, Thylefors B (1998) The global impact of eye injuries. Ophthalmic Epidemiol 5(3):143–169

    CAS  Article  Google Scholar 

  4. 4.

    Munier A, Gunning T, Kenny D, O'Keefe M (1998) Causes of blindness in the adult population of the Republic of Ireland. Br J Ophthalmol 82(6):630–633

    CAS  Article  Google Scholar 

  5. 5.

    Viestenz A, Schrader W, Kuchle M, Walter S, Behrens-Baumann W (2008) Management of a ruptured globe. Ophthalmologe 105(12):1163–1174; quiz 1175. https://doi.org/10.1007/s00347-008-1815-y

    CAS  Article  PubMed  Google Scholar 

  6. 6.

    Koo L, Kapadia MK, Singh RP, Sheridan R, Hatton MP (2005) Gender differences in etiology and outcome of open globe injuries. J Trauma 59(1):175–178

    Article  Google Scholar 

  7. 7.

    Yucel OE, Demir S, Niyaz L, Sayin O, Gul A, Ariturk N (2016) Clinical characteristics and prognostic factors of scleral rupture due to blunt ocular trauma. Eye (Lond) 30(12):1606–1613. https://doi.org/10.1038/eye.2016.194

    CAS  Article  Google Scholar 

  8. 8.

    Jian-Wei L, Zhen-Bo H, Shu-Na W, Yu-Guang Z, Ai-Jun D (2015) The clinical characteristics of alcohol-related ocular rupture. Graefes Arch Clin Exp Ophthalmol 253(8):1307–1311. https://doi.org/10.1007/s00417-014-2809-x

    Article  PubMed  Google Scholar 

  9. 9.

    Rahman I, Maino A, Devadason D, Leatherbarrow B (2006) Open globe injuries: factors predictive of poor outcome. Eye (Lond) 20(12):1336–1341. https://doi.org/10.1038/sj.eye.6702099

    CAS  Article  Google Scholar 

  10. 10.

    Kuhn F, Maisiak R, Mann L, Mester V, Morris R, Witherspoon CD (2002) The Ocular Trauma Score (OTS). Ophthalmol Clin N Am 15(2):163–165 vi

    Article  Google Scholar 

  11. 11.

    Shah A, Blackhall K, Ker K, Patel D (2009) Educational interventions for the prevention of eye injuries. Cochrane Database Syst Rev (4):CD006527. doi:https://doi.org/10.1002/14651858.CD006527.pub3

  12. 12.

    Lipscomb HJ (2000) Effectiveness of interventions to prevent work-related eye injuries. Am J Prev Med 18(4 Suppl):27–32

    CAS  Article  Google Scholar 

  13. 13.

    Mancini G, Baldasseroni A, Laffi G, Curti S, Mattioli S, Violante FS (2005) Prevention of work related eye injuries: long term assessment of the effectiveness of a multicomponent intervention among metal workers. Occup Environ Med 62(12):830–835. https://doi.org/10.1136/oem.2004.019570

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  14. 14.

    Vieira ER, Palmer RC, Chaves PH (2016) Prevention of falls in older people living in the community. BMJ 353:i1419. https://doi.org/10.1136/bmj.i1419

    Article  PubMed  Google Scholar 

  15. 15.

    Feng K, Hu YT, Ma Z (2011) Prognostic indicators for no light perception after open-globe injury: eye injury vitrectomy study. Am J Ophthalmol 152(4):654–662 e652. https://doi.org/10.1016/j.ajo.2011.04.004

    Article  PubMed  Google Scholar 

  16. 16.

    Zhang Y, Zhang MN, Jiang CH, Yao Y, Zhang K (2010) Endophthalmitis following open globe injury. Br J Ophthalmol 94(1):111–114. https://doi.org/10.1136/bjo.2009.164913

    CAS  Article  PubMed  Google Scholar 

  17. 17.

    Beshay N, Keay L, Dunn H, Kamalden TA, Hoskin AK, Watson SL (2017) The epidemiology of open globe injuries presenting to a tertiary referral eye hospital in Australia. Injury 48(7):1348–1354. https://doi.org/10.1016/j.injury.2017.04.035

    Article  PubMed  Google Scholar 

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Correspondence to Emily Hughes.

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Hughes, E., Fahy, G. A 24-month review of globe rupture in a tertiary referral hospital. Ir J Med Sci 189, 723–726 (2020). https://doi.org/10.1007/s11845-019-02097-2

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Keywords

  • Globe rupture
  • Ophthalmic trauma