Skip to main content

Controversies in Open Globe Injury Management

  • Chapter
  • First Online:
Management of Open Globe Injuries

Abstract

Every year, open globe injuries (OGIs) affect approximately 266,000 patients worldwide (Negrel and Thylefors B. Ophthalmic Epidemiol. 1998;5:143–69). The management of these patients remains controversial, particularly for the following areas: antibiotic prophylaxis for endophthalmitis, repair of posterior ruptures, injuries with lens disruption, repair of eyes with no light perception (NLP), and the risk for developing sympathetic ophthalmia. This chapter will review these controversial topics in the management of open globe injuries. We will first present an evidence based review of the current literature in this area, followed by an expert opinion by one of our editors.

Expert Opinions by: Christopher Andreoli, M.D., Michael Yoon, M.D., Lucia Sobrin, M.D., M.P.H., Alice Lorch M.D., Peter Veldman, M.D., Dean Eliott M.D.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Negrel AD, Thylefors B. The global impact of eye injuries. Ophthalmic Epidemiol. 1998;5:143–69.

    Article  CAS  PubMed  Google Scholar 

  2. Narang S, Gupta V, Gupta A, et al. Role of prophylactic intravitreal antibiotics in open globe injuries. Indian J Ophthalmol. 2003;51:39–44.

    PubMed  Google Scholar 

  3. Lorch A, Sobrin L. Prophylactic antibiotics in posttraumatic infectious endophthalmitis. Int Ophthalmol Clin. 2013;53:167–76.

    Article  PubMed  Google Scholar 

  4. Mieler WF, Ellis MK, Williams DF, et al. Retained intraocular foreign bodies and endophthalmitis. Ophthalmology. 1990;97:1532.

    Article  CAS  PubMed  Google Scholar 

  5. Banker TP, McClellan AJ, Wilson BD, et al. Culture-positive endophthalmitis after open globe injuries with and without retained intraocular foreign bodies. Ophthalmic Surg Lasers Imaging Retina. 2016;48(8):632–7.

    Article  Google Scholar 

  6. Chhabra S, Kunimoto DY, Kazi L, et al. Endophthalmitis after open globe injury: microbiologic spectrum and susceptibilities of isolates. Am J Ophthalmol. 2006;142:852–4.

    Article  PubMed  Google Scholar 

  7. Bhagat N, Nagori S, Zarbin M. Post-traumatic Infectious Endophthalmitis. Surv Ophthalmol. 2001;56:214–51.

    Article  Google Scholar 

  8. Soheilian M, Rafati N, Mohebbi MR, et al. Prophylaxis of acute posttraumatic bacterial endophthalmitis: a multicenter, randomized clinical trial of intraocular antibiotic injection, report 2. Arch Ophthalmol. 2007;125(4):460–5.

    Article  CAS  PubMed  Google Scholar 

  9. Andreoli CM, Andreoli MT, Kloek CE, et al. Low rate of endophthalmitis in a large series of open globe injuries. Am J Ophthalmol. 2009;147(4):601–8.

    Article  PubMed  Google Scholar 

  10. Tabatabaei SA, Soleimani M, Behrooz MJ, et al. Systemic oral antibiotics as a prophylactic measure to prevent endopthalmitis in patients with open globe injuries in comparison with intravenous antibiotics. Retina. 2016;36:360–5.

    Article  CAS  PubMed  Google Scholar 

  11. Du toit N, Mustak S, Cook C. Randomized controlled trial of prophylactic antibiotic treatment for the prevention of endophthalmitis after open globe injury at Groote Schuur Hospital. Br J Ophthalmol. 2017;101:862–7.

    Article  PubMed  Google Scholar 

  12. Saeed MU, Chang BY, Khandwala M, et al. Twenty year review of histopathological findings in enucleated/eviscerated eyes. J Clin Pathol. 2006;59(2):153–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Moshfeghi DM, Moshfeghi AA, Finger PT. Enucleation. Surv Ophthalmol. 2000;44:277–301.

    Article  CAS  PubMed  Google Scholar 

  14. Salehi-Had H, Andreoli CM, Andreoli MT, et al. Visual outcomes of vitreoretinal surgery in eyes with severe open-globe injury presenting with no-light-perception vision. Graefes Arch Clin Exp Ophthalmol. 2009;247:477–83.

    Article  PubMed  Google Scholar 

  15. Han YS, Kavoussi SC, Adelman RA. Visual recovery following open globe injury with initial no light perception. Clin Ophthalmol. 2015;9:1443–8.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Bhagat N, Turbin R, Langer P, et al. Approach to management of eyes with no light perception after open globe injury. J Ophthalmic Vis Res. 2016;11(3):313–8.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Savar A, Andreoli MT, Kloek CE, et al. Enucleation for open globe injury. Am J Ophthalmol. 2009;147:595–600.

    Article  PubMed  Google Scholar 

  18. McAlinden C, Saldanha M, Laws D. Evisceration for the management of ocular trauma. BMJ Case Rep. https://doi.org/10.1136/bcr-2013-201235.

  19. Zheng C, Wu AY. Enucleation versus evisceration in ocular trauma: a retrospective review and study of current literature. Orbit. 2013;32(6):356–61.

    Article  PubMed  Google Scholar 

  20. du Toit N, Motala MI, Richards J, et al. The risk of sympathetic ophthalmia following evisceration for penetrating eye injuries at Groote Schuur Hospital. Br J Ophthalmol. 2008;92:61–3.

    Article  PubMed  Google Scholar 

  21. O’Donnell BA, Kersten R, McNab A, et al. Enucleation versus evisceration. Clin Experiment Ophthalmol. 2005;33(1):5–9.

    Article  PubMed  Google Scholar 

  22. Nakra T, Simon GJ, Douglas RS, et al. Comparing outcomes of enucleation and evisceration. Ophthalmology. 2006;113(12):2270–5.

    Article  PubMed  Google Scholar 

  23. Tari AS, Malihi M, Kasaee A, et al. Enucleation with hydroxyapatite implantation versus evisceration plus scleral quadrisection and alloplastic implantation. Ophthal Plast Reconstr Surg. 2009;25(2):130–3.

    Article  PubMed  Google Scholar 

  24. Ababneh OH, AboTaleb EA, Abu Ameerh MA, et al. Enucleation and evisceration at a tertiary care hospital in a developing country. BMC Ophthalmol. 2015;15:120.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Frost WA. What is the best method of dealing with a lost eye? Br Med J. 1887;1(1378):1153–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Ruedemann AD Jr. Sympathetic ophthalmia after evisceration. Am J Ophthalmol. 1964;57:770–90.

    Article  PubMed  Google Scholar 

  27. Green WR, Maumenee AE, Sanders TE, et al. Sympathetic uveitis following evisceration. Trans Am Acad Ophthalmol Otolaryngol. 1972;76(3):625–44.

    PubMed  CAS  Google Scholar 

  28. Friedlin J, Pak J, Tessler HH, et al. Sympathetic ophthalmia after injury in the Iraq War. Ophthal Plast Reconstr Surg. 2006;22(2):133–4.

    Article  Google Scholar 

  29. Pieramici DJ, MacCumber MW, Humayun MU, et al. Open-globe injury. Update on types of injuries and visual results. Ophthalmology. 1996;103(11):1798–803.

    Article  CAS  PubMed  Google Scholar 

  30. Soni NG, Bauza AM, Son JH, et al. Open globe ocular trauma: functional outcome of eyes with no light perception at initial presentation. Retina. 2013;33(2):380–6.

    Article  PubMed  Google Scholar 

  31. Schmidt GW, Broman AT, Hindman HB. Vision survival after open globe injury predicted by classification and regression tree analysis. Ophthalmology. 2008;115(1):202–9.

    Article  CAS  PubMed  Google Scholar 

  32. Feng K, Hu YT, Ma Z. Prognostic indicators for no light perception after open-globe injury: eye injury vitrectomy study. Am J Ophthalmol. 2011;152(4):654–662.e2.

    Article  PubMed  Google Scholar 

  33. Agrawal R, Wei HS, Teoh S. Predictive factors for final outcome of severely traumatized eyes with no light perception. BMC Ophthalmol. 2012;12:16.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Chee YE, Kanoff JM, Eliott D. Remarkable visual recovery after severe open globe injury. Am J Ophthalmol Case Rep. 2016;3:34–5.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Kuhn F, Maisiak R, Mann L, et al. The Ocular Trauma Score (OTS). Ophthalmol Clin North Am. 2002;15(2):163–5.

    Article  PubMed  Google Scholar 

  36. Ye J, Lou L, Jin K, et al. Vision-related quality of life and appearance concerns are associated with anxiety and depression after eye enucleation: a cross-sectional study. PLoS One. 2015;10(8):e0136460.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Hope-Stone L, Brown SL, Heimann H, et al. Phantom eye syndrome: patient experiences after enucleation for uveal melanoma. Ophthalmology. 2015;122(8):1585–90.

    Article  PubMed  Google Scholar 

  38. Lubin JR, Albert DM, Weinstein M. Sixty-five years of sympathetic ophthalmia: a clinicopathologic review of 105 cases. Ophthalmology. 1980;87(2):109–21.

    Article  CAS  PubMed  Google Scholar 

  39. Cunningham ET, Kilmartin D, Agarwal M, Zierhut M. Sympathetic ophthalmia. Ocular Immun Inflamm. 2017;25(2):149–51.

    Article  Google Scholar 

  40. Castiblanco CP, Adelman RA. Sympathetic ophthalmia. Graefes Arch Clin Exp Ophthalmol. 2009;247:289–302.

    Article  PubMed  Google Scholar 

  41. Aziz HA, Flynn HW, Young RC. Sympathetic ophthalmia: clinicopathologic correlation in a consecutive case series. Retina. 2015;35(8):1696–703.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Dor L. La guérison des deux yeux dans l'ophtalmie sympathique. Arch d'Opht. 1931;48:811.

    Google Scholar 

  43. Fuchs A. Arch Oftal B. Aires. 1932;7:67.

    Google Scholar 

  44. Joy HH. A survey of cases of sympathetic ophthalmia occurring in New York State. Arch Ophthalmol. 1935;14(5):733–41.

    Article  Google Scholar 

  45. Irvine R. Sympathetic ophthalmia: a clinical review of 63 cases. Arch Ophthalmol. 1940;24:149–67.

    Article  Google Scholar 

  46. Stafford WR. Sympathetic ophthalmia. Report of a case occurring ten and one-half days after injury. Arch Ophthamol. 1965;74:521–4.

    Article  CAS  Google Scholar 

  47. Nettleship E. Trans Ophthal Soc UK. 1886;170.

    Google Scholar 

  48. Muga R, Maul E. The management of lens damage in perforating corneal lacerations. Br J Ophthalmol. 1978;62(11):784–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Assi A, Chacra CB, Cherfan G. Combined lensectomy, vitrectomy, and primary intraocular lens implantation in patients with traumatic eye injury. Int Ophthalmol. 2008;28(6):387–94.

    Article  PubMed  Google Scholar 

  50. Rubsamen PE, Irvin WD, McCuen BW, et al. Primary intraocular lens implantation in the setting of penetrating ocular trauma. Ophthalmology. 1995;102(1):101–7.

    Article  CAS  PubMed  Google Scholar 

  51. Hikichi T, Yoshida A, Hasegawa T, Ohnishi M, Sato T, Muraoka S. Wound healing of scleral self-sealing incision: a comparison of ultrasound biomicroscopy and histology findings. Graefes Arch Clin Exp Ophthalmol. 1998;236(10):775–8.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Tieger, M.G., Kloek, C., Lorch, A.C. (2018). Controversies in Open Globe Injury Management. In: Grob, S., Kloek, C. (eds) Management of Open Globe Injuries. Springer, Cham. https://doi.org/10.1007/978-3-319-72410-2_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-72410-2_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-72409-6

  • Online ISBN: 978-3-319-72410-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics