To report acute onset lens particle glaucoma associated with a spontaneous anterior capsular dehiscence. A 66-year-old man presented with spontaneous anterior lens capsule dehiscence with an acute onset of right eye pain that was associated with white particles in the anterior chamber angle and intraocular pressure (IOP) of 55 mmHg. No trauma or other inflammatory antecedents were reported. A hypermature cataract was observed at slit lamp exam. After medical treatment without IOP control, we performed extracapsular cataract extraction and anterior vitrectomy. Anterior chamber aspirate confirmed the presence of macrophages. The postoperative IOP at one month was 16 mmHg OD without medication. Spontaneous dehiscence of the anterior lens capsule in a patient with a hypermature cataract may release lens cortical material, resulting in lens particle glaucoma. Prompt surgical removal of the lens material usually controls the high IOP, and the need for additional glaucoma surgery is not common.
Aged ; Cataract ; Cataract Extraction ; Eye Injuries/*complications/surgery ; Glaucoma, Open-Angle/*diagnosis/*etiology/surgery ; Humans ; Male

We report a case of traumatic optic neuropathy accompanying a grease gun injury to the orbit. A 48-year-old man with a grease gun injury visited our clinic with decreased visual acuity, proptosis and limited extraocular movement (EOM). Orbital CT revealed a crescent mass of fat in the medial intraconal space. The grease was exuded from a lacerated conjunctival wound. The visual evoked potential (VEP) test demonstrated a decreased response in the left eye. Proptosis and EOM were improved after surgical removal of the grease. Systemic high-dose corticosteroid therapy was administered for suspected traumatic optic neuropathy, after which VEP nearly recovered, while visual acuity was slightly improved. A second surgery for traumatic cataract did not further improve visual acuity.
*Accidents, Occupational ; Evoked Potentials, Visual ; Eye Injuries, Penetrating/diagnosis/*surgery ; Humans ; *Lubricants ; Male ; Optic Nerve Injuries/diagnosis/*surgery ; Orbit/*injuries ; Visual Acuity

This case report describes a case of self-inflicted chronic bacterial keratoconjunctivitis involving the patient's own semen. A 20-year-old male soldier was referred to our clinic for the evaluation of refractory chronic bacterial conjunctivitis. Over the previous 4 months, he had been treated for copious mucous discharge, conjunctival injection, and superficial punctate keratitis in both eyes at an army hospital and a local eye clinic. Despite the use of topical and systemic antibiotics according to the results of conjunctival swab culture, there was no improvement. During the repeated smear and culture of conjunctival swabs, surprisingly, a few sperm were detected on Gram staining, revealing that the condition was self-inflicted bacterial keratoconjunctivitis involving the patient's own semen. Thus, in cases of chronic keratoconjunctivitis that do not respond to appropriate antibiotic treatment, self-inflicted disease or malingering should be considered.
Chronic Disease ; Conjunctiva/*injuries/microbiology/pathology ; Cornea/microbiology/*pathology ; Diagnosis, Differential ; Eye Infections, Bacterial/diagnosis/*etiology/microbiology ; Eye Injuries/*complications/diagnosis ; Humans ; Keratoconjunctivitis/diagnosis/*etiology/microbiology ; Male ; Self Mutilation/*complications/diagnosis ; *Semen ; Young Adult

OBJECTIVE: To discuss the characteristics and main problems of eye injuries in forensic identification. METHODS: Sixty cases of eye injury in forensic expertise were retrospectively analyzed according to sex, age, employment, trauma-causing instrument and injury type, respectively. RESULTS: Of the 60 cases there are 61.7% being peasants and workers, 85.0% suffering from blunt trauma and 63.3% suffering from simple contusion. CONCLUSION Eyes injuries was mostly caused by blunt trauma. Pathological change of fundus was an important factor affecting the vision function. The injury-causing instruments, injury sites and medical history of eyes should be considered while evaluating the vision.
Adolescent ; Adult ; Child ; Expert Testimony ; Eye Diseases/pathology* ; Eye Injuries/diagnosis* ; Female ; Forensic Pathology ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Vision Disorders/pathology* ; Wounds, Nonpenetrating/diagnosis* ; Young Adult

Traumatic rupture of the superior oblique muscle is rare. We report a case of a 54-year-old man injured by the metal hook of a hanger, resulting in a rupture of the superior oblique muscle tendon. He complained of torsional diplopia when in the primary position. The distal margin of the superior oblique muscle was reattached to sclera 5 and 9 mm apart from the medial insertion of the superior rectus muscle. One week after the operation, torsional diplopia disappeared. However, a 4-prism diopter ipsilateral hypertropia was observed. Three months later, hypertropia gradually increased to 20 prism dioptors and the second operation was done to correct vertical diplopia.
Diplopia/etiology/physiopathology/surgery ; Eye Injuries/complications/*diagnosis/surgery ; *Eye Movements ; Humans ; Male ; Middle Aged ; Oculomotor Muscles/*injuries/physiopathology/surgery ; Ophthalmologic Surgical Procedures/*methods ; Strabismus/etiology/physiopathology/surgery ; Tendon Injuries/complications/*diagnosis/surgery

Phialemonium keratitis is a very rare case and we encountered a case of keratitis caused by Phialemonium obovatum (P. obovatum) after penetrating injury to the cornea. This is the first case report in the existing literature. A 54-year-old male was referred to us after a penetration injury, and prompt primary closure was performed. Two weeks after surgery, an epithelial defect and stromal melting were observed near the laceration site. P. obovatum was identified, and then identified again on repeated cultures. Subsequently, Natacin was administered every two hours. Amniotic membrane transplantation was performed due to a persistent epithelial defect and impending corneal perforation. Three weeks after amniotic membrane transplantation, the epithelial defect had completely healed, but the cornea had turned opaque. Six months after amniotic membrane transplantation, visual acuity was light perception only, and corneal thinning and diffuse corneal opacification remained opaque. Six months after amniotic membrane transplantation, visual acuity was light perception only, and corneal thinning and diffuse corneal opacification remained.
Cornea/*injuries/microbiology/pathology ; Diagnosis, Differential ; Eye Infections, Fungal/diagnosis/etiology/*microbiology ; Eye Injuries, Penetrating/*complications/diagnosis ; Follow-Up Studies ; Fungi/isolation & purification ; Humans ; Keratitis/diagnosis/etiology/*microbiology ; Male ; Middle Aged

We report a case of a retained graphite anterior chamber foreign body that was masquerading as stromal keratitis. A 28-year-old male visited with complaints of visual disturbance and hyperemia in his right eye for four weeks. On initial examination, he presented with a stromal edema involving the inferior half of the cornea, epithelial microcysts, and moderate chamber inflammation. Suspecting herpetic stromal keratitis, he was treated with anti-viral and anti-inflammatory agents. One month after the initial visit, anterior chamber inflammation was improved and his visual acuity recovered to 20/20, but subtle corneal edema still remained. On tapering the medication, after three months, a foreign body was incidentally identified in the inferior chamber angle and was surgically removed resulting in complete resolution of corneal edema. The removed foreign body was a fragment of graphite and he subsequently disclosed a trauma with mechanical pencil 12 years earlier. This case showed that the presence of an anterior chamber foreign body should always be considered in the differential diagnosis of idiopathic localized corneal edema.
Adult ; Anterior Chamber/*injuries/pathology ; Corneal Stroma/*pathology ; Diagnosis, Differential ; Eye Foreign Bodies/*diagnosis/physiopathology/surgery ; Eye Injuries, Penetrating/*diagnosis/physiopathology/surgery ; *Graphite ; Humans ; Keratitis/*diagnosis ; Male ; Ophthalmologic Surgical Procedures ; Visual Acuity

Intraorbital wooden foreign bodies may present difficulties in diagnosis due to their radiolucent nature. Delayed recognition and management can cause significant complications. We present a case report that demonstrates these problems and the sequela that can follow. A 56-year-old man presented with a 3-cm laceration in the right upper eyelid, sustained by a slipping accident. After computed tomography (CT) scanning and ophthalmology consultation, which revealed no fractures and suggested only pneumophthalmos, the wound was repaired by a plastic surgery resident. Ten days later, the patient’s eyelid displayed signs of infection including pus discharge. Antibiotics and revisional repair failed to solve the infection. Nearly 2 months after the initial repair, a CT scan revealed a large wooden fragment in the superomedial orbit. Surgical exploration successfully removed the foreign body and inflamed pocket, and the patient healed uneventfully. However, the prolonged intraorbital infection had caused irreversible damage to the superior rectus muscle, with upgaze diplopia persisting 1 year after surgery and only minimal muscle function remaining. We report this case to warn clinicians of the difficulties in early diagnosis of intraorbital wooden foreign bodies and the grave prognosis of delayed management.
Anti-Bacterial Agents ; Delayed Diagnosis ; Diagnosis ; Diplopia ; Early Diagnosis ; Eye Foreign Bodies ; Eye Injuries, Penetrating ; Eyelids ; Foreign Bodies* ; Humans ; Lacerations ; Middle Aged ; Ophthalmology ; Orbit ; Prognosis ; Suppuration ; Surgery, Plastic ; Tomography, X-Ray Computed ; Wounds and Injuries

We reviewed the medical records of 122 patients (122 eyes) who had been admitted for the traumatic hyphema at the Wallace memorial Baptist Hospital between January 1993 and June 1996, excluding perforating eye injury. And according to the degree of hyphema, the incidence of its complications such as early glaucoma, late glaucoma, rebleeding, or conreal staining , and decreased final visual acuity was analyzed. The degree of hyphema was graded by the amount of the anterior chamber filled with blood clot after layering of the red blood cells: Grade I was defined as less than one third of anterior chamber, Grade II as one third to one half of it, Grade III as one half to nearly total of it, or Grade IV as total of it. The early or late glaucoma was defined as intraocular pressure using Goldmann` s applanation tonometer of 21mmHg or more on admission or at about 1 month after admission. The decreased final visual acuity is defined as final corrected visual acuity using Hans chart of 0.5 or less. Of 122 eyes, there were 92 eyes(75.4%) in Grade I, 20 eyes(16.4%) in Grade II, 6 eyes(4.9%) in Grade III, or 4 eyes(12.3%) in Grade IV. According to the grade, the incidence of early glaucoma was 10.9%(10 eyes) in Grade I, 25.0%(5 eyes) in Grade II, 16.7%(1 eye) in Grade III, or 25.0%(1eye) in Grade IV; that of late glaucoma was 3.3%(3eyes) in Grade I, 5.0%(1 eye) in Grade II, zero in Grade III, or 25%(1 eye) in Grade IV; that of rebleeding was zero in Grade I, 10.0%(2 eyes) in Grade II, 50.0%(3 eyes) in Grade III, or 50.0%(2 eyes) in Grade IV; that of conreal staining was 50.0%(2 eyes) in Grade IV but zero in Grade I, Grade II or Grade III; and that of decreased final visual acuity was 8.7%(8 eyes) in Grade I, 20.0%(4 eyes) in Grade II, 33.3%(2 eyes) in Grade III or 25%(1 eye) in Grade IV. The higher the grade, the higher the incidence of its complication and decreased final visual acuity not showing the statistical significance (P>0.05). However, the incidence of rebleeding and decreased final visual acuity was higher in Grade II to IV groups showing the statistical significance in comparison with Grade I(P<0.01). Therefore, it is considered that diagnosis, treatment , and follow-up should be made correctly and attentively in Grade II to IV groups than in Grade I.
Anterior Chamber ; Diagnosis ; Erythrocytes ; Eye Injuries ; Follow-Up Studies ; Glaucoma ; Humans ; Hyphema* ; Incidence* ; Intraocular Pressure ; Medical Records ; Protestantism ; Visual Acuity*

OBJECTIVE: To study the correlativity between the projected visual chart vision ("projector vision" in this paper) and the measured values of contrast vision, and to explore the application of contrast vision in identifying visual impairment after eye injury in the clinical forensic medicine. METHODS: One hundred and twenty nine eyes of seventy-nine young volunteers were collected for examination both of projector vision and contrast vision. In the examination of contrast vision, the contrast of optotypes were set to 100%, 25% and 10%, respectively. The correlativity of both collected experimental data were statistically analyzed. RESULTS: Projector vision was consistent with 100% contrast vision. There was a close and positive correlation between the contrast of optotypes and measured vision values. Under the same contrast of optotypes, projector vision presented a linear correlation with the average value of contrast vision. CONCLUSION There is a close correlation between projector vision and contrast vision. The contrast vision can be applied to judicial identification in the clinical forensic medicine.
Adult ; Contrast Sensitivity ; Eye Injuries/diagnosis* ; Female ; Humans ; Male ; Middle Aged ; Vision Tests ; Visual Acuity ; Young Adult