RESUMO
ABSTRACT Purpose: We aimed to study the characteristics of ocular trauma, an important but largely preventable global cause of blindness, in the United States. Methods: Retrospective chart review of the National Trauma Data Bank (2008-2014) was performed. All patients with ocular trauma were identified using ICD-9CM codes. The collected data were statistically analyzed with student's t-test, Chi-squared test, and logistic regression analysis performed using the SPSS software. The significance was set at p<0.05. Results: It was found that 316,485 (5.93%) of the 5,336,575 admitted trauma patients had ocular injuries. Their mean (SD) age was 41.8 (23) years, and most of them were men (69.4%). Race/ethnicity distribution was White 66.1%, Black 15.1%, and Hispanic 12.3%. The common injuries were orbital 39.5% and eye/adnexa contusions 34%. Associated traumatic brain injury was present in 58.2%. The frequent mechanisms were falls 25.5%, motor vehicle accident-occupant 21.8%, and struck by/against 17.6%. Patients <21 years of age had higher odds of cut/pierce injuries (OR=3.29, 95%CI=3.07-3.51) than the other age groups, those aged 21-64 years had higher odds of motor vehicle accident-cyclist (OR=4.95, 95%CI=4.71-5.19), and those >65 years had higher odds of falls (OR=16.75, 95%CI=16.39-17.12); p<0.001. The Blacks had a greater likelihood of firearm injuries (OR=3.24, 95%CI=3.10-3.39) than the other racial/ethnic groups, the Hispanics experienced more of cut/pierce injuries (OR=2.01, 95%CI=1.85-2.18), and the Whites experienced more of falls (OR=2.3, 95%CI=2.3-2.4); p<0.001. The Blacks (OR=3.41, 95%CI=3.34-3.48) and Hispanics (OR=1.75, 95%CI=1.71-1.79) mostly suffered assaults, while the Whites suffered unintentional injuries (OR=2.78 95%CI=2.74-2.84); p<0.001. Optic nerve/visual pathway injuries had the greatest association with very severe injury severity scores (OR=3.27, 95%CI=3.05-3.49) and severe Glasgow Coma Scores (OR=3.30, 95%CI=3.08-3.54); p<0.001. The mortality rate was 3.9%. Conclusions: Male preponderance and falls, motor vehicle accident-occupant, and struck by/against mechanisms agree with the previous reports. The identified demographic patterns underscore the need to develop group-specific preventive measures.
RESUMO Objetivo: O trauma ocular é uma causa importante e amplamente evitável de cegueira em todo o mundo. Nosso objetivo é estudar suas características nos EUA. Métodos: Revisão retrospectiva do National Trauma Data Bank (2008-2014). Todos os pacientes com trauma ocular foram identificados com códigos CID-9CM. Os dados coletados foram analisados estatísticamente e o teste t de student foi utilizado. As análises qui-quadrado e de regressão logística foram realizadas com o software SPSS. A significância foi estabelecida em p<0,05. Resultados: 316.485 (5,93%) de 5.336.575 pacientes internados com trauma, apresentaram lesões oculares. A média (DP) de idade foi de 41,8 (23) anos. A maioria era do sexo masculino (69,4%). A distribuição raça/etnia foi branca: 66,1%, negra; 15,1% e hispânica: 12,3%. As lesões comuns foram orbitárias: 39,5% e contusões dos olhos/anexos: 34%. A maioria (58,2%) teve lesão cerebral traumática. Os mecanismos frequentes foram: quedas: 25,5%, acidente com veículos motorizados: 21,8% e acidentes atingidos por algo/contra algo: 17,6%. Os pacientes <21 anos apresentaram chance aumentada de lesões com corte/perfuração (RC=3,29; IC95% = 3,07-3,51) do que outras faixas etárias, aqueles entre 21-64 anos responderam por acidente automobilístico-ciclista: (RC=4,95; IC95% = 4,71-5,19) e aqueles >65 anos foram vítimas de quedas (RC=16,75; IC 95% = 16,39-17,12); p<0,001. Os negros apresentaram maior probabilidade de lesões por arma de fogo (RC=3,24; IC95% = 3,10-3,39) do que outras raças/etnias e os hispânicos tiveram mais lesões de corte/perfuração (RC=2,01; IC95%= 1,85-2,18) enquanto os brancos tiveram mais quedas: (RC=2,3; IC95%= 2,3-2,4); p<0,001. Os negros (RC=3,41; IC95% = 3,34-3,48) e os hispânicos (RC=1,75; IC95% = 1,71-1,79) sofreram principalmente agressões e os brancos tiveram lesões não intencionais (RC=2,78; IC95% 2,74-2,84); p<0,001. Lesões do nervo óptico/via visual apresentaram maior associação com escore de gravidade de lesão muito grave (RC=3,27; IC95%= 3,05-3,49) e escores graves de Coma de Glasgow (RC=3,30; IC95%= 3,08-3,54); p<0,001. A taxa de mortalidade foi de 3,9%. Conclusões: Houve preponderância masculina a quedas, a acidentes com veículo motorizado atingidos por algo/contra algo conforme os relatos anteriores. Os padrões demográficos identificados realçam a necessidade de desenvolver medidas de prevenção específicas para os diferentes grupos.
RESUMO
OBJECTIVE: Describe the ophthalmological sequelae of patients diagnosed with blunt eye injury by paintball. MATERIAL AND METHODS: There were a total 14 cases with a diagnosis of blunt trauma by paintball were treated at the ophthalmology emergency department of the Barraquer Clinic in Bogotá, Colombia. All patients underwent a complete ophthalmological examination with their respective controls according to their outcome. RESULTS: The frequency of eye trauma by paintball was 3.01%. Fourteen eyes were evaluated, age range from 9 to 49 years. Cases were unilateral, 1 woman and 13 men, initial visual acuity less than 20/30 in 12 eyes. Only 5 eyes progressed satisfactorily, and 3 were surgically intervened. The cases that did not show any improvement in visual acuity were related to posterior pole problems, with the most frequent being macular alterations, choroidal rupture, choroidal detachment, retinal tear, and retinal folds. In 3eyes, clinical improvement of visual acuity was evidenced secondary to haemorrhagic processes that resolved with medical treatment. One of them underwent surgical treatment of the lens with an intraocular lens implant. In 2eyes, the visual recovery was very satisfactory and 100% in another. CONCLUSION: Paintball has increased as a sport and recreational activity, where paint projectiles are fired with compressed air weapons. It carries risks of suffering various trauma that can lead to catastrophic episodes, in terms of visual health, and repercussions on the quality of life of those affected.
Assuntos
Traumatismos em Atletas/complicações , Traumatismos Oculares/complicações , Ferimentos não Penetrantes/complicações , Adolescente , Adulto , Traumatismos em Atletas/prevenção & controle , Traumatismos em Atletas/cirurgia , Criança , Corioide/lesões , Hemorragia Ocular/etiologia , Hemorragia Ocular/terapia , Traumatismos Oculares/prevenção & controle , Traumatismos Oculares/cirurgia , Dispositivos de Proteção dos Olhos , Feminino , Humanos , Implante de Lente Intraocular , Masculino , Pessoa de Meia-Idade , Descolamento Retiniano/etiologia , Descolamento Retiniano/terapia , Ruptura/etiologia , Ruptura/terapia , Resultado do Tratamento , Ferimentos não Penetrantes/cirurgia , Adulto JovemRESUMO
Se describe el caso clínico de un niño de 11 años de edad, procedente de un distrito de Timor Oriental, que recibió un trauma en el ojo derecho al caer de un árbol y enclavársele un fragmento de una rama en la órbita de ese ojo, por lo cual fue trasladado de urgencia al Hospital Nacional Guido Valadares de Dili, donde fue ingresado y se decidió operar inmediatamente para extraer el cuerpo extraño intraorbitario -- cuya longitud era de 10,5 cm --. El paciente evolucionó con buen estado general y una agudeza visual de 6/18 en el ojo dañado, de modo que al quinto día se le dio el alta hospitalaria.
The case report of a 11 years child is described, coming from a Timor Oriental district who suffered from a trauma in the right eye when falling from a tree and a fragment of branch was introduced in the orbit of that eye, reason why he was transferred as an emergency to Guido Valadares of Dili National Hospital, where he was admitted and it was decided to operate immediately to extract the strange intraorbitary body--which measured 10,5 cm--. The patient had a good general clinical course and a visual acuity of 6/18 in the damaged eye, so by the fifth day he was discharged from the hospital(AU)
Assuntos
Humanos , Masculino , Criança , Corpos Estranhos no Olho , Traumatismos Oculares , Timor-LesteRESUMO
Se describe el caso clínico de un niño de 11 años de edad, procedente de un distrito de Timor Oriental, que recibió un trauma en el ojo derecho al caer de un árbol y enclavársele un fragmento de una rama en la órbita de ese ojo, por lo cual fue trasladado de urgencia al Hospital Nacional "Guido Valadares" de Dili, donde fue ingresado y se decidió operar inmediatamente para extraer el cuerpo extraño intraorbitario -- cuya longitud era de 10,5 cm --. El paciente evolucionó con buen estado general y una agudeza visual de 6/18 en el ojo dañado, de modo que al quinto día se le dio el alta hospitalaria.
The case report of a 11 years child is described, coming from a Timor Oriental district who suffered from a trauma in the right eye when falling from a tree and a fragment of branch was introduced in the orbit of that eye, reason why he was transferred as an emergency to "Guido Valadares" of Dili National Hospital, where he was admitted and it was decided to operate immediately to extract the strange intraorbitary body--which measured 10,5 cm--. The patient had a good general clinical course and a visual acuity of 6/18 in the damaged eye, so by the fifth day he was discharged from the hospital.
Assuntos
Serviços de Saúde Ocular , Lesões da Córnea , Criança , Timor-LesteRESUMO
Objetivos: determinar la frecuencia de evisceración según edad, sexo, ojo afectado, criterio quirúrgico y causa más frecuente. Métodos: se realizó un estudio descriptivo, longitudinal y retrospectivo a través de la revisión de las historias clínicas de 89 pacientes a quienes se les realizó la evisceración en el período de enero 2002 a diciembre 2011 en el Hospital Militar Central Dr. Luis Díaz Soto. Se aplicaron métodos de estadística descriptiva para el procesamiento de los datos. Resultados: predominó el grupo de edad de 31-40 años con frecuencia absoluta (20), que constituyó el 22,4 por ciento de la muestra; el sexo masculino representó el 67,4 por ciento; predominó el ojo izquierdo en los casos eviscerados con 53 por ciento y la forma electiva de tratamiento con 78,7 por ciento. La causa más frecuente fue la ptisis bulbi con 32,7 por ciento. Conclusiones: son eviscerados con mayor frecuencia los ojos izquierdos de adultos jóvenes del sexo masculino, con criterio electivo de tratamiento quirúrgico. La ptisis bulbi es la causa más frecuente de evisceración(AU)
Objectives: to determine the evisceration frequency according to age, sex, affected eye, surgical approach and more frequent cause. Methods: descriptive, longitudinal and retrospective study was done through the revision from the clinical histories of 89 patients to all of them were applied the evisceration in the period of January 2002 to December 2011 in the Central Military Hospital Dr. Luis Díaz Soto. Methods of descriptive statistic were applied for the prosecution of the data. Results: there was bigger incidence in the 31-40 year-old group representing 22,4 percent of the sample, the male sex represented 67,4 percent, the left eye prevailed with 53 percent in the cases evisceration and the elective way of treatment with 78,7 percent. The most frequent cause was the ptisis bulbi occupying 32,7 percent.Conclusions: evisceration was done frequently in left eyes of young men, with elective approach of surgical treatment. The ptisis bulbi was the most frequent cause in evisceration(AU)
Assuntos
Humanos , Masculino , Adulto , Evisceração do Olho/estatística & dados numéricos , Evisceração do Olho/métodos , Traumatismos Oculares/cirurgia , Epidemiologia Descritiva , Estudos Retrospectivos , Estudos LongitudinaisRESUMO
Objetivos: determinar la frecuencia de evisceración según edad, sexo, ojo afectado, criterio quirúrgico y causa más frecuente. Métodos: se realizó un estudio descriptivo, longitudinal y retrospectivo a través de la revisión de las historias clínicas de 89 pacientes a quienes se les realizó la evisceración en el período de enero 2002 a diciembre 2011 en el Hospital Militar Central Dr. Luis Díaz Soto. Se aplicaron métodos de estadística descriptiva para el procesamiento de los datos. Resultados: predominó el grupo de edad de 31-40 años con frecuencia absoluta (20), que constituyó el 22,4 por ciento de la muestra; el sexo masculino representó el 67,4 por ciento; predominó el ojo izquierdo en los casos eviscerados con 53 por ciento y la forma electiva de tratamiento con 78,7 por ciento. La causa más frecuente fue la ptisis bulbi con 32,7 por ciento. Conclusiones: son eviscerados con mayor frecuencia los ojos izquierdos de adultos jóvenes del sexo masculino, con criterio electivo de tratamiento quirúrgico. La ptisis bulbi es la causa más frecuente de evisceración(AU)
Objectives: to determine the evisceration frequency according to age, sex, affected eye, surgical approach and more frequent cause. Methods: descriptive, longitudinal and retrospective study was done through the revision from the clinical histories of 89 patients to all of them were applied the evisceration in the period of January 2002 to December 2011 in the Central Military Hospital Dr. Luis Díaz Soto. Methods of descriptive statistic were applied for the prosecution of the data. Results: there was bigger incidence in the 31-40 year-old group representing 22,4 percent of the sample, the male sex represented 67,4 percent, the left eye prevailed with 53 percent in the cases evisceration and the elective way of treatment with 78,7 percent. The most frequent cause was the ptisis bulbi occupying 32,7 percent. Conclusions: evisceration was done frequently in left eyes of young men, with elective approach of surgical treatment. The ptisis bulbi was the most frequent cause in evisceration(AU)
Assuntos
Humanos , Masculino , Adulto , Traumatismos Oculares/cirurgia , Evisceração do Olho/métodos , Evisceração do Olho/estatística & dados numéricos , Processamento Eletrônico de Dados , Epidemiologia Descritiva , Estudos Retrospectivos , Estudos LongitudinaisRESUMO
BACKGROUND: The Ocular Trauma Score (OTS) is a scale that estimates the prognosis of injured eyes after treatment, whose results are consistent with those of longitudinal studies. The time between injury presentation and initial care has been described as a prognostic factor for visual outcome, but the OTS features of eyes receiving early or late care after trauma have not been compared. MATERIAL AND METHODS: Non-experimental, comparative, retrospective, cross sectional study. Patients from either gender, aged 5-80 years, with open globe trauma, without previous diseases that reduced visual acuity or previous intraocular surgery were included. The distribution of the OTS variables was identified. The sample was divided in two: group 1 (time between trauma occurrence and initial care ≤ 24 hours) and 2 (time > 24 hours). The frequency of OTS categories of unfavorable prognosis (1-3) was compared between groups (χ(2)). RESULTS: 138 eyes of 138 patients, mean age 28.8 years, 65.2% male. The evolution time ranged 2-480 hours (mean 39.9); 103 eyes were assigned to group 1 (74.6%), and 35 to group 2 (25.4%). The proportion of categories 1-3 in group 1 (82.5%, n = 85) did not differ from that in group 2 (80%, n = 28; p = 1.0). CONCLUSION: The proportion of OTS categories with unfavorable prognosis did not show significant differences between the eyes who received care before or after 24 hours that could contribute to a different outcome, besides the delay in starting treatment.
Assuntos
Intervenção Médica Precoce , Traumatismos Oculares/terapia , Índices de Gravidade do Trauma , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Transversais , Traumatismos Oculares/classificação , Traumatismos Oculares/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Ferimentos Penetrantes/classificação , Ferimentos Penetrantes/cirurgia , Ferimentos Penetrantes/terapia , Adulto JovemRESUMO
Paciente masculino de 27 años de edad, trabajador agrícola, que fue ingresado en el Hospital Militar Central Dr Carlos J Finlay" por haber sufrido una herida penetrante por arma de fuego, producida por la impulsión retrógrada del percutor al disparar una escopeta artesanal de cacería, que provocó estallido del globo ocular izquierdo, fractura de la pared externa de la órbita y heridas palpebrales. Se retiró el cuerpo extraño, se completó la evisceración del ojo izquierdo, se recolocó el fragmento fracturado de la órbita en posición anatómica, se regularizaron los tejidos blandos intra y periorbitarios, preparando la cavidad orbitaria para la colocación posterior de la prótesis; y se realizó la hemostasia, la exploración de la cavidad neoformada por el cuerpo extraño en los tejidos blandos de la región fronto-temporal y la plastia palpebral. Se logró con éxito la reconstrucción palpebral y con posterioridad, la rehabilitación con fines estéticos mediante prótesis ocular(AU)
A 27 year-old male farmer patient was admitted to "Dr. Carlos J. Finlay" Central Military Hospital suffering a penetrating gunshot wound, caused by the retrograde hammer when shooting a handmade hunting shotgun. This injured caused his left eyeball burst, fracture of the outer wall of the orbit and eyelid injuries. Foreign matter was removed. His left eye evisceration was completed. The fractured orbit fragment was repositioned in anatomical position. Intra and periorbital soft tissues were regularized, preparing the orbital cavity for the subsequent placement of prosthesis; and hemostasis was performed, as well as exploration the newly formed cavity by foreign matter in the soft tissues of the frontal-temporal region and eyelid plasty. Eyelid reconstruction and further rehabilitation for aesthetic purposes by ocular prosthesis was successfully achieved(AU)
Assuntos
Humanos , Masculino , Adulto , Traumatismos Oculares/cirurgia , Ferimentos por Arma de Fogo/cirurgia , Exenteração Orbitária/métodos , Olho Artificial/efeitos adversosRESUMO
Paciente masculino de 27 años de edad, trabajador agrícola, que fue ingresado en el Hospital Militar Central "Dr. Carlos J. Finlay" por haber sufrido una herida penetrante por arma de fuego, producida por la impulsión retrógrada del percutor al disparar una escopeta artesanal de cacería, que provocó estallido del globo ocular izquierdo, fractura de la pared externa de la órbita y heridas palpebrales. Se retiró el cuerpo extraño, se completó la evisceración del ojo izquierdo, se recolocó el fragmento fracturado de la órbita en posición anatómica, se regularizaron los tejidos blandos intra y periorbitarios, preparando la cavidad orbitaria para la colocación posterior de la prótesis; y se realizó la hemostasia, la exploración de la cavidad neoformada por el cuerpo extraño en los tejidos blandos de la región fronto-temporal y la plastia palpebral. Se logró con éxito la reconstrucción palpebral y con posterioridad, la rehabilitación con fines estéticos mediante prótesis ocular.
A 27 year-old male farmer patient was admitted to "Dr. Carlos J. Finlay" Central Military Hospital suffering a penetrating gunshot wound, caused by the retrograde hammer when shooting a handmade hunting shotgun. This injured caused his left eyeball burst, fracture of the outer wall of the orbit and eyelid injuries. Foreign matter was removed. His left eye evisceration was completed. The fractured orbit fragment was repositioned in anatomical position. Intra and periorbital soft tissues were regularized, preparing the orbital cavity for the subsequent placement of prosthesis; and hemostasis was performed, as well as exploration the newly formed cavity by foreign matter in the soft tissues of the frontal-temporal region and eyelid plasty. Eyelid reconstruction and further rehabilitation for aesthetic purposes by ocular prosthesis was successfully achieved.
Assuntos
Humanos , Masculino , Ferimentos por Arma de Fogo/cirurgia , Traumatismos Oculares/cirurgia , Exenteração Orbitária/métodos , Olho Artificial/efeitos adversosRESUMO
Se presenta un caso clínico asistido de urgencia en el Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez Hernández, de la ciudad de Matanzas, en el año 2012, con un cuerpo extraño intraocular a nivel del cristalino en una paciente del sexo femenino, de 43 años de edad, ama de casa, con antecedente de trauma ocular en su hogar. En el examen físico presentaba déficit visual de 0,3 con herida corneal, que afectaba, además, limbo corneo escleral y cristalino con cuerpo extraño incluido. En examen ecográfico se observó imagen ecogénica compatible con cuerpo extraño a nivel del cristalino. Se suturó córnea y se extrajo cuerpo extraño con evolución satisfactoria; no presentando secuelas(AU)
We present a clinical case attended at the emergency unit of the University Clinic-Surgical Hospital Comandante Faustino Perez, of Matanzas, in 2012, with a foreign intraocular body at the level of the crystalline lens in a female patient aged 43 years old, housewife, with antecedents of an ocular trauma at home. At the physical examination she had a visual deficit of 0,3, and a corneal injury affecting also the cornea-scleral limbus and the crystalline with an included foreign body. At the echographic examination we found an echogenic image compatible with a foreign body at the level of the crystalline. The cornea was sutured and the foreign body was extracted with a satisfactory evolution; there were not sequels(AU)
Assuntos
Humanos , Feminino , Adulto , Traumatismos Oculares/cirurgia , Traumatismos Oculares/etiologia , Corpos Estranhos no Olho/complicações , Relatos de CasosRESUMO
Se presenta un caso clínico asistido de urgencia en el Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez Hernández, de la ciudad de Matanzas, en el año 2012, con un cuerpo extraño intraocular a nivel del cristalino en una paciente del sexo femenino, de 43 años de edad, ama de casa, con antecedente de trauma ocular en su hogar. En el examen físico presentaba déficit visual de 0,3 con herida corneal, que afectaba, además, limbo corneo escleral y cristalino con cuerpo extraño incluido. En examen ecográfico se observó imagen ecogénica compatible con cuerpo extraño a nivel del cristalino. Se suturó córnea y se extrajo cuerpo extraño con evolución satisfactoria; no presentando secuelas.
We present a clinical case attended at the emergency unit of the University Clinic-Surgical Hospital Comandante Faustino Perez, of Matanzas, in 2012, with a foreign intraocular body at the level of the crystalline lens in a female patient aged 43 years old, housewife, with antecedents of an ocular trauma at home. At the physical examination she had a visual deficit of 0,3, and a corneal injury affecting also the cornea-scleral limbus and the crystalline with an included foreign body. At the echographic examination we found an echogenic image compatible with a foreign body at the level of the crystalline. The cornea was sutured and the foreign body was extracted with a satisfactory evolution; there were not sequels.
RESUMO
La rehabilitación en oftalmología tiene como función fundamental lograr el máximo aprovechamiento posible del resto visual. El traumatismo ocular es considerado una de las entidades nosológicas frecuentes que conllevan a una rehabilitación visual. Las causas que provocan este tipo de trauma son variadas y dentro de estas, las agresiones con intención de provocar daños con secuelas son muy frecuentes. Es objetivo de esta revisión puntualizar la importancia de la rehabilitación en pacientes con traumatismo ocular e incentivar el buen accionar de todos los oftalmólogos en cuanto a su atención(AU)
The main goal of rehabilitation in ophthalmology is to use as much as possible the residual vision. Ocular trauma is considered one of the common diseases that imply visual rehabilitation. The causes of eye injuries are varied; among them assaults with intent to cause damage are the most common. The objective of this article was to point out the importance of rehabilitation in patients with ocular trauma and to encourage all the ophthalmologists to act accordingly(AU)
Assuntos
Humanos , Masculino , Feminino , Traumatismos Oculares/reabilitaçãoRESUMO
El traumatismo ocular, independientemente de la lateralidad, es considerado una de las entidades nosológicas frecuentes que conllevan a una rehabilitación visual. Las causas que provocan un traumatismo ocular son variadas y dentro de estas, las agresiones con intención de provocar daños con secuelas son una de las más frecuentes. Este aspecto trae consigo todo un proceso médico-legal, donde los principios éticos por parte de los facultativos deben estar bien establecidos. Es objetivo de esta revisión incentivar el buen accionar ético de todos los oftalmólogos en cuanto a la atención de estos pacientes, así como enfatizar en el adecuado manejo medico-legal implícito en este tipo de afección(AU)
Ocular trauma, regardless of laterality, is considered one of the common diseases entities that implies visual rehabilitation. The causes of eye injuries are varied. Assaults with intent to cause damage are the most common. This issue involves a medical-legal process where the ethical principles of the physicians must be well established. The objective of our article was to encourage good ethical actions of all ophthalmologists and to emphasize the proper medical-legal management involved in this type of diseases(AU)
Assuntos
Humanos , Masculino , Feminino , Traumatismos Oculares , Ética Médica , Consentimento Livre e Esclarecido/ética , Prontuários Médicos , Atestado de SaúdeRESUMO
La rehabilitación en oftalmología tiene como función fundamental lograr el máximo aprovechamiento posible del resto visual. El traumatismo ocular es considerado una de las entidades nosológicas frecuentes que conllevan a una rehabilitación visual. Las causas que provocan este tipo de trauma son variadas y dentro de estas, las agresiones con intención de provocar daños con secuelas son muy frecuentes. Es objetivo de esta revisión puntualizar la importancia de la rehabilitación en pacientes con traumatismo ocular e incentivar el buen accionar de todos los oftalmólogos en cuanto a su atención.
The main goal of rehabilitation in ophthalmology is to use as much as possible the residual vision. Ocular trauma is considered one of the common diseases that imply visual rehabilitation. The causes of eye injuries are varied; among them assaults with intent to cause damage are the most common. The objective of this article was to point out the importance of rehabilitation in patients with ocular trauma and to encourage all the ophthalmologists to act accordingly.
RESUMO
El traumatismo ocular, independientemente de la lateralidad, es considerado una de las entidades nosológicas frecuentes que conllevan a una rehabilitación visual. Las causas que provocan un traumatismo ocular son variadas y dentro de estas, las agresiones con intención de provocar daños con secuelas son una de las más frecuentes. Este aspecto trae consigo todo un proceso médico-legal, donde los principios éticos por parte de los facultativos deben estar bien establecidos. Es objetivo de esta revisión incentivar el buen accionar ético de todos los oftalmólogos en cuanto a la atención de estos pacientes, así como enfatizar en el adecuado manejo medico-legal implícito en este tipo de afección.
Ocular trauma, regardless of laterality, is considered one of the common diseases entities that implies visual rehabilitation. The causes of eye injuries are varied. Assaults with intent to cause damage are the most common. This issue involves a medical-legal process where the ethical principles of the physicians must be well established. The objective of our article was to encourage good ethical actions of all ophthalmologists and to emphasize the proper medical-legal management involved in this type of diseases.
RESUMO
Objetivo: Determinar el comportamiento de las urgencias traumáticas oftálmicas en un Hospital Provincial Docente de agosto a noviembre de 2008. Método: Se realizó un estudio descriptivo y transversal cuyo universo estuvo constituido por 531 pacientes con traumatismos oculares producidos por agentes mecánicos, excluyendo las lesiones por agentes físicos y químicos, ya que el primero es el agente que con más frecuencia produce lesiones a nivel del globo ocular. Se utilizaron las siguientes variables: grupos de edades, sexo, mecanismo de producción, tipo de traumatismo, localización de las heridas y del cuerpo extraño intraocular. Resultados: El grupo de edad más afectado fue entre 20 y 39 años (71.6por ciento) y el sexo masculino (81.7por ciento). El mecanismo de producción de los traumatismos más significativo fueron las agresiones (52.5 por ciento), las heridas se localizaron con mayor frecuencia en córnea (70.5 por ciento) y la mayor localización de cuerpo extraño intraocular fue en el segmento anterior (89.4 por ciento). Conclusiones: Las urgencias traumáticas oftálmicas fueron frecuentes en este estudio comportándose de forma similar a otras casuísticas revisadas sobre este tema al repercutir de forma integral en la salud visual(AU)
Objective: To determine the deportment of ophthalmologic traumatic urgencies in a Provincial Ophthalmologic Hospital, from August to November, 2008. Method: A descriptive and transversal study was made; universe was constituted by 531 patients with ocular traumas due to mechanical agents, excluding lesions by physical and chemical agents because the first ones are the most frequent. It was taken into consideration some variables such as: age, sex, mechanism and type of trauma, localization of wound and intraocular foreign body. Results: The group of age between 20 to 39 years old was more affected (71.6 percentil), and males with 81.7 percentil. Aggressions (52.5 percentil) were the most important mechanism of trauma, the wound in cornea was common (70.5 percentil) and finally the localization of intraocular foreign body was more frequent in anterior segment (89.4 percentil) than in posterior segment. Conclusions: Ophthalmologic traumatic urgencies were very numerous in this study with a similar deportment from other review researches about this topic to resound integrally in visual health. Key words: Trauma, eyes, lesions, aggressions, mechanism of occurrence(AU)
Assuntos
Humanos , Traumatismos Oculares , Emergências/epidemiologia , Ferimentos e Lesões , Epidemiologia Descritiva , Estudos TransversaisRESUMO
El objetivo de este trabajo es determinar la frecuencia del traumatismo ocular infantil con afectación de la agudeza visual (AV), manejo de urgencia y relación entre la AV al momento de la consulta y luego de un mes de evolución. Se realizó un estudio observacional, descriptivo, con 318 pacientes menores de 16 años, de ambos sexos, que acudieron al servicio de Oftalmología del Hospital de Clínicas, entre setiembre de 2006 y julio de 2007. De los pacientes que consultaron por traumatismo ocular con afectación de la agudeza visual se analizaron datos demográficos, agente causante del trauma, circunstancia, lugar donde se produjo el accidente, tiempo de evolución, AV, tipo de trauma, zona afecta y tratamiento de urgencia. De los 318 niños que consultaron al departamento de urgencias del servicio durante el periodo de estudio, 101 (31,7%) lo hicieron por traumatismo ocular. De éstos, 55 (54,5%) presentó disminución de la agudeza visual. El trauma fue cerrado en el 85,5% de los pacientes y abierto en el 14,5%. Los principales agentes causantes del trauma fueron rama de plantas, palo, piedra, explosivos, alambre y varilla de hierro. La AV al mes de la primera consulta mejoró en el 83,5% de los casos, permaneció igual en el 14,5% y empeoró en el 2%. Existe una relación directa entre AV inicial y AV al mes de la primera consulta (p= 0,01), y una relación inversa entre el tiempo de evolución y la AV al mes (p= 0,013).El traumatismo ocular infantil es un motivo de consulta frecuente en los servicios de urgencia oftalmológica. La AV inicial y el tiempo de evolución constituyen factores pronósticos de la AV final en estos pacientes.
The objective of this work was to determine the frequency of child ocular trauma affecting visual acuity (VA), management of urgencies and relation between the VA at the time of the consultation and after one month of evolution. This was an observational descriptive study of 318 patients, girls and boys under 16 years who attended the Ophthalmology Service of the Hospital de Clínicas from September, 2006 to July, 2007. The following data of the patients that consulted for eye trauma affecting their visual acuity were analyzed: demographic data, causative agent of the trauma, circumstances, place of accident, time of evolution, VA, trauma type, affected zone and urgency treatment. A total of 318 children consulted the urgency department of the service and 101 (31.7%) of them consulted for eye trauma. Of these, 55 (54.5%) showed a decrease of the visual acuity. The trauma was closed in 85.5% patients and open in 14.5%. The main causative agents of trauma were tree branches, sticks, stones, explosives, wires and iron rods. After one month of consultation, VA improved in 83.5% of the cases, remains equal in 14.5% and worsened in 2%. There was a direct relation between the initial VA and the VA at one month (p = 0.01) and an inverse relation between time of evolution and the VA at one month (p = 0.013). The child eye traumatism is a frequent reason of consultation in the ophthalmic urgency services. The initial VA and the time of evolution are prognosis factors of the final VA of these patients.