Management

In this chapter only a brief overview is given (Table 2.11.2); see Chaps. 1.8, 2.12-2.15, and 2.17-2.20 for details. A few additional issues are discussed below:

• As described in Chap. 1.8, treatment of a patient with an open globe injury must not be a mechanical, one-by-one restoration of tissue pathologies. If a corneal wound and a hyphema are present, the goal is not to introduce sutures until the wound is watertight and wait until the hyphema clears. The surgeon must first design a strategic plan, which answers the overall questions,5 and then a tactical plan, which answers

4 i.e., the wound is not self-sealing

5 e.g., Is surgery urgent? Is there a posterior scleral extension of the corneal wound? Is the risk of endophthalmitis high? Is an ECH imminent? Is the IOP high? Is there vitreous prolapse into the AC? Is there a lens injury? Is there injury to the posterior segment?

Table 2.11.2 Management issues in eyes with open globe injury.1

Variable

Comment

History

Find out what happened and how (the injury's circumstances)

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