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




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

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