Mechanical Globe Trauma 218411 Contusion

A blunt object with insufficient momentum to cause rupture initially compresses the eye antero-posteriorly; this is followed by a rebound effect and

2 Detailed description of the management is beyond the scope of this book; the reader is referred to glaucoma textbooks.

3 Should not be administered in the acute, only in the chronic, phase because they may increase the inflammation.

Fig. 2.18.1 Endophthalmitis following trabeculectomy for trauma-related glaucoma. Trabeculectomy was able to lower the IOP in this eye, but years later a bleb-related infection developed. The bleb has purulent material in it and there is also a 1-mm hypopyon (Courtesy of V. Mester, Abu Dhabi, U.A.E.)

subsequent oscillations with decreasing frequency (see Chap. 2.10). Several consequences of such an injury can lead to IOP elevation. Data from the USEIR [10] show that 3.4% of contused eyes develop glaucoma, and that the independent risk factors4 are:

• Lens injury (dislocation more so than cataract)

• Initial visual acuity of <20/200

• Angle recession

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