Visual loss from mismanaged ocular injury with foreign body impaction: A Case Report
Ocular injury occurs commonly and it may lead to visual impairment if it is not properly managed. We report the case of a 35-year old man with a retained infected ocular foreign body in his right eye following an injury. The foreign body was not discovered despite consulting non-ophthalmologists at a Maternity Centre and an Optical Shop over a period of ten days. At presentation at the Specialist Hospital, he was unable to see with swelling of the eyelid, red eye and discharge. On examination, the visual acuity in the affected eye was NLP and an infected stick that penetrated the eyeball was discovered in the superonasal aspect of sclera covered by the swollen upper lid. This resulted in endophthalmitis, cataract and blindness of that eye.
Ocular injuries must be promptly referred to the ophthalmologist for appropriate care and to prevent complications. The case clearly showed a diagnostic and therapeutic challenge for paramedics who encounter eye injuries outside the tertiary hospital setting. Therefore, this report raises public health concern intended to increase awareness on the management of eye injuries.
The incorporation of Primary Eye Health into Primary Health Care along with training and re-training of Community Health Extension Workers, General Practitioners and other rural health workers cannot be overemphasized.
2. Mac Ewen CJ. Eye injuries: a prospective survey of 5671 cases. Br J Ophthalmol 1989; 73: 888-894.
3. Schein OD, Hibberd PL, Shingleton BJ, et al. Spectrum and burden of ocular injury. Ophthalmology 1986; 95(1): 300-5.
4. Murdoch IE, Morris SS, Cousens SN. People and eyes: statistical approaches in ophthalmology. Br J Ophthalmol 1998; 82 (8): 971-3.
5. Nwosu SN. Blindness and visual impairment in Anambra state Nigeria. Trop Geogr Med 1994; 46(6): 346-9.
6. Elebusunu M. Aetiology of childhood blindness in Benin-City, Nigeria. Public Health. 1987; 101(1): 59-62.
7. Adeoti CO, Bello TO, Ashaye AO. Blinding ocular injuries. Niger J Surg Sci 2004; 14(2): 44-6.
8. Soni M, Khan IU, Jadoon Z. The pattern of ocular trauma in patients at Govt. Naseerullah Khan Babar Memorial Hospital, Peshawar (A study from 2010-2014). Ophthalmol Update. 2015; 13(4): 271-5.
9. Onakpoya OH, Adeoye A, Adeoti CO, Ajite K. Epidemiology of ocular trauma among the elderly in a developing country. Ophthalmic Epidemiol 2010; 17(5): 315-20.
10. Desai P, MacEwen CJ, Baines P, Minaissian DC. Epidemiology and implications of ocular trauma admitted to hospital in Scotland. J Epidemiol Community Health 1996; 50(4): 436–41.
11. Onyekonwu GC, Chuka-Okosa CM. Pattern and visual outcome of eye injuries in children at Abakaliki, Nigeria. West Afr J Med 2008; 27(3): 152-4.
12. Ashaye AO. Eye injuries in children and adolescents: A report of 205 cases. J Natl Med Assoc 2009; 10(1): 51-6.
13. Thylefors B. Epidemiological patterns of ocular trauma. Aust N Z J Ophthalmol 1992; 20(1): 95–8.
14. Palmer JJ, Chinanayi F, Gilbert A, Pillay D, Fox S, Jaggernath J, et al. Trends and implications for achieving VISION 2020 human resources for eye health targets in 16 countries of sub-Saharan Africa by the year 2020. Human Resources Health 2014; 12(1): 45.
15. Palmer JJ, Chinanayi F, Gilbert A, Pillay D, Fox S, Jaggernath J, et al. Managing human resources for eye health in 21 countries of sub-Saharan Africa: Current progress towards Vision 2020. Human Resource Health 2014; 12(1): 44.
16. Jonas JB, Knorr HL, Budde WM. Prognostic factors in ocular injuries caused by intraocular or retrobulbar foreign bodies. Ophthalmology 2000; 107: 823-8.
17. Wong TY, Seet MB, Ang CL. Eye injuries in twentieth-century warfare: a historical perspective. Surv Ophthalmol 1997; 41: 433-59.
18. Idris I, Alam M, Masud MZ, Yaqoob H. Clinical and morphological characteristics of IOFB presented to a Tertiary Care Centre of Khyber Pakhtunkhwa. Ophthalmol Update 2015; 13(4): 258-61.
19. Groess lS, Nanda SK, Mieler WF. Assault-related penetrating ocular injury. Am J Ophthalmol 1993; 15(116): 26-33.
20. Napora KJ, Obuchowska I, Sidorowicz A, Mariak Z. [Intraocular and intraorbital foreign bodies characteristics in patients with penetrating ocular injury]. Klin Oczna 2009; 111: 307-12.
21. Adeoye AO. Eye injuries in the young in Ile-Ife, Nigeria. Niger J Med 2002; 11(1): 26-9.
22. Han SB, Yu HG. Visual outcome after open globe injury and its predictive factors in Korea. J Trauma. 2010; 69: E66-72.
23. YalcinTök O, Tok L, Eraslan E, Ozkaya D, Ornek F, Bardak Y. Prognostic factors influencing final visual acuity in open globe injuries. J Trauma 2011; 71: 1794-800.
24. Kelly SP, Reeves GMB. Penetrating eye injuries from writing instruments. Clin Ophthalmol 2012; 6(1): 41–4.
25. Green L W, Raeburn JM. Health. What is it? What will it become? Health Promotion. 1988; 3: 151-7.
26. Eye injuries. Dictionary of Sport and Exercise Science and Medicine by Churchill Livingstone. 2008. Retrieved January 30, 2018, from https://medical dictionary.thefreedictionary.com/eye+injuries.
Copyright (c) 2018 Annals of Health Research
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The articles and other materials published in the Annals of Health Research are protected by the Nigerian Copyright laws. The journal owns the copyright over every article, scientific and intellectual materials published in it. However, the journal grants all authors, users and researchers access to the materials published in the journal with the permission to copy, use and distribute the materials contained therein only for academic, scientific and non-commercial purposes.