Occult globe rupture: diagnostic and treatment challenge
| Autor: | Argyrios Chronopoulos, Gabriele Thumann, James Scott Schutz, Jong Min Ong |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Globe rupture
Pars plana medicine.medical_specialty genetic structures Ruptured Globe medicine.medical_treatment Vitrectomy Ocular Hypotension Diagnostic Techniques Ophthalmological Eye injuries 03 medical and health sciences 0302 clinical medicine Eye Injuries Plateau iris Medicine Scleral rupture Humans Ultrasonography Rupture business.industry Posterior Eye Segment medicine.disease eye diseases Surgery Vitreous Hemorrhage Ophthalmology medicine.anatomical_structure Vitreous hemorrhage 030221 ophthalmology & optometry sense organs medicine.symptom business Tomography X-Ray Computed 030217 neurology & neurosurgery Sclera |
| Zdroj: | Survey of ophthalmology. 63(5) |
| ISSN: | 1879-3304 |
| Popis: | Occult globe rupture is a traumatic dehiscence of the sclera at or posterior to the rectus muscle insertions without a visible eye wall defect on slit lamp examination. Occult scleral ruptures are important because they can be difficult to diagnose, but normally require preoperative protection against external pressure to reduce risk of herniation of ocular contents through the rupture and then urgent surgical repair to restore eye wall structural integrity and achieve optimum prognosis. A deeper-than-normal anterior chamber with posteriorly retracted plateau iris seen immediately after acute ocular trauma is virtually pathognomonic of posterior globe dehiscence. Three additional less specific signs are helpful: extensive chemosis that is often hemorrhagic, relative hypotony, and vitreous hemorrhage. Although the diagnosis is normally clinical, made by history of direct severe ocular trauma and careful anterior-segment slit lamp examination, computed tomography and ultrasonography can be helpful when thorough slit lamp examination is not possible. Strong suspicion of occult rupture should engender surgical exploration. Vitreous hemorrhage, vitreous or retinal incarceration, and retinal tears or detachment may necessitate subsequent pars plana vitrectomy or other vitreoretinal surgery. When pars plana vitrectomy is indicated, special precautions are suggested if watertight closure of the globe rupture has not been possible. |
| Databáze: | OpenAIRE |
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