Open Globe Injuries Presenting With Normal or High Intraocular Pressure. Issue 4 (July 2016)

• Record Type: Journal Article
• Authors: Margo, Jordan A.; Feldman, Samantha; Addis, Hampton; Bodanapally, Uttam K.; Ellish, Nancy; Saeedi, Osamah
• Is Part Of: Eye & contact lens. Volume 42:Issue 4(2016:Jul.)
• Publication Date: 2016-07
• Subjects: Open globe injury -- High intraocular pressure -- Retrobulbar hemorrhage; Contact lenses -- Periodicals; Intraocular lenses -- Periodicals; Orthokeratology -- Periodicals; Anterior segment (Eye) -- Diseases -- Periodicals; 617.7523
• DOI: 10.1097/ICL.0000000000000188
• Languages: English
• ISSNs: 1542-2321

Abstract

Abstract : Objectives: To determine the frequency, clinical characteristics, and visual outcomes of patients who present with high or normal intraocular pressure (IOP) and open globe injuries. Design: Retrospective chart review. Setting: University of Maryland Medical Center, a level 1 trauma center. Patient or Study Population: All cases of open globe injury presenting to The University of Maryland Medical Center from July 2005 to January 2014. Observation: Demographics, initial physical examination, computed tomography findings, IOP of the affected and unaffected eyes, and follow-up evaluations. Main Outcome Measures: (1) IOP 10 mm Hg or greater and (2) visual acuity. Results: Of 132 eyes presenting with open globe injury, IOP was recorded in 38 (28%). Mean IOP for the affected and unaffected eyes was 14±10.3 mm Hg and 16.6±4.1 mm Hg, respectively. Twenty-three (59.4%) eyes had IOP greater than 10 mm Hg. Six eyes (16.2%) had IOP greater than 21 mm Hg. Using bivariate analysis, IOP greater than 10 mm Hg was associated with posterior open globe injury ( P =0.01), posterior hemorrhage ( P =0.04), and intraconal retrobulbar hemorrhage ( P =0.05). Adjusting for age, sex, and race, IOP greater than 10 mm Hg was associated with the presence of posterior open globe injury on clinical examination ( P =0.04). Higher presenting IOP was found to predict light perception or worse vision ( P =0.01). Multivariate analysis showed that poor presenting vision was the best predictor of poor final vision ( P <0.01). Conclusions: High IOP does not exclude open globe injury. It is a frequent finding in patients with open globe injuries and may be associated with posterior injury and poor visual prognosis.