Prevention of self-induced re-injury to ruptured globe with a surgically fixated plastic eye shield
Purpose: Open globe injury is an emergent, vision threatening condition. To ensure the best possible visual outcome after an open globe, it is essential to protect the eye from further trauma during the critical period of healing. In cases where the open globe is caused by repeated self-mutilation,...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-06-01
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| Series: | American Journal of Ophthalmology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993622002225 |
| _version_ | 1811231700529709056 |
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| author | Gregory Brandon Caudill Mitchell Jay Wolin John Delmar Siddens |
| author_facet | Gregory Brandon Caudill Mitchell Jay Wolin John Delmar Siddens |
| author_sort | Gregory Brandon Caudill |
| collection | DOAJ |
| description | Purpose: Open globe injury is an emergent, vision threatening condition. To ensure the best possible visual outcome after an open globe, it is essential to protect the eye from further trauma during the critical period of healing. In cases where the open globe is caused by repeated self-mutilation, long term prevention of re-injury must also be considered and can pose a significant challenge. Observations: Here we describe a 68-year-old male with a history of severe intellectual disability. The patient presented after an episode of eye self-mutilation, resulting in an open globe injury. After being taken to the operating room for emergent repair of the eye, the primary concern was how to prevent re-injury. Ultimately, as an alternative to the long-term use of restraints, the decision was made to fixate a plastic eye shield over the affected eye using sutures. The eye shield prevented any unwanted manipulation of the eye while implanted, despite several attempts. After 18 days, the eye shield was forcibly removed by the patient. However, this allowed adequate healing time, and there has not been any repeated damage to the eye since. Conclusions and Importance: Our proposal to suture a plastic eye shield to the orbital rims of a patient is an attempt to allow the eye to heal while avoiding prolonged use of restraints and minimizing long-term hospital stays. This intervention may prove to be beneficial for the population of psychologically or cognitively impaired individuals, as they are often implicated in cases of self-inflicted ocular trauma. To our knowledge, this is the first description of the use of this method. |
| first_indexed | 2024-04-12T10:49:15Z |
| format | Article |
| id | doaj.art-b8ce9599348749bda33cb72ab42410b4 |
| institution | Directory Open Access Journal |
| issn | 2451-9936 |
| language | English |
| last_indexed | 2024-04-12T10:49:15Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj.art-b8ce9599348749bda33cb72ab42410b42022-12-22T03:36:19ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362022-06-0126101476Prevention of self-induced re-injury to ruptured globe with a surgically fixated plastic eye shieldGregory Brandon Caudill0Mitchell Jay Wolin1John Delmar Siddens2University of South Carolina School of Medicine Greenville, 607 Grove Rd, Greenville, SC, 29605, USA; Corresponding author. 66 Duke Street, Greenville, SC, 29605, USA.University of South Carolina School of Medicine Greenville, 607 Grove Rd, Greenville, SC, 29605, USAPrisma Health System, Department of Surgery, Division of Ophthalmology and Oculoplastic and Reconstructive Surgery, 104 Simpson St, Greenville, SC, 29605, USAPurpose: Open globe injury is an emergent, vision threatening condition. To ensure the best possible visual outcome after an open globe, it is essential to protect the eye from further trauma during the critical period of healing. In cases where the open globe is caused by repeated self-mutilation, long term prevention of re-injury must also be considered and can pose a significant challenge. Observations: Here we describe a 68-year-old male with a history of severe intellectual disability. The patient presented after an episode of eye self-mutilation, resulting in an open globe injury. After being taken to the operating room for emergent repair of the eye, the primary concern was how to prevent re-injury. Ultimately, as an alternative to the long-term use of restraints, the decision was made to fixate a plastic eye shield over the affected eye using sutures. The eye shield prevented any unwanted manipulation of the eye while implanted, despite several attempts. After 18 days, the eye shield was forcibly removed by the patient. However, this allowed adequate healing time, and there has not been any repeated damage to the eye since. Conclusions and Importance: Our proposal to suture a plastic eye shield to the orbital rims of a patient is an attempt to allow the eye to heal while avoiding prolonged use of restraints and minimizing long-term hospital stays. This intervention may prove to be beneficial for the population of psychologically or cognitively impaired individuals, as they are often implicated in cases of self-inflicted ocular trauma. To our knowledge, this is the first description of the use of this method.http://www.sciencedirect.com/science/article/pii/S2451993622002225TraumaOpen globeWound careCognitive impairment |
| spellingShingle | Gregory Brandon Caudill Mitchell Jay Wolin John Delmar Siddens Prevention of self-induced re-injury to ruptured globe with a surgically fixated plastic eye shield American Journal of Ophthalmology Case Reports Trauma Open globe Wound care Cognitive impairment |
| title | Prevention of self-induced re-injury to ruptured globe with a surgically fixated plastic eye shield |
| title_full | Prevention of self-induced re-injury to ruptured globe with a surgically fixated plastic eye shield |
| title_fullStr | Prevention of self-induced re-injury to ruptured globe with a surgically fixated plastic eye shield |
| title_full_unstemmed | Prevention of self-induced re-injury to ruptured globe with a surgically fixated plastic eye shield |
| title_short | Prevention of self-induced re-injury to ruptured globe with a surgically fixated plastic eye shield |
| title_sort | prevention of self induced re injury to ruptured globe with a surgically fixated plastic eye shield |
| topic | Trauma Open globe Wound care Cognitive impairment |
| url | http://www.sciencedirect.com/science/article/pii/S2451993622002225 |
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