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PHOTO ESSAY
Year : 2022  |  Volume : 2  |  Issue : 2  |  Page : 595-596

Penetrating ocular trauma with a long plastic toy arrow


Department of Cornea and Refractive Surgeries, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India

Date of Submission15-Aug-2021
Date of Acceptance27-Oct-2021
Date of Web Publication13-Apr-2022

Correspondence Address:
Sanira S Vaghmare
Department of Cornea and Refractive Surgeries, Aravind Eye Hospital and Post graduate Institute, Anna Nagar, Madurai, Tamil Nadu - 625 020
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_2141_21

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  Abstract 


Keywords: Foreign body, penetrating ocular trauma, plastic arrow


How to cite this article:
Vaghmare SS, Radhakrishnan N, Prajna N V. Penetrating ocular trauma with a long plastic toy arrow. Indian J Ophthalmol Case Rep 2022;2:595-6

How to cite this URL:
Vaghmare SS, Radhakrishnan N, Prajna N V. Penetrating ocular trauma with a long plastic toy arrow. Indian J Ophthalmol Case Rep [serial online] 2022 [cited 2022 May 18];2:595-6. Available from: https://www.ijoreports.in/text.asp?2022/2/2/595/342929



We present a difficult case of penetrating injury with a large plastic arrow with the long shaft of the arrow protruding outside the eye.

A 58-year-old female presented with a penetrating trauma to the left eye with a blunt plastic toy arrow while playing with her grandchild [Figure 1]a and [Figure 1]b. On examination, the visual acuity was perception of light with inaccurate projection of rays. The arrowhead was hinged at the cornea with a long, thick protruding shaft hanging over the left side of the face. A metal core was noted inside the plastic shaft of the arrow in computed tomography of orbit and the arrowhead was found to be within the orbital cavity [Figure 2]a and [Figure 2]b. After ruling out orbital wall fractures and intracranial extension, wound exploration was performed under general anesthesia and the penetrating arrowhead was removed under strict aseptic precautions with repair of corneoscleral laceration with nylon interrupted sutures. Postoperative vision in the left eye was perception of light with inaccurate projection of rays. Postoperative examination revealed an edematous cornea with intact corneoscleral tear sutures and a formed globe [Figure 3]. Postoperative ultrasonography revealed a total retinal detachment with choroidal hemorrhage and dislocated crystalline lens in the vitreous cavity.
Figure 1: (a and b) Image showing a blunt plastic toy arrow in the left eye of the patient causing penetrating ocular injury

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Figure 2: (a and b) Computed tomographic image in coronal and sagittal section showing the penetrating plastic toy arrow in the left eye

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Figure 3: Postoperative day 1 picture of anterior segment of left eye showing well sutured corneal tear

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  Discussion Top


Ocular trauma is one of the leading causes of unilateral blindness.[1] Penetrating injuries associated with intraocular foreign bodies carry a poor prognosis.[2] The shape, mass, and physical nature of the foreign body can impact the visual outcome.[3] Our patient had a large complex foreign body - an arrow with a long shaft. An attempt at removal of the foreign body by the patient might have led to multiple complications such as inability to achieve hemostasis, endophthalmitis, and inadvertent trauma to adjacent intracranial structures.

Human rights statements and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later revisions. Informed consent was obtained from the patient for being included in the study. No patient identity particulars have been disclosed.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Négrel AD, Thylefors B. The global impact of eye injuries. Ophthalmic Epidemiol 1998;5:143-69.  Back to cited text no. 1
    
2.
Loporchio D, Mukkamala L, Gorukanti K, Zarbin M, Langer P, Bhagat N. Intraocular foreign bodies: A review. Surv Ophthalmol 2016;61:582-96.  Back to cited text no. 2
    
3.
Jonas JB, Knorr HL, Budde WM. Prognostic factors in ocular injuries caused by intraocular or retrobulbar foreign bodies. Ophthalmology 2000;107:823-8.  Back to cited text no. 3
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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