gms | German Medical Science

Whenever confronted with a patient of ocular trauma, as an ophthalmologist one must 'take a step back' and try and rule out life threatening injuries. All the patients with open globe injuries should be evaluated on a emergency basis, evaluation should include brief history mainly highlighting about the details of incidence and object which lead to ocular trauma. Quick comprehensive clinical examination, making sure that no more trauma is caused to the traumatized eyes. The initial four prong management is carried out in patients with ocular trauma.

• To minimize possibility of further trauma.
• Minimize risk of infection.
• Minimize psychological trauma to the patient and his family
• Minimize legal problems to yourself and to your institute

• Restoration of structural integrity
• Achieve watertight closure
• Prevent infection
• Smooth and optically effective refractive surface
• Refractive closure: Spherical cornea
  - minimize astigmatism
  - better contact lens fitting
• Reduce scarring
• Removal of disrupted lens and vitreous
• Avoid uveal and vitreous incarceration
• Removal of intraocular foreign bodies
• Do no harm !

• 10-0 Nylon or 11-0 Nylon for cornea, 7-0 vicryl or 8-0 vicryl for sclera
• Perpendicular to laceration
• 90 % Depth
• Equal depth
• Length 1.5 - 2 mm
• Knot : 2 - 1 - 1 or 3 - 1 - 1
• Burying the knot
• Vertical & Shelved Linear lacerations - Vertical incisions closed first

Corneal wound repair being done by novice surgeon and the principles of primary globe repair are not adhered to (Figure 1 [Fig. 1]).

Wound revision being done for same eye by following up standard principles of corneal wound repair (Figure 2 [Fig. 2]).