Citation

Chung YW, Lee SY, La TY. Int. J. Ophthalmol. 2022; 15(3): 523-526.

Copyright

(Copyright © 2022, Press of International Journal of Ophthalmology)

DOI

10.18240/ijo.2022.03.25

PMID

35310048

PMCID

PMC8907039

Abstract

Transorbital penetrating injury is one emergency faced by ophthalmologists during primary care that requires special attention because it can lead to serious ophthalmic and neurological sequela. Of all head injuries, intracranial penetrating injuries occur at a low rate of 0.4%[1], and trans- orbital-cranial penetrating injuries are even more rare, but do occur more frequently in young children than in adults[2-3]. Because the orbital roof is adjacent to the brain, trans-orbital- cranial penetrating injuries may not only damage the eyeball, orbital soft tissues, and optic nerve, but may also cause intracranial damage, such as brain abscess, intracerebral bleeding, cerebrospinal fluid rhinorrhea, pneumocephalus, cerebral meningitis, and carotid-cavernous fistula, which can result in death[2,4]. Despite the seriousness, it is difficult to identify the degree of trans-orbital-cranial injury as the range of injury is narrow and deep in most cases, and neurological symptoms can take several days to weeks to manifest[2,4]. For these reasons, the injury may not be diagnosed accurately in the early stages. In addition, as most patients visit hospitals after removing the penetrating object, the injury is easily mistaken as a minor wound if there are no abnormal findings on ophthalmic trauma examinations. Since infants cannot communicate, it is difficult to identify the details injuries that are not directly witnessed by guardians. Poor cooperation by infants further hinders trauma evaluation...

Language: en