Retinal Detachment May Follow an Open Globe Injury

Retinal detachment occurred in more than one quarter of open globe injury cases

(RxWiki News) Immediate treatment is critical for patients who experience an open globe injury. But even after treatment, vision problems like retinal detachment may still arise.

An open globe injury occurs after trauma to the eye like being punched or getting stuck with a pen, and retinal detachment occurs when the retina separates from the rest of the eye.

A recent study found that patients who experienced an open globe injury were more likely to have retinal detachment if they were older and had poorer vision compared to patients who did not have retinal detachment.

"Seek immediate medical attention if you experience any eye trauma."

This study was led by Dean Eliott, MD, in the Department of Ophthalmology at Harvard Medical School in the Massachusetts Eye and Ear Infirmary. This research team looked at cases of retinal detachment in patients who experienced an open globe injury.

An open globe injury occurs when the cornea (the clear, front part of the eye) or the sclera (the white outer wall of the eye) experiences trauma caused by a blunt or sharp object.

Dr. Eliott and team analyzed data from 892 patients in the Massachusetts Eye and Ear Infirmary between 1999 and 2011 who experienced an open globe injury in either or both of their eyes.

Patients received treatment for their injuries immediately following diagnosis of an open globe injury. Retinal detachment was determined with medical diagnosis.

Several factors were taken into account when the researchers analyzed their findings, including age, sex, date, time and place of injury, how the injury occurred, clinical findings (e.g., clearness of vision), date and time of open globe repair surgery, zone of injury (the specific area of the eye where the injury occurred), date of retinal detachment diagnosis, date of retinal detachment surgery and last date of follow-up.

Open globe injuries are categorized based on where the injury occurs. A Zone 1 injury occurs in the cornea, a Zone 2 injury occurs in the sclera closer to the border of the cornea, and a Zone 3 injury occurs in the sclera farther away from the border of the cornea.

A total of 255 cases, 29 percent of patients, developed retinal detachment after open globe injury.

The researchers found that patients who experienced retinal detachment after an open globe injury were more likely to be older, have poorer vision and to have vitreous hemorrhage (where blood leaks into the vitreous humor, which is connected to the retina) than patients who did not.

Most of the patients who developed retinal detachment were found to have developed it within the first month after the open globe injury. Of the 255 patients who developed retinal detachment, 72 percent of these cases were identified within the first month.

These researchers also found that patients who developed retinal detachment were more likely to have a Zone 3 injury than those without retinal detachment. Those patients with a Zone 3 injury had over a six times greater chance of developing retinal detachment than a patient with a Zone 1 injury.

The study's authors noted that retinal detachment is quite common after an open globe injury. Certain patients are at an increased risk of retinal detachment, including those with poorer visual acuity (clearness of vision) and those who had a higher zone of injury (a Zone 2 or 3 injury compared to a Zone 1 injury).

These authors concluded that physicians should be aware of these risk factors for retinal detachment when treating patients.

This study was published on January 1 in Ophthalmology.

The study authors reported no competing interests.

Review Date: 
January 7, 2014