Ophthalmologica Indonesiana
Vol 42 No 2 (2016): Ophthalmologica Indonesiana

Visual Recovery after Penetrating Injury Through the Orbit

Kukuh Prasetyo (Department of Ophthalmology, Faculty of Medicine, Universitas Padjadjaran Cicendo National Eye Hospital, Bandung, West Java)
Angga Kartiwa (Department of Ophthalmology, Faculty of Medicine, Universitas Padjadjaran Cicendo National Eye Hospital, Bandung, West Java)



Article Info

Publish Date
09 Feb 2017

Abstract

Background: Penetrating trauma through the orbit cavity by blunt edged instrument could bring destructionto many organs located in it. This article is aimed to report a case of severe penetrating injury throughthe orbit cavity with a good visual recovery after surgical treatment.Case Illustration: A 29-year-old male came to Cicendo National Eye Hospital with a complaint ofbloody eye. His head was hit by fallen wall from behind while he was working using crowbar thatcaused the tip of crowbar penetrated into intracranial cavity through the right orbit cavity. Vital signswere within normal limit, with the crowbar fixated on 2 mm below the margin of inferior orbital edge.Visual acuity was 2/60 (bed side examination) without any RAPD. CT-scan showed the tip of crowbarentered cranial cavity. Patient was diagnosed with penetrating injury through the orbit and referred toNeurosurgery Department. Operation was done under general anesthesia and it was found that the tipripped of duramater on frontal region and both inferior rectus and inferior oblique muscle were rippedoff. We decided to leave the eye and give methyl prednisolone iv 1 g a day. Post operative examinationshowed that the visual acuity was 20/60 and patient was unable to move the right eye downward.Patient did not complain of double vision on primary position.Conclusion: Penetrating injury could be devastating for many organs inside the orbit. With a carefulexamination and correct management, vision can be saved.Keywords: penetrating injury, orbital cavityBackground: Penetrating trauma through the orbit cavity by blunt edged instrument could bring destructionto many organs located in it. This article is aimed to report a case of severe penetrating injury throughthe orbit cavity with a good visual recovery after surgical treatment.Case Illustration: A 29-year-old male came to Cicendo National Eye Hospital with a complaint ofbloody eye. His head was hit by fallen wall from behind while he was working using crowbar thatcaused the tip of crowbar penetrated into intracranial cavity through the right orbit cavity. Vital signswere within normal limit, with the crowbar fixated on 2 mm below the margin of inferior orbital edge.Visual acuity was 2/60 (bed side examination) without any RAPD. CT-scan showed the tip of crowbarentered cranial cavity. Patient was diagnosed with penetrating injury through the orbit and referred toNeurosurgery Department. Operation was done under general anesthesia and it was found that the tipripped of duramater on frontal region and both inferior rectus and inferior oblique muscle were rippedoff. We decided to leave the eye and give methyl prednisolone iv 1 g a day. Post operative examinationshowed that the visual acuity was 20/60 and patient was unable to move the right eye downward.Patient did not complain of double vision on primary position.Conclusion: Penetrating injury could be devastating for many organs inside the orbit. With a carefulexamination and correct management, vision can be saved.Keywords: penetrating injury, orbital cavityrauma pada wajah merupakan masalahsosial serta masalah kesehatanmasyarakat disebabkan karena frekuensiserta besaran masalah yang ditimbulkan, sertaketerkaitan dengan kecelakaan lalu lintas,tindak kejahatan, serta kaitannya denganrasa tidak aman. Bola mata meski hanyameliputi 0,27% dari seluruh permukaan tubuh,dan merupakan 4% dari seluruh permukaanwajah, mata merupakan bagian tubuh ketigayang paling terekspose oleh trauma.1,2 Kehilanganpenglihatan pada satu atau keduamata merupakan

Copyrights © 2016






Journal Info

Abbrev

journal

Publisher

Subject

Health Professions Medicine & Pharmacology Public Health

Description

Ophthalmologica Indonesiana is an open accessed online journal and comprehensive peer-reviewed ophthalmologist journal published by the Indonesian Ophthalmologist Association / Perhimpunan Dokter Spesialis Mata (PERDAMI). Our main mission is to encourage the important science in the clinical area of ...