Odhav Ashika, Kollipara Ramya, Teymoorian Savak, Lord Ron K, Lyon David B
Eye Foundation of Kansas City and Vision Research Center, Department of Ophthalmology, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.
J Emerg Med. 2013 May;44(5):e345-7. doi: 10.1016/j.jemermed.2012.11.035. Epub 2013 Feb 8.
Accidental eye trauma with spray guns are rare, but potentially very serious, injuries. Although it is agreed that these injuries require immediate and vigorous therapy, the specifics of such therapy are poorly defined. With latex paint sprayer injuries to hands and extremities, resulting chemical-induced inflammation, high-pressure necrosis, ischemic necrosis, and gangrene require surgical debridement and possibly, amputation. With eye injuries, treatment is directed at preservation of vision, as there is a potential risk of visual loss.
There is currently no consensus on optimal treatment of ocular spray paint injuries. Here we propose a management approach to ocular spray paint injuries with a successful outcome in the case reported.
We report the first case, to our knowledge, of an industrial airless spray gun injury that resulted in subconjunctival deposition of latex paint in a soft contact lens wearer. Vision was preserved with medical management consisting of irrigation and topical corticosteroids, antibiotics and cycloplegics.
Although latex paint spray gun injuries to the eye are not encountered frequently in practice, this case shows that conservative medical management with no surgical intervention is effective for ocular injuries with preserved vision.
喷枪导致的意外眼外伤虽罕见,但可能极为严重。尽管人们一致认为此类损伤需要立即进行积极治疗,但具体治疗方法尚不明确。对于乳胶漆喷枪导致的手部和四肢损伤,由此引发的化学性炎症、高压性坏死、缺血性坏死以及坏疽需要进行手术清创,甚至可能需要截肢。对于眼部损伤,治疗旨在保护视力,因为存在视力丧失的潜在风险。
目前对于眼部喷漆损伤的最佳治疗方法尚无共识。在此,我们报告一例眼部喷漆损伤的治疗方法,并取得了成功的治疗结果。
据我们所知,我们报告了首例工业无气喷枪损伤导致软性隐形眼镜佩戴者结膜下乳胶漆沉积的病例。通过冲洗以及局部使用皮质类固醇、抗生素和睫状肌麻痹剂等药物治疗,视力得以保留。
尽管在实际操作中眼部乳胶漆喷枪损伤并不常见,但该病例表明,对于视力得以保留的眼部损伤,不进行手术干预的保守药物治疗是有效的。