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16 岁女消防员被高压水枪致双侧眼球破裂伴双侧爆裂性骨折 1 例报告

BILATERAL EYE INJURY WITH BILATERAL BLOWOUT FRACTURE CAUSED BY A HIGH-PRESSURE WATER JET IN 16-YEARS-OLD FIREMAN GIRL. CASE REPORT.

出版信息

Cesk Slov Oftalmol. 2021 Spring;77(2):88-93. doi: 10.31348/2021/12.

Abstract

PURPOSE

The aim is to present a report of a case of bilateral eye injury with bilateral blowout fracture caused by a high-pressure water jet from a fire hose in a 16-year-old girl during a competition for young firefighters.

METHODS

We present a case report of a 16-year-old female patient with bilateral extensive eyelid contusion, oedema and lacerations of upper eyelids, lacerations of bulbar conjunctiva, contusion of both eyes, left optic nerve and bilateral blowout fractures of orbits.  Results: The initial ocular examination revealed "hand motion" in the right eye and no light perception in the left eye. Intraocular pressure was low in both eyes. Motility of both eyes was reduced, especially in the left eye. Lacerations of the eyelids and conjunctiva required a surgical procedure. No repair of the upper canaliculus of the left eye was attempted. Paralytic mydriasis and loss of lens accommodation in both eyes did not change throughout the follow-up period. A surgical procedure was applied to resolve the left blowout fracture, ocular motility of the right eye improved spontaneously. Traumatic cataract developed in the left eye within 1 year after injury, requiring cataract surgery and posterior capsule lens implantation, the right lens remained clear. Massive scarring of the retina and choroid in the lower parts of the eyes and in the macula reduced best corrected visual acuity in the right eye to 0.15 and in the left eye to 0.08. Intraocular pressure is within normal limits without any glaucoma therapy. The follow up period is three years.

CONCLUSION

This is the first reported case of child with an eye injury caused by a high-pressure water jet during a sports activity.

摘要

目的

报告 1 例 16 岁少女在参加青年消防员竞赛时被消防水带高压水射流击中双眼导致双侧眼球爆裂性骨折的病例。

方法

我们报告了 1 例 16 岁女性患者,双侧广泛眼睑挫伤、水肿和上眼睑裂伤、球结膜裂伤、双眼挫伤、左眼视神经挫伤和双侧眼眶爆裂性骨折。结果:初次眼部检查显示右眼“手动”,左眼无光感。双眼眼压均较低。双眼运动受限,左眼更明显。眼睑和结膜裂伤需要手术治疗。左眼上泪小管未尝试修复。麻痹性瞳孔散大伴双眼晶状体调节丧失,在随访期间无变化。行手术治疗解决左眼爆裂性骨折,右眼眼球运动自发性改善。伤后 1 年内左眼外伤性白内障形成,需行白内障手术并植入后房型人工晶状体,右眼晶状体保持透明。双眼下部视网膜和脉络膜广泛瘢痕形成,黄斑部视网膜和脉络膜瘢痕形成,右眼最佳矫正视力降至 0.15,左眼降至 0.08。眼压在正常范围内,无需任何青光眼治疗。随访期为 3 年。

结论

这是首例报道的儿童在运动中因高压水射流致眼部受伤的病例。

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