Ubm of blunt trauma in pediatric population
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Ubm of blunt trauma in pediatric population my presentation in EGPES- Ghardaga 2017 young ophthalmologist
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Ubm of blunt trauma in pediatric population
- 1. UBM of Blunt Trauma in Pediatric Population Mohamed ELShafie Assistant lecturer of ophthalmology Kafr ELShiekh university
- 2. We always get trauma in our hospitalsmost of these injuries are 2ry to blunt object
- 3. Pathophysiology of Blunt Ocular Trauma If a large object hits the eye, most of the impact is usually taken by the orbital margin.
- 4. • There are four main mechanisms: 1- Coup (injury at the same point) 2- Contrecoup (injury at the opposite point) 3- Equatorial expansion 4- Global repositioning Mechanism of Blunt Ocular Trauma
- 5. Effects on the Cornea Blood stained cornea Corneal Abrasion Corneal Edema
- 6. Effects on the Iris and Ciliary Body Hyphema Angle recession Iridodialysis Traumatic mydriasisCyclodialysis Cleft
- 7. Effects on the Lens and Zonules • Traumatic cataract • Lens Subluxation • Anterior Capsule Rupture • Posterior Capsule Rupture
- 8. A meticulous evaluation& appropriate treatment of the traumatized eye are crucial in preventing visual impairment. However, evaluation of anterior segment by clinical examination alone is limited by trauma related media opacities.
- 9. Ultrasound Biomicroscopy High frequency ultrasound (50-100MHZ) Images with high resolution (50 um) Depth of penetration (5mm) Can image through opaque cornea Coupling media: Fluid Patient position: Supine Skilled examiner Time consuming
- 10. Study included 95 eyes of 95 patients representing with blunt ocular trauma attending the outpatient clinics of Mansoura ophthalmic center during the period from October 2013 to October 2014.
- 11. Comparison between clinical and UBM findings: UBM detect structural changes which may be missed or can’t be detected by clinical examination especially with opaque media. Finding Clinical evaluation UBM evaluation P value No % No % Iridodialysis 20 21.1% 25 26.3% 0.394 Hyphema 43 45.3% 45 47.4% 0.771 Angle recession 1 1.1% 7 7.4% 0.030* Cyclodialysis 2 2.1% 4 4.2% 0.407 Lens subluxation 7 7.4% 12 12.6% 0.227
- 12. 17 years old patient exposed to blunt trauma . Clinically slit lamp showed corneal oedema, which mask visaulization of the anterior segment UBM examination showed subluxated lens with vitreous prolapsed in AC.
- 13. A case with angle recession that couldn't be detected clinically Tear in the ciliary body itself, between the circular and the longitudinal fibers
- 14. A 6-year-old child with traumatic cataract. UBM evaluation was useful in detecting zonular dialysis before surgery.
- 15. Separation of the ciliary body from the scleral spur resulting in cleft A 14 year-old patient exposed in her right eye to a rocket firework followed by hypotony. Cyclodialysis was obvious by UBM
- 16. • Never take blunt trauma to eye lightly. • In the setting of ocular trauma, you must first “take a step back” and examine the eye in detail. • UBM is a useful tool in detection of ocular pathology after trauma especially in detection of cyclodialysis and angle recession.
Editor's Notes
- If a small object hits the eye, the eye itself may take most of the impact.
- tear is in the ciliary body itself, between the circular and the longitudinal fibers