THEORY

Trauma Oculi Perforans

Disease • Can result severe visiol loss

• Perforating injuries have both entrance and exit wound

entity • Man 5.5 grater than woman

• Can be due to injury from any sharp or high velocity object

Etiology • The most common sharp object stick, knives, scissors,

screwdriver, and nails

Risk • Male > female

• Failure to wear adequate protection while performing high
risk activities
Factor
Diagnosis

• Help identify timing of the injury and mecanism

• Hisroty using safety glasses or prescription glasses
History • History of limited vision in the fellow eye

• Visual acuity and pupillary exam most important elemen

Physical • Dialted exam should be done to look posterior segmen
exam

• Subconjungtival hemorrhage, shallow or flat anterior chamber, hifema, iris

deformities, lens disruption or posterior segmen such as vitreus
Sign and hemorrhage, retinal tear, or retinal haemorhage
symptomps • Symptomps : pain or double vision, foreign body sensation
Diagnostic Procedure

• When direct visualization is not possible,

gentle ultrasound and computed tomography
should be used to evaluate the globe.
Magnetic resonance imaging is
contraindicated in any case where a metal
object is thought to be involved
Ocular Traumatic Score
• To predict the visual outcome of patients after open-globe
ocular trauma. The score's predictive value is used to counsel
patients and their families and to manage their expectations
Management

• Penetrating or perforating injuries should be

evaluated and treated immediately. Depending on
the material causing the injury and location of
entry, severe vision loss can occur
• Surgery. Globe exploration should be performed in
suspected penetrating trauma with possible
vitrectomy if vitreous hemorrhage with an
intraocular foreign body or retinal detachment is
present
Medication :

• Tetanus toxoid for dirty wounds

• Antibiotics (intravitreal, intracameral,
topical, and systemic)  routinely used
for prophylaxis against infection
• Steroid
• Cycloplegic
• Aqueous suppressants  high IOP
Enukleasi
• Definisi : tindakan pembedahan mengeluarkan bola mata dengan melepas
dan memotong jaringan yang mengikatnya di dalam rongga mata. Jaringan
yang dipotong adalah seluruh otot penggerak bola mata, sebagian nervus
optikus anterior dan melepaskan konjungtiva dari bola mata dengan usaha
untuk mempertahankan konjungtiva tersebut, kapsula Tenon serta otot
extraokuler

Indikasi :
• Visus yang sangat turun dengan nyeri pada rongga orbita
• Tumor intraokular
• Trauma hebat dengan resiko sympatethic ophtalmia
• Ptisis bulbi
• Endoftalmis/panoftalmitis
• Kosmetik
Terima Kasih