Management of Corneal Lacerations and Perforations

Gargi K. Vora, MD; Ramez Haddadin, MD; James Chodosh, MD, MPH

Disclosures

Int Ophthalmol Clin. 2013;53(4):1-10. 

In This Article

Abstract and Introduction

Introduction

Corneal trauma can cause significant ocular morbidity and visual difficulty. Prompt diagnosis and management is required to prevent these complications. Although open globe injuries are uncommon, corneal lacerations and perforations represent 6.8% to 14.7% of ocular traumatic injuries presenting in an emergency medical setting.[1–3] Corneal lacerations can be full or partial thickness. In this report, a corneal perforation, which is different from globe perforation, involving an entry and exit wound, represents full-thickness injury with tissue loss.

Several retrospective studies report common characteristics and demographics of patients presenting with such injuries. A Chinese study of 715 traumatic corneal perforations reported the trauma most often occurred by penetrating wounds followed by explosion injuries. The patients were mostly farm workers and physical laborers.[4] Most studies of ocular emergencies report a male preponderance, with peak age between 15 and 30 years.[2,4–7]

Pediatric corneal injuries represent a significant challenge in diagnosis and management and are unfortunately common in the pediatric emergency setting. In a Taiwanese study reviewing 18 years of 156 pediatric eye injuries, 40.4% were diagnosed with corneal lacerations.[6] Another study reported that corneal laceration was the most frequent finding in pediatric perforating eye injuries. The most frequent long-term complications were corneal leukomas and anterior synechiae in these patients.[7]

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