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Corneoscleral Laceration Follow-up

  • Author: Guruswami Giri, MD, FRCS; Chief Editor: Hampton Roy, Sr, MD  more...
 
Updated: Jul 05, 2016
 

Further Outpatient Care

Most patients with corneoscleral laceration are discharged home and are seen as outpatients at appropriate times as determined by the status of the eye.

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Further Inpatient Care

Inpatient care is not necessary in most circumstances.

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Inpatient & Outpatient Medications

The author recommends oral antibiotics for 7-10 days, although no established controlled study supports this recommendation.

The author uses topical steroids, antibiotics, and cycloplegics for a few weeks. Depending on the intraocular pressure, topical antiglaucoma medication may be needed.

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Deterrence/Prevention

Eye protection with safety glasses should be considered while working with mechanical tools or playing sports. Contact sports may need to be deferred for months or permanently.

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Complications

The following complications are associated with corneoscleral lacerations:

  • Endophthalmitis, which occurs in 2-7% of patients with ocular trauma
  • Iris damage
  • Glaucoma, which can occur acutely or later, possibly related to angle recession
  • Epithelial downgrowth
  • Fibrous ingrowth
  • Cystoid macular edema
  • Sympathetic ophthalmia, which can occur anytime after the trauma (One case of sympathetic ophthalmia occurred 50 years after the initial trauma.)
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Prognosis

Prognosis depends on several factors.[7]

Patients with a small corneoscleral laceration without any other intraocular injury have a better prognosis.

Patients with other intraocular injuries, intraocular foreign bodies, endophthalmitis, late presentation, or agricultural-related injuries tend to have a poor prognosis.

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Patient Education

For excellent patient education resources, visit eMedicineHealth's Eye and Vision Center. Also, see eMedicineHealth's patient education article Eye Injuries.

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Contributor Information and Disclosures
Author

Guruswami Giri, MD, FRCS Vitreo-Retinal Surgeon, Sacramento, CA

Guruswami Giri, MD, FRCS is a member of the following medical societies: American Academy of Ophthalmology, Royal College of Surgeons of Edinburgh, Royal College of Ophthalmologists

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Christopher J Rapuano, MD Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Director of the Cornea Service, Co-Director of Refractive Surgery Department, Wills Eye Hospital

Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Ophthalmological Society, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, International Society of Refractive Surgery, Cornea Society, Eye Bank Association of America

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cornea Society, Allergan, Bausch & Lomb, Bio-Tissue, Shire, TearScience, TearLab<br/>Serve(d) as a speaker or a member of a speakers bureau for: Allergan, Bausch & Lomb, Bio-Tissue, TearScience.

Chief Editor

Hampton Roy, Sr, MD Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

Stephen D Plager, MD 

Stephen D Plager, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Society of Cataract and Refractive Surgery, California Medical Association

Disclosure: Nothing to disclose.

References
  1. McGwin G Jr, Hall TA, Xie A, et al. Trends in eye injury in the United States, 1992-2001. Invest Ophthalmol Vis Sci. 2006 Feb. 47(2):521-7. [Medline].

  2. McGwin G Jr, Xie A, Owsley C. Rate of eye injury in the United States. Arch Ophthalmol. 2005 Jul. 123(7):970-6. [Medline].

  3. Ryan SJ, Allen AW. Pars plana vitrectomy in ocular trauma. Am J Ophthalmol. 1979 Sep. 88(3 Pt 1):483-91. [Medline].

  4. Brinton GS, Topping TM, Hyndiuk RA, et al. Posttraumatic endophthalmitis. Arch Ophthalmol. 1984 Apr. 102(4):547-50. [Medline].

  5. Essex RW, Yi Q, Charles PG, et al. Post-traumatic endophthalmitis. Ophthalmology. 2004 Nov. 111(11):2015-22. [Medline].

  6. Schemmer GB, Driebe WT Jr. Posttraumatic Bacillus cereus endophthalmitis. Arch Ophthalmol. 1987 Mar. 105(3):342-4. [Medline].

  7. Barr CC. Prognostic factors in corneoscleral lacerations. Arch Ophthalmol. 1983 Jun. 101(6):919-24. [Medline].

  8. Albert DM, Jakobiec FA. Principles and Practice of Ophthalmology. WB Saunders Co; 2000. Vol 6: 5179-5217.

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