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Corneoscleral Laceration Workup

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

Laboratory Studies

Patients with corneoscleral lacerations should have cultures performed in the operating room if the wound appears infected. Cultures from the wound should be obtained before the patient is prepared for surgery with Betadine. Cultures can also be obtained from any intraocular foreign bodies or tissue resected during surgery.

Blood agar, chocolate agar, thioglycolate, and Sabouraud agar are recommended. Gram and Giemsa stains can also be obtained.

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Imaging Studies

Imaging should be considered when an intraocular foreign body is suspected. X-ray films and CT scans are quick and can be readily obtained. MRI should not be obtained if any possibility exists of a metallic foreign body in the eye or the orbit.

A CT scan is also useful in assessing any injury to the orbital bone in patients who have sustained blunt trauma.

A B-scan ultrasound examination that is gently performed by an expert may be helpful in identifying an intraocular foreign body.

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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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