 |
|
Here's Egg in Your Eye: An Unusual Penetrating Eye Injury
Arch Ophthalmol. 2002;120:666-667.
INTRODUCTION
Many unique, interesting, and even bizarre cases of penetrating eye
injuries have previously been reported. Examples include injuries caused by
a fishing hook1 and a golf tee,2 pecking injuries due to magpies3
and cormorants,4 and even a boa constrictor
bite that perforated its owner's right eye.5
This report presents a case of a penetrating eye injury caused by an exploding
emu egg, which to the best of our knowledge is the first such case reported
in the ophthalmic literature. (Note: The emu is a large native bird of Australia,
and adult birds may grow to more than 6 ft in standing height. Emu eggs are
routinely about 5 times the size of a normal chicken egg.)
Report of a Case
A 10-year-old boy sustained a severe penetrating injury to his left
eye from an exploding emu egg. He was expelling the egg's contents with an
air compressor when yolk blocked the exit hole, causing the egg to explode.
An examination revealed a full-thickness paracentral laceration of the cornea,
extending from the superior to inferior limbus. The boy's visual acuity was
light perception only OS. A computed tomographic scan revealed a large foreign
body lodged in the nasal retina.
Later that day, the boy underwent surgery. The prolapsed vitreous was
excised, and the corneal wound was sutured so that the intraocular pressure
could be maintained. A 3-port pars plana vitrectomy and lensectomy were performed.
The eggshell fragment embedded in the nasal retina was identified and removed
from the eye with intraocular forceps via the corneal laceration, which was
reopened (Figure 1 and Figure 2). The corneal wound was resutured,
an inferonasal segmental scleral buckle was applied, and perfluoropropane
gas was injected into the eye.
|
|
|
|
Figure 1. Removal of the emu eggshell fragment
from the eye via the corneal laceration.
|
|
|
|
|
|
|
Figure 2. The colorful, triangular, 11-mm
emu eggshell fragment adjacent to the corneal laceration.
|
|
|
An intraoperative vitreous biopsy was obtained, and intravitreal injections
of vancomycin hydrochloride (1 mg/0.1 mL) and ceftazidime (2.25 mg/0.1 mL)
were administered. Biopsy cultures revealed a mixed growth of viridans streptococci, Haemophilus parainfluenzae, Neisseria species, and Staphylococcus aureus (coagulase-positive). Oral and topical
ciprofloxacin hydrochloride therapy was commenced postoperatively.
Six months later, further surgery was performed involving a sutured-in
posterior chamber intraocular lens. At the most recent follow-up visit, the
boy's pinhole visual acuity had improved to 20/30 OS.
Comment
For penetrating eye injuries involving organic matter, it is essential
to collect vitreous and/or other appropriate intraocular specimens during
the initial surgical procedure. Once intravitreal antibiotics are given, it
may be very difficult to isolate the infecting organisms from subsequent aspirates.4 This is particularly important in penetrating
injuries with a high risk of infection such as those including animal, soil,
or water contamination. In addition, when gas or oil exchange is performed,
injecting intravitreal antibiotics beforehand enables an appropriate concentration
to be maintained after the exchange.
This case report presents a very unusual penetrating eye injury that,
with appropriate and timely treatment, resulted in a good clinical outcome.
AUTHOR INFORMATION
The authors thank Claire Cantwell and the Central Medical Illustration
Unit, Royal Brisbane Hospital, Herston, Queensland, for their assistance with
the preparation of the photographs.
David J. Hilford, MBBS(Hons);
Lawrence R. Lee, FRANZCO
Brisbane, Queensland
Corresponding author and reprints: Lawrence R. Lee, FRANZCO, Department
of Ophthalmology, Royal Brisbane Hospital, PO Box 41, Herston, Queensland
4029, Australia (e-mail: eye{at}cityeye.com.au).
REFERENCES
1. Krott R, Bartz-Schmidt KV, Heimann K. Laceration of the eye with a fishing hook. Br J Ophthalmol. 1999;83:1194.
FREE FULL TEXT
2. Mulvihill A, O'Sullivan J, Logan P. Penetrating eye injury caused by a golf tee. Br J Ophthalmol. 1997;81:91.
3. Horsburgh BJ, Stark DJ, Harrison JD. Ocular injuries caused by magpies. Med J Aust. 1992;157:756-759.
ISI
| PUBMED
4. Lee LR, O'Hagan S, Dal Pra M. Aeromonas sobria endophthalmitis. Aust N Z J Ophthalmol. 1997;25:299-300.
FULL TEXT
|
ISI
| PUBMED
5. Kleinman DM, Dunne EF, Taravella MJ. Boa constrictor bite to the eye. Arch Ophthalmol. 1998;116:949-950.
FREE FULL TEXT
SECTION EDITOR: W. RICHARD GREEN, MD
|
