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Li Q, Xu YX. Globe luxation may prevent myopia in a child: A case report. World J Clin Cases 2022; 10:4574-4579. [PMID: 35663058 PMCID: PMC9125280 DOI: 10.12998/wjcc.v10.i14.4574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 02/11/2022] [Accepted: 03/25/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Globe luxation is rare and is mostly due to direct orbital trauma with fractures of the medial and floor walls, which displace the globe into the maxillary sinus. Only a few cases have been reported; moreover, patients who suffer global luxation rarely achieve eyesight recovery. CASE SUMMARY This report describes the treatment and prognosis of global luxation occurring in a child. A 6-year-old boy presented with left globe luxation that occurred after a sudden stop on a tricycle, without any injury to the orbital or maxillofacial bony structures. After admission to the hospital, an external canthus incision, globe repositioning, orbital exploration and temporary blepharoplasty were performed. Finally, the child completely recovered and maintained good eyesight in his left eye even though the right eye developed myopia after four years of follow-up. CONCLUSION The aim of this study was to report the special occurrence of globe luxation in the child and share some experience of the treatment. Immediate surgical management plays an important role in the recovery of visual function, and globe luxation may prevent nearsightedness by reducing the distortion of the eyeball, shortening the axis and improving ciliary function.
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Affiliation(s)
- Qian Li
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui Province, China
| | - Yu-Xin Xu
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui Province, China
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Pushker N. Born with a luxated globe: An ocular emergency. World J Emerg Med 2022; 13:158-159. [DOI: 10.5847/wjem.j.1920-8642.2022.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 08/02/2021] [Indexed: 11/19/2022] Open
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Das D, Mohapatra A, Modaboyina S, Agrawal S. Bilateral globe luxation with multiple facial fractures: what next? BMJ Case Rep 2021; 14:e244099. [PMID: 34479895 PMCID: PMC8420692 DOI: 10.1136/bcr-2021-244099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2021] [Indexed: 11/04/2022] Open
Abstract
Luxation of the globe is a rare, vision-threatening event that can presently spontaneously or following trauma. A 35-year-old man presented with bilaterally luxated globe, postroad traffic accident. On imaging, bilateral LeFort fracture type 1, 2 and 3 with palatal split along with nasal bone and orbital floor fracture. Both condyles and left parasymphysis of mandible were fractured. There was no evidence of intracranial injury. There was pneumothorax on the right side for which intercostal drainage (ICD) tube was placed. On exploring, bilateral optic nerve avulsion was present. Both the globes were repositioned and a temporary tarsorrhaphy was placed for cosmetic rehabilitation. On follow-up visits after 6 months, both eyes were in their sockets with minimal exodeviation. It is important to reposition the globes, even with extensive periorbital fracture at the earliest. The longer the globe and orbital structures are prolapsed, the poorer are the structural and cosmetic prognosis owing to ocular ischaemia.
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Affiliation(s)
- Deepsekhar Das
- Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Avilasha Mohapatra
- Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Sujeeth Modaboyina
- Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Sahil Agrawal
- Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
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Gupta H, Natarajan S, Vaidya S, Gupta S, Shah D, Merchant R, Deshpande S. Traumatic eye ball luxation: A stepwise approach to globe salvage. Saudi J Ophthalmol 2017; 31:260-265. [PMID: 29234230 PMCID: PMC5717501 DOI: 10.1016/j.sjopt.2017.06.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Revised: 05/28/2017] [Accepted: 06/06/2017] [Indexed: 11/29/2022] Open
Abstract
Craniofacial trauma is often associated with orbital and ocular injuries. We report a case of a 21-year-old male with motor vehicular accident, orbital roof blow-in fracture, cerebrospinal fluid (CSF) leak, and left sided globe luxation with corneal abrasion and complete conjunctival denuding. The patient was managed by a multispeciality team and the eyeball was protected by amniotic membrane graft (AMG) biological dressing with novel use of inverted sterile metallic bowl as mechanical protection till the patient stabilized. During surgery, eyeball was reposited and ocular surface was reconstructed using amniotic membrane and symblepharon ring. Surgical correction and plating of the facial fractures and dural repair with autologus tensor fascia lata was done. Post surgery ocular surface was intact, ocular motility was well preserved and the globe was prephthisical. Traumatic eyeball luxation is a rare, but dramatic presentation which may occur in a blow in fracture when the intra orbital volume reduces and expels the eye ball out of the socket. This may be associated with extra ocular muscle rupture or optic nerve avulsion. The visual prognosis is nil in majority cases. However, the management is targeted towards globe preservation in view of psychological benefit and ease of cosmetic or prosthetic rehabilitation. Knowing the mechanism of luxation helps to plan the management. A stepwise approach for globe salvage is recommended. Team efforts to take care of various morbidities with special steps to safeguard the eye help to optimize outcomes.
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Affiliation(s)
- Himika Gupta
- Department of Ophthalmology, MGM Medical College and University, Kamothe, Navi Mumbai, Maharashtra, India
| | - Srivalli Natarajan
- Department of Oro Maxillofacial Surgery, MGM Dental College and University, Kamothe, Navi Mumbai, Maharashtra, India
| | - Sushrut Vaidya
- Department of Oro Maxillofacial Surgery, MGM Dental College and University, Kamothe, Navi Mumbai, Maharashtra, India
| | - Shipra Gupta
- Department of Ophthalmology, MGM Medical College and University, Kamothe, Navi Mumbai, Maharashtra, India
| | - Dinesh Shah
- Department of Oro Maxillofacial Surgery, MGM Dental College and University, Kamothe, Navi Mumbai, Maharashtra, India
| | - Raj Merchant
- Department of Oro Maxillofacial Surgery, MGM Dental College and University, Kamothe, Navi Mumbai, Maharashtra, India
| | - Shrikant Deshpande
- Department of Ophthalmology, MGM Medical College and University, Kamothe, Navi Mumbai, Maharashtra, India
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Noman SA, Shindy MI. Immediate Surgical Management of Traumatic Dislocation of the Eye Globe into the Maxillary Sinus: Report of a Rare Case and Literature Review. Craniomaxillofac Trauma Reconstr 2016; 10:151-158. [PMID: 28523089 DOI: 10.1055/s-0036-1584393] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 02/28/2016] [Indexed: 01/16/2023] Open
Abstract
We report a case of complete dislocation of the globe into the maxillary sinus, with immediate repositioning of the globe. This report highlights the importance of early surgical repair of orbital fracture and globe repositioning to regain the maximum amount of ocular functions. A review of literature found 19 cases of globe dislocation into the maxillary sinus: One case was enucleated 2 months after misdiagnosis as traumatic enucleation, six cases were documented no vision or no light perception, three cases did not have reported vision (patients did not survive), and nine cases with postoperative vision. We recommend early surgical intervention to restore the cosmetic and visual function of the dislocated eye.
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Affiliation(s)
- Samer Abduljabar Noman
- Department of Oral and Maxillofacial Surgery, Faculty of Oral and Dental Medicine, Sana'a University, Sana'a, Yemen
| | - Mostafa Ibrahim Shindy
- Department of Oral and Maxillofacial Surgery, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
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Amaral MBF, Carvalho MF, Ferreira AB, Mesquita RA. Traumatic globe luxation associated with orbital fracture in a child: a case report and literature review. J Maxillofac Oral Surg 2013; 14:323-30. [PMID: 25861192 DOI: 10.1007/s12663-013-0539-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 05/16/2013] [Indexed: 12/27/2022] Open
Abstract
Orbital fracture associated with traumatic globe luxation is rare, as it generally requires trauma with high energy for this to occur. The present case report focused on a child who had been hit by a motorcycle, leading to a globe luxation of the left eye and fractures of the superolateral orbital walls. The patient presented initial cosmetic and psychological benefits from the repositioning of the intact globe and the reduction of the orbital fractures. However, a subsequent evisceration of the globe was required due to persistent proptosis and pain. An ocular prosthesis was also implanted, thus recovering the patient's aesthetics. Thirty-four well-documented cases of traumatic globe luxation could be found in the English literature since 1970. The mean age of patients presenting traumatic globe luxation was 29.5 years. The male gender proved to be more prevalent, with traffic collisions representing the most common accident etiology. Direct orbital trauma with fractures of medial and floor walls displacing the globe into the maxillary sinus represented the most common injury mechanism (38.2 %), followed by an elongated object entering the orbit (26.5 %). Optical nerve avulsion is the most serious complication seen in association with traumatic globe luxation, with the repositioning of the initial globe, with no enucleation or evisceration, representing the main form of management.
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Affiliation(s)
- Márcio Bruno Figueiredo Amaral
- Oral and Maxillofacial Surgery Service, Hospital João XXIII/FHEMIG, Av. Professor Alfredo Balena, 400, Santa Efigênia, Belo Horizonte, MG 30130-100 Brazil ; Department of Oral and Maxillofacial Surgery, School of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Av. Dom José Gaspar, 500, Coração Eucarístico, Belo Horizonte, MG 30535-901 Brazil ; Department of Oral Surgery and Pathology. School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG 31270-901 Brazil
| | - Matheus Furtado Carvalho
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Av. Dom José Gaspar, 500, Coração Eucarístico, Belo Horizonte, MG 30535-901 Brazil
| | - André Baptista Ferreira
- Ophthalmologic Service, Hospital João XXIII/FHEMIG, Av. Alfredo Balena, 400, Santa Efigênia, Belo Horizonte, MG 30130-100 Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology. School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG 31270-901 Brazil
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Yaman A, Ozturk T, Soylev MF. Reversal of optic neuropathy secondary to voluntary globe luxation. J AAPOS 2009; 13:210-2. [PMID: 19157936 DOI: 10.1016/j.jaapos.2008.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2007] [Revised: 09/07/2008] [Accepted: 09/25/2008] [Indexed: 10/21/2022]
Abstract
Luxation of the globe is rare in the general population and may be spontaneous, voluntary, or traumatic. Spontaneous or voluntary globe luxation results from shallow orbit, floppy eyelids, lax orbital ligaments, backward displacement of orbital septum, or proptotic eyes due to orbital tumors or infiltrative processes, as in Grave's ophthalmopathy. The authors report a case with unilateral voluntary globe luxation presented with unilateral progressive visual loss.
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Affiliation(s)
- Aylin Yaman
- Department of Ophthalmology, Dokuz Eylul University, Izmir, Turkey.
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