Rani Himayani, Rani and Helmi Ismunandar, Helmi (2019) Traumatic Globe Luxation After Blunt Trauma: A Case Report. In: Eyelid and Oculofacial Symposium National University of Singapore, 10-11 Mei 2019, Singapura.

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Abstract

Purpose : To report management of a traumatic globe luxation after blunt trauma. Traumatic Luxation of the eye globe is a rare occasion but it carries a risk of threat to permanent vision loss especially when associated with very high intraocular pressure. Appropriate intervention should be undertaken instantly. Methods : A case report a 8-year-old girl was referred with a protrusion the globe after blunt trauma by door handle approximately three hours before come to emergency departement hospital, red eye, and pain without decreased vision in the left eye. Visual acuity for the right eye and left eye was 20/20 with snelen chart examination. The examination of the anterior segmen on right eye within normal limit. The anterior segmen on left eye, found a complete protrusion the globe with displaced anteriorly and posterior part of globe was caught tightly by the closed lids, ciliaris injection and hyperemia conjunctiva, cornea show early signs of exposure keratitis. The movement of left eye were grossly restricted all gazes. The posterior segment was normal of both eyes. Results : A urgent CT-Scan orbital head examination was performed and showed complete the protrusion of the left globe with intact orbital walls, the optic nerve and extraocular muscle did not show any avulsion. Patient was diagnosed with a traumatic globe luxation. Patient was hospitalized and put on intravenous corticosteroid (1 miligram methylprednisolone per kilograms of body weight) to take care of possible optic nerve compression and prophylactic antibiotics. Patient was urgently taken for surgery under general anesthesia to reposit the protruded eyeball, lateral canthotomy was done, orbital exploration with inserted the finger from canthotomy site into the orbit and a tight girdle of tenon was felt behind the globe on palpation. A trial to reposition the globe with the help of a cotton tip applicator while gently pushing the globe back into place was successful. Central tarsorrhaphy was done which was releases after 1 week. After 15 days post operatively the globe was inposition, with good ocular movement and visual acuity of the left eye 20/20. The color vision and contrast sensitivity test was also normal. Conclusion : In globe protrusion, proper assessment of severity and extent of tissue involvement is very crucial. Canthotomy/ cantholysis, globe reposition at its place and complete tarsorrhaphy helps in keeping the globe in position. In this patient early intervention with globe repositioning led to prevention complication of optic disc damage and can be a key factor to regain good vision.

Item Type:	Conference or Workshop Item (Poster)
Subjects:	R Medicine > RE Ophthalmology
Divisions:	Fakultas Kedokteran (FK) > Prodi Pendidikan Dokter
Depositing User:	dr. RANI HIMAYANI, Sp.M
Date Deposited:	18 Nov 2019 07:22
Last Modified:	18 Nov 2019 07:22
URI:	http://repository.lppm.unila.ac.id/id/eprint/16819

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