[Contusion changes in ophthalmic tonus: clinical observations and pathogenesis]

Area of Science:

• Ophthalmology
• Trauma research
• Physiology

Background:

• Contusions to the eyeball can lead to significant alterations in intraocular pressure (IOP).
• Understanding these pressure changes is crucial for managing ocular trauma.
• Previous studies highlight the complexity of IOP responses following blunt eye injury.

Purpose of the Study:

• To investigate the patterns and causes of reactive and secondary changes in intraocular pressure following eyeball contusions.
• To identify the primary factors contributing to the postcontusion reactive syndrome.

Main Methods:

• Clinical examination of 151 patients with eyeball contusions.
• Analysis of intraocular pressure (IOP) variations, including reactive hypertension, reactive hypotony, secondary hypertension, and stable hypotony.
• Ultrasonic examination to diagnose conditions like expulsive hemorrhage and vascular membrane detachment.

Main Results:

• Secondary hypertension was observed in 48.34% of cases, often associated with intraocular hemorrhages and structural damage.
• Reactive hypotony occurred in 31.79% of patients, with expulsive hemorrhage and vascular membrane detachment identified in 76.92% via ultrasound.
• Factors like rapid IOP fluctuations, anterior chamber volume loss, and the kallikrein-kinin system activation were implicated in the reactive syndrome.

Conclusions:

• Blunt ocular trauma frequently causes significant intraocular pressure dysregulation.
• Secondary hypertension is often linked to intraocular bleeding and structural damage, while hypotony relates to vascular issues.
• The kallikrein-kinin system plays a role in the complex pathophysiology of postcontusion reactive syndrome.