Prognosis and treatment of perforating ocular injuries. The John Luhr memorial lecture

A review of 77 perforating ocular injuries was undertaken with emphasis on prognostic indicators and a better approach to therapy. The most common cause of perforating eye injuries was violence. It was found that over one fourth of the cases resulted in blindness or enucleation. Scleral involvement had a grave prognosis with nearly half of the eyes lost to blindness or enucleation. When vitreous was involved, 70% of the eyes were lost. The social disability associated with perforating ocular injuries is a significant factor. Microsurgical therapy must be carefully planned for each case and radical treatment of the lens and vitreous is essential. Serial sub-tenons steroids are necessary to decrease the destructive fibrosis associated with the healing process. It is felt that this retrospective review establishes a clear relationship between inadequate surgical technique and blind eyes while providing suggestions to prevent further blindness.