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Updated: Dec 20, 2025
Corneal Epithelial Abrasion with Ocular Burr As a Model for Cornea Wound Healing
Published on: July 10, 2018
[Clinical observation of ocular injury caused by chestnut burr]
Insights
Ocular injuries from chestnut burrs commonly involve foreign bodies, fungal keratitis, and necrotizing scleritis. Prompt removal of burr foreign bodies and early intervention for fungal keratitis are crucial for optimal outcomes.
Area of Science:
- Ophthalmology
- Traumatology
Background:
- Chestnut burrs can cause significant ocular injuries.
- Prompt diagnosis and management are essential to prevent vision loss.
Purpose of the Study:
- To analyze the clinical characteristics and treatment of ocular injury caused by chestnut burr.
- To identify common injury types and effective management strategies.
Main Methods:
- Retrospective case series study.
- Analysis of 48 patients with ocular injuries caused by chestnut burrs.
- Follow-up of at least 3 months for all patients.
Main Results:
- Common injuries include corneal/scleral foreign bodies (27.1%), fungal keratitis (50.0%), and necrotizing scleritis (22.9%).
- Fungal keratitis often involved *Alternaria spp.* and required interventions ranging from antifungal drugs to penetrating keratoplasty.
- Necrotizing scleritis was linked to retained foreign bodies and treated with scleral exploration.
Conclusions:
- Chestnut burr ocular injuries present as foreign bodies, fungal keratitis, or necrotizing scleritis.
- Early removal of foreign bodies and prompt treatment for fungal keratitis are vital.
- Scleral incision and exploration are effective for necrotizing scleritis, often resulting from delayed foreign body removal.
Abstract:
Objective: To analyze the clinical characteristics and treatment of ocular injury caused by chestnut burr. Methods: Retrospective case series study. Data of 48 patients (48 eyes) with ocular injuries caused by chestnut burrs hospitalized in Qingdao Eye Hospital were collected from January 2013 to March 2019. All patients were followed up for at least 3 months. The time of seeking medical advice, lesion region, and characteristics and treatment methods were analyzed. Results: There were 48 patients, including 33 males and 15 females, aged 19 to 74 years [mean, (56±10) years]. The time of injury was late September (25 cases) and early October (23 cases). The shortest time to visit our hospital was 3 hours after injury, and the longest was 8 months after injury. There were 13 cases (27.1%, 13/48) with corneal and/or scleral foreign bodies. All patients were treated with corneal or scleral foreign body extraction. Twenty-four patients (50.0%, 24/48) developed fungal keratitis. Among them, 18 patients had a corneal ulcer, and the infection involved the superficial or full-thickness corneal layer. Six patients had no corneal ulcer, and the infection involved the deep stroma and corneal endothelial surface. The positive rate of fungal examination by confocal microscopy was 87.5% (21/24). Antifungal drugs (2 cases), corneal debridement (5 cases), conjunctival flap covering (2 cases), corneal stroma injection (1 case), and penetrating keratoplasty(14 cases) were given according to the depth of fungal infection. Most of the pathogens were Alternaria spp. Eleven patients (22.9%, 11/48) with necrotizing scleritis were treated with exploration of the sclera. Three patients had scleral foreign body residues on ultrasound biomicroscopy examination, which were removed by operation. Four patients were found to have fungi at the necrotic site of the sclera. Conclusions: The main types of ocular injuries caused by chestnut burrs are corneal and/or scleral foreign bodies, fungal keratitis, and necrotizing scleritis. Chestnut burr foreign bodies should be removed as soon as possible. In the case of fungal keratitis, a drug or surgical intervention should be carried out as early as possible. Necrotizing scleritis is often induced by long-term foreign body retention. Scleral incision and exploration is an effective form of treatment. (Chin J Ophthalmol, 2020, 56: 370-375).
