Eagling et al reported a grading scheme for perforating injuries of the eye. The author is from the Birmingham and Midland Eye Hospital.


Patient selection: perforating injury to the globe




laceration of the cornea or anterior sclera with or without uveal prolapse but no damage to lens


laceration of the cornea or anterior sclera with lens damage


posterior segment with vitreous loss


both anterior and posterior segment involved



Patients with Grade 1 tinjuries tended to have a good outcome while most patients with Grade 4 injury had a bad outcome (poor light perception)


Problems contributing to poor outcomes:

(1) endophthalmitis

(2) traction retinal detachment

(3) sympathetic ophthalmitis


Grade 1 injuries were associated with wound astigmatism if a corneal laceration exceeds one third of the corneal diameter. This may be related to corneal flattening along the wound.


Grade 2 injuries can have a poor outcome in children under 8 years of age because of the development of squint and amblyopia.


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