Ruptured globe due to penetrating injury
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Operative notes:
Steps:
Conjunctival Peritomy around the tear was performed.
Wound explored.
Abscission of the prolapsed intra-ocular contents was done.
Scleral laceration sutured with multiple interrupted 8-0 vicryl sutures.
Conjunctival closure with 8-0 vicryl.
Full thickness sub-periosteal flap was raised along with the medial wall of the orbit.
The medial wall of the orbit was exposed till the apex of the orbit.
Soft tissue dissection is done medially to palpate the foreign body.
The foreign body was felt medially just above the optic foramen.
Foreign body retrieved with artery forceps.
Lynch incision sutured using 4 and 5-0 vicryl sutures.
Hemostasis was achieved.
Findings:
Lid edema.
Large sub-conjunctival hemorrhage with chemosis nasally.
Large scleral laceration extending from 1mm posterior to the limbus to 10mm posterior to the limbus along 1 o'clock with gross prolapse of intra-ocular contents.
Very hypotonus eye.
Total hyphema obscuring the other details.
A lead pellet was lodged at the rim of the optic canal, suggesting optic nerve damage.
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