Rethinking on improving the level of emergency treatment of ocular trauma in China_Chinese Journal of Ocular Fundus Diseases

Authors：

 Yan Hua

Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin 300052, China;

Corresponding author：

Yan Hua, Email: zyyyanhua@tmu.edu.cn

Keywords：

Ocular trauma; Emergency; Treatment; Standard protocol; Editorial

DOI：

10.3760/cma.j.cn511434-20250102-00002

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Emergency treatment of ocular trauma is a systematic and complicated work. Rapid and correct diagnosis and treatment are needed to maximize the recovery of ocular structure and function. In recent years, China has made remarkable progress in the emergency treatment of eye trauma, including the development of Expert consensus on the norms of emergency treatment of eye trauma in China (2019), the establishment of a national ocular trauma database, and the development of VisionGo artificial Intelligence prediction system for eye trauma. These measures improve the treatment level of ocular trauma and provide support for the prediction of postoperative visual acuity in severely dull eyes. However, with the development of economy and society, the characteristics of ocular trauma in our country have changed. For example, the majority of hospitalized patients were open eye injuries, farmers and workers were the main occupational groups, and the proportion of eye injuries caused by traffic injuries increased year by year, and the proportion of women and minors increased. Although the annual loss of life of eye trauma disability in China has decreased faster than the world average, the emergency treatment of eye trauma still faces many challenges, such as regional differences, insufficient primary medical resources, lack of standardized training, and insufficient promotion of emergency treatment standards. In order to cope with these challenges, it is necessary to further strengthen the popularization of science and technology for the prevention and treatment of eye trauma, standardize the emergency treatment process, strengthen the training of grass-roots medical personnel, strengthen the safety of emergency surgery, and pay special attention to the particularity of children's ocular trauma. In addition, relevant research has been actively carried out to establish a complete database of emergency patients with eye trauma to promote the accurate prevention and treatment of ocular trauma.

1.	中华医学会眼科学分会眼外伤学组. 中国眼外伤急诊救治规范专家共识(2019年)[J]. 中华眼科杂志, 2019, 55(9): 647-651. DOI: 10.3760/cma.j.issn.0412-4081.2019.09.004.Ophthalmology Group, Ophthalmology Society, Chinese Medical Association. Expert consensus on the norms of emergency treatment of eye trauma in China (2019)[J]. Chin J Ophthalmol, 2019, 55(9): 647-651. DOI: 10.3760/cma.j.issn.0412-4081.2019.09.004.
2.	Wang X, Feng K, He S, et al. The continuous treatment of anterior segment open globe injury: an eye injury vitrectomy study[J]. Quant Imaging Med Surg, 2023, 13(9): 6257-6267. DOI: 10.21037/qims-23-645.
3.	Feng K, Yao Y, Wang ZJ, et al. Mechanism and prognostic indicators for explosion-related eye trauma: eye injury vitrectomy study[J/OL]. Acta Ophthalmol, 2021, 99(6): e956-e962[2021-01-08]. https://pubmed.ncbi.nlm.nih.gov/33417310/. DOI: 10.1111/aos.14713.
4.	Chen HJ, Feng K, Feng XF, et al. Traumatic choroidal injuries-classification, incidence, diagnosis and prognosis twenty-year results of eye injury vitrectomy study[J/OL]. Acta Ophthalmol, 2021, 99(3): e387-e393[2020-10-29]. https://pubmed.ncbi.nlm.nih.gov/33124167/. DOI: 10.1111/aos.14578.
5.	Feng K, Wang CG, Hu YT, et al. Clinical features and prognosis of eyeball rupture: eye injury vitrectomy study[J]. Clin Exp Ophthalmol, 2015, 43(7): 629-636. DOI: 10.1111/ceo.12534.
6.	Feng K, Hu Y, Wang C, et al. Risk factors, anatomical, and visual outcomes of injured eyes with proliferative vitreoretinopathy: eye injury vitrectomy study[J]. Retina, 2013, 33(8): 1512-1518. DOI: 10.1097/IAE.0b013e3182852469.
7.	Feng K, Hu YT, Ma Z. Prognostic indicators for no light perception after open-globe injury: eye injury vitrectomy study[J]. Am J Ophthalmol, 2011, 152(4): 654-662. DOI: 10.1016/j.ajo.2011.04.004.
8.	Feng K, Shen L, Pang X, et al. Case-control study of risk factors for no light perception after open-globe injury: eye injury vitrectomy study[J]. Retina, 2011, 31(10): 1988-1996. DOI: 10.1097/IAE.0b013e318213d8c7.
9.	Yan H, Yang K, Ma Z, et al. Guideline for the treatment of no light perception eyes induced by mechanical ocular trauma[J]. J Evid Based Med, 2022, 15(3): 302-314. DOI: 10.1111/jebm.12496.
10.	中华医学会眼科学分会眼外伤学组. 中国眼内异物伤诊疗专家共识(2021年)[J]. 中华眼科杂志, 2021, 57(11): 819-824. DOI: 10.3760/cma.j.cn112142-20210810-00373.Ophthalmology Group, Ophthalmology Society, Chinese Medical Association. Chinese expert consensus on the diagnosis and treatment of intraocular foreign bodies (2021)[J]. Chin J Ophthalmol, 2021, 57(11): 819-824. DOI: 10.3760/cma.j.cn112142-20210810-00373.
11.	中华医学会眼科学分会眼外伤学组. 中国机械性眼外伤无光感眼救治专家共识(2020年)[J]. 中华眼科杂志, 2020, 56(11): 815-819. DOI: 10.3760/cma.j.cn112142-20200805-00528.Ophthalmology Group, Ophthalmology Society, Chinese Medical Association. Chinese expert consensus on treatment of mechanical eye trauma without light eye (2020)[J]. Chin J Ophthalmol, 2020, 56(11): 815-819. DOI: 10.3760/cma.j.cn112142-20200805-00528.
12.	Meng X, Wang Q, Chen S, et al. An interpretable model predicts visual outcomes of no light perception eyes after open globe injury[J]. Br J Ophthalmol, 2024, 108(2): 285-293. DOI: 10.1136/bjo-2022-322753.
13.	Guo H, Yu J, He T, et al. Early use of intravitreal triamcinolone to inhibit traumatic proliferative vitreoretinopathy: a randomised clinical trial[J]. Br J Ophthalmol, 2024, 108(8): 1161-1167. DOI: 10.1136/bjo-2023-324318.
14.	Liao M, Zhu X, Lu Y, et al. Multi-omics profiling of retinal pigment epithelium reveals enhancer-driven activation of RANK-NFATc1 signaling in traumatic proliferative vitreoretinopathy[J/OL]. Nat Commun, 2024, 15(1): 7324[2024-08-25]. https://pubmed.ncbi.nlm.nih.gov/39183203/. DOI: 10.1038/s41467-024-51624-y.
15.	Liang M, Wang Z, He K, et al. An antifouling supramolecular polymer ophthalmic ointment alleviates symblepharon in rat alkali burn eyes[J]. Biomater Sci, 2024, 12(15): 3905-3917. DOI: 10.1039/d4bm00637b.
16.	Guo M, Zhu Y, Shi Y, et al. Inhibition of ferroptosis promotes retina ganglion cell survival in experimental optic neuropathies[J/OL]. Redox Biol, 2022, 58: 102541[2022-11-15]. https://pubmed.ncbi.nlm.nih.gov/36413918/. DOI: 10.1016/j.redox.2022.102541.
17.	Song Y, Liao M, Zhao X, et al. Vitreous M2 macrophage-derived microparticles promote RPE cell proliferation and migration in traumatic proliferative vitreoretinopathy[J]. Invest Ophthalmol Vis Sci, 2021, 62(12): 26. DOI: 10.1167/iovs.62.12.26.
18.	Guo H, Wang T, Yu J, et al. Vitreous olink proteomics reveals inflammatory biomarkers for diagnosis and prognosis of traumatic proliferative vitreoretinopathy[J/OL]. Front Immunol, 2024, 15: 1355314[2024-02-22]. https://pubmed.ncbi.nlm.nih.gov/38455059/. DOI: 10.3389/fimmu.2024.1355314.
19.	Li C, Fu Y, Liu S, et al. The global incidence and disability of eye injury: an analysis from the global burden of disease study 2019[J/OL]. EClinicalMedicine, 2023, 62: 102134[2023-08-09]. https://pubmed.ncbi.nlm.nih.gov/37599904/. DOI: 10.1016/j.eclinm.2023.102134.
20.	李冬嫦, 付婧, 王滔, 等. 儿童眼外伤2298例的回顾性分析[J]. 国际眼科杂志, 2022, 22(3): 521-524. DOI: 10.3980/j.issn.1672-5123.2022.3.36.Li DC, Fu J, Wang T, et al. Retrospective analysis of 2298 children with ocular trauma[J]. Int Eye Sci, 2022, 22(3): 521-524. DOI: 10.3980/j.issn.1672-5123.2022.3.36.
21.	孙智勇, 孟玉, 颜华. 儿童眼外伤临床特点及预后[J]. 中华眼外伤职业眼病杂志, 2017, 39(5): 392-394. DOI: 10.3760/cma.j.issn.2095-1477.2017.05.019.Sun ZY, Meng Y, Yan H. Clinical characteristics and prognosis of pediatric ocular trauma[J]. Chin J Ocul Traum Occupat Eye Dis, 2017, 39(5): 392-394. DOI: 10.3760/cma.j.issn.2095-1477.2017.05.019.
22.	Olitsky SE, Nelson BA, Brooks S. The sensitive period of visual development in humans[J]. J Pediatr Ophthalmol Strabismus, 2002, 39(2): 69-72. DOI: 10.3928/0191-3913-20020301-04.
23.	王甜, 颜华. 儿童眼外伤特点及治疗进展[J]. 中华眼外伤职业眼病杂志, 2016, 38(11): 877-880. DOI: 10.3760/cma.j.issn.2095-1477.2016.11.022.Wang T, Yan H. The characteristics and treatment progress in pediatric ocular trauma[J]. Chin J Ocul Traum Occupat Eye Dis, 2016, 38(11): 877-880. DOI: 10.3760/cma.j.issn.2095-1477.2016.11.022.

1. 中华医学会眼科学分会眼外伤学组. 中国眼外伤急诊救治规范专家共识(2019年)[J]. 中华眼科杂志, 2019, 55(9): 647-651. DOI: 10.3760/cma.j.issn.0412-4081.2019.09.004.Ophthalmology Group, Ophthalmology Society, Chinese Medical Association. Expert consensus on the norms of emergency treatment of eye trauma in China (2019)[J]. Chin J Ophthalmol, 2019, 55(9): 647-651. DOI: 10.3760/cma.j.issn.0412-4081.2019.09.004.
2. Wang X, Feng K, He S, et al. The continuous treatment of anterior segment open globe injury: an eye injury vitrectomy study[J]. Quant Imaging Med Surg, 2023, 13(9): 6257-6267. DOI: 10.21037/qims-23-645.
3. Feng K, Yao Y, Wang ZJ, et al. Mechanism and prognostic indicators for explosion-related eye trauma: eye injury vitrectomy study[J/OL]. Acta Ophthalmol, 2021, 99(6): e956-e962[2021-01-08]. https://pubmed.ncbi.nlm.nih.gov/33417310/. DOI: 10.1111/aos.14713.
4. Chen HJ, Feng K, Feng XF, et al. Traumatic choroidal injuries-classification, incidence, diagnosis and prognosis twenty-year results of eye injury vitrectomy study[J/OL]. Acta Ophthalmol, 2021, 99(3): e387-e393[2020-10-29]. https://pubmed.ncbi.nlm.nih.gov/33124167/. DOI: 10.1111/aos.14578.
5. Feng K, Wang CG, Hu YT, et al. Clinical features and prognosis of eyeball rupture: eye injury vitrectomy study[J]. Clin Exp Ophthalmol, 2015, 43(7): 629-636. DOI: 10.1111/ceo.12534.
6. Feng K, Hu Y, Wang C, et al. Risk factors, anatomical, and visual outcomes of injured eyes with proliferative vitreoretinopathy: eye injury vitrectomy study[J]. Retina, 2013, 33(8): 1512-1518. DOI: 10.1097/IAE.0b013e3182852469.
7. Feng K, Hu YT, Ma Z. Prognostic indicators for no light perception after open-globe injury: eye injury vitrectomy study[J]. Am J Ophthalmol, 2011, 152(4): 654-662. DOI: 10.1016/j.ajo.2011.04.004.
8. Feng K, Shen L, Pang X, et al. Case-control study of risk factors for no light perception after open-globe injury: eye injury vitrectomy study[J]. Retina, 2011, 31(10): 1988-1996. DOI: 10.1097/IAE.0b013e318213d8c7.
9. Yan H, Yang K, Ma Z, et al. Guideline for the treatment of no light perception eyes induced by mechanical ocular trauma[J]. J Evid Based Med, 2022, 15(3): 302-314. DOI: 10.1111/jebm.12496.
10. 中华医学会眼科学分会眼外伤学组. 中国眼内异物伤诊疗专家共识(2021年)[J]. 中华眼科杂志, 2021, 57(11): 819-824. DOI: 10.3760/cma.j.cn112142-20210810-00373.Ophthalmology Group, Ophthalmology Society, Chinese Medical Association. Chinese expert consensus on the diagnosis and treatment of intraocular foreign bodies (2021)[J]. Chin J Ophthalmol, 2021, 57(11): 819-824. DOI: 10.3760/cma.j.cn112142-20210810-00373.
11. 中华医学会眼科学分会眼外伤学组. 中国机械性眼外伤无光感眼救治专家共识(2020年)[J]. 中华眼科杂志, 2020, 56(11): 815-819. DOI: 10.3760/cma.j.cn112142-20200805-00528.Ophthalmology Group, Ophthalmology Society, Chinese Medical Association. Chinese expert consensus on treatment of mechanical eye trauma without light eye (2020)[J]. Chin J Ophthalmol, 2020, 56(11): 815-819. DOI: 10.3760/cma.j.cn112142-20200805-00528.
12. Meng X, Wang Q, Chen S, et al. An interpretable model predicts visual outcomes of no light perception eyes after open globe injury[J]. Br J Ophthalmol, 2024, 108(2): 285-293. DOI: 10.1136/bjo-2022-322753.
13. Guo H, Yu J, He T, et al. Early use of intravitreal triamcinolone to inhibit traumatic proliferative vitreoretinopathy: a randomised clinical trial[J]. Br J Ophthalmol, 2024, 108(8): 1161-1167. DOI: 10.1136/bjo-2023-324318.
14. Liao M, Zhu X, Lu Y, et al. Multi-omics profiling of retinal pigment epithelium reveals enhancer-driven activation of RANK-NFATc1 signaling in traumatic proliferative vitreoretinopathy[J/OL]. Nat Commun, 2024, 15(1): 7324[2024-08-25]. https://pubmed.ncbi.nlm.nih.gov/39183203/. DOI: 10.1038/s41467-024-51624-y.
15. Liang M, Wang Z, He K, et al. An antifouling supramolecular polymer ophthalmic ointment alleviates symblepharon in rat alkali burn eyes[J]. Biomater Sci, 2024, 12(15): 3905-3917. DOI: 10.1039/d4bm00637b.
16. Guo M, Zhu Y, Shi Y, et al. Inhibition of ferroptosis promotes retina ganglion cell survival in experimental optic neuropathies[J/OL]. Redox Biol, 2022, 58: 102541[2022-11-15]. https://pubmed.ncbi.nlm.nih.gov/36413918/. DOI: 10.1016/j.redox.2022.102541.
17. Song Y, Liao M, Zhao X, et al. Vitreous M2 macrophage-derived microparticles promote RPE cell proliferation and migration in traumatic proliferative vitreoretinopathy[J]. Invest Ophthalmol Vis Sci, 2021, 62(12): 26. DOI: 10.1167/iovs.62.12.26.
18. Guo H, Wang T, Yu J, et al. Vitreous olink proteomics reveals inflammatory biomarkers for diagnosis and prognosis of traumatic proliferative vitreoretinopathy[J/OL]. Front Immunol, 2024, 15: 1355314[2024-02-22]. https://pubmed.ncbi.nlm.nih.gov/38455059/. DOI: 10.3389/fimmu.2024.1355314.
19. Li C, Fu Y, Liu S, et al. The global incidence and disability of eye injury: an analysis from the global burden of disease study 2019[J/OL]. EClinicalMedicine, 2023, 62: 102134[2023-08-09]. https://pubmed.ncbi.nlm.nih.gov/37599904/. DOI: 10.1016/j.eclinm.2023.102134.
20. 李冬嫦, 付婧, 王滔, 等. 儿童眼外伤2298例的回顾性分析[J]. 国际眼科杂志, 2022, 22(3): 521-524. DOI: 10.3980/j.issn.1672-5123.2022.3.36.Li DC, Fu J, Wang T, et al. Retrospective analysis of 2298 children with ocular trauma[J]. Int Eye Sci, 2022, 22(3): 521-524. DOI: 10.3980/j.issn.1672-5123.2022.3.36.
21. 孙智勇, 孟玉, 颜华. 儿童眼外伤临床特点及预后[J]. 中华眼外伤职业眼病杂志, 2017, 39(5): 392-394. DOI: 10.3760/cma.j.issn.2095-1477.2017.05.019.Sun ZY, Meng Y, Yan H. Clinical characteristics and prognosis of pediatric ocular trauma[J]. Chin J Ocul Traum Occupat Eye Dis, 2017, 39(5): 392-394. DOI: 10.3760/cma.j.issn.2095-1477.2017.05.019.
22. Olitsky SE, Nelson BA, Brooks S. The sensitive period of visual development in humans[J]. J Pediatr Ophthalmol Strabismus, 2002, 39(2): 69-72. DOI: 10.3928/0191-3913-20020301-04.
23. 王甜, 颜华. 儿童眼外伤特点及治疗进展[J]. 中华眼外伤职业眼病杂志, 2016, 38(11): 877-880. DOI: 10.3760/cma.j.issn.2095-1477.2016.11.022.Wang T, Yan H. The characteristics and treatment progress in pediatric ocular trauma[J]. Chin J Ocul Traum Occupat Eye Dis, 2016, 38(11): 877-880. DOI: 10.3760/cma.j.issn.2095-1477.2016.11.022.

Chinese Journal of Ocular Fundus Diseases

Latest ArticlesRethinking on improving the level of emergency treatment of ocular trauma in China

Abstract Full text Figures/Tables Video References Cited by

Format

Content