الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
• Globe injuries are often seen in combination with other orbital injuries. • Clinical ophthalmologic examination is the key to rapid and accurate diagnosis of most ocular injuries. • Glaucoma after closed globe injury is a major concern because many cases may go unnoticed and, without close follow-up, are diagnosed many years later as having irreversible glaucomatous optic nerve damage. • Two peak incidences of glaucoma after trauma have been reported, less than 1 year and at least 10 years after trauma. • The clinician should always consider trauma as a possible mechanism of elevated intraocular pressure in every patient with unilateral glaucoma. • A thorough knowledge of the risk factors for post-traumatic glaucoma and careful examination are required for rapid identification of affected patients. • Glaucoma can occur acutely or more often delayed as in angle recession. • Ocular features commonly seen in eyes with traumatic glaucoma are poor baseline visual acuity, hyphema, an angle recession of more than 180°, traumatic cataracts, displacement of the lens, and iris injuries. • However, only a few eyes develop glaucoma, despite the presence of traumatic damage. • Two subgroups of hyphema patients warrant special attention: Sickle cell hemoglobinopathy & patients with a rebleed. • Hospitalization with activity restriction and close observation has not been proven to prevent rebleeding. It may, however, be recommended for patients requiring close IOP monitoring. • Although amino-caproic acid can decrease the incidence of secondary hemorrhage following a traumatic hyphema, side effects and cost generally limit its use to a case-by-case basis. • Patients with unilateral angle cleavage glaucoma have a 50% chance of developing open-angle glaucoma in the fellow eye. • The presence of a cyclodialysis was protective against the occurrence of chronic glaucoma. • Many of the mechanisms encountered with blunt trauma can also be at play in cases of glaucoma after penetrating injury • In open globe trauma, the first and most important cause of late onset glaucoma is the formation of extensive peripheral anterior synechiae. • Most IOP difficulties (after trauma) can be managed medically. • Surgical intervention is usually reserved for cases with elevated IOP uncontrolled by medical therapy. • The definite treatment of lens-related glaucoma is lens extraction. • The causes of elevated IOP following anterior segment surgery are numerous, and their relative frequency has changed with evolving surgical techniques. • Increased pigmentation of the angle on gonioscopic findings, a higher baseline IOP, and the absence of a cyclodialysis cleft on UBM or gonioscopic findings, along with the previously described features of hyphema, angle recession, and lens injury, can assist in the identification of eyes with closed globe injury, predisposed to chronic glaucoma.