Bilateral Eye Injury with Bilateral Blowout Fracture Caused by High-pressure Water Jet in 16-year-old Female Firefighter. Case Report

Abstract

Purpose: The aim is a report of a case of bilateral eye injury with bilateral blowout fracture caused by a high-pressure water jet from a fire hose in 16-years old girl during a competition for young fire fighters. Methods: We present a case report of a 16-years old female patient presenting with bilateral extensive eyelid contusion, oedema and lacerations of upper eyelids, lacerations of bulbar conjunctiva, contusion of both eyes, left optic nerve and bilateral blow out fractures of orbits. Results: The initial ocular examination revealed "hand motion" in the right eye and no sensation of light on the left eye. Intraocular pressure was low on both eyes. Motility of both eyes was reduced, especially on the left eye. Lacerations of eyelids and conjunctiva required surgical approach. No repair of the upper canaliculus of the left eye was attempted. Paralytic mydriasis and loss of lens accommodation in both eyes did not change throughout follow- up period. Surgical approach required left blowout fracture, ocular motility of the right eye improved spontaneously. Traumatic cataract developed on the left eye within 1 year after injury and required cataract surgery and posterior capsule lens implantation, the right lens remain clear. A massive scaring of retina and choroid in inferior parts of eyes and in a macula reduced the best-corrected visual acuity on the right eye to 0.15 and on the left eye to 0.08. Intraocular pressure is within normal limits without any glaucoma therapy. Follow up period is three years. Conclusion: This is the first reported case of child with eye injury caused by a high-pressure water jet and during a sport activity.