Rund um Silvester gibt es in den augenärztlichen Rettungsstellen regelmäßig Personen
mit feuerwerksbedingten Augenverletzungen – wie häufig sind diese Verletzungen? Nimmt
deren Zahl in den letzten Jahren zu? Wie häufig werden unbeteiligte Personen verletzt?
Wie kann man in schweren Fällen unübersichtliche Befunde strukturiert erheben? Und
welche Therapieansätze stehen für mechanische, thermische und chemische feuerwerksbedingte
Augenverletzungen zur Verfügung?
Abstract
Wherever consumer fireworks are used, incidents with eye injuries do occur. In Germany,
their number has increased in the past nine years, a clear overrepresentation of minors
and bystanders is documented. Eyes are affected by a very individual combination of
thermal, chemical and mechanical impact, resulting in minor to most complex injuries
to adnexes, eye surface, iris, lens, sclera and/or posterior segment. Diagnostics
may be complicated and require a structured approach, that is proposed here. Open
globe injuries and intraocular foreign bodies necessitate early surgical intervention.
In thermal and chemical burns early rinsing and antiphlogistic therapy is major for
prevention of scarring and secondary glaucoma. The need for early or late replacement
of limbal stem cells may yet emerge. Consequences of blunt trauma can be traumatic
cataract, phakic or pseudophakic lens luxation, ruptures to all structures of the
eye with long-term effects such as retinal detachment,
choroidal or retinal pigment epithelial rupture and formation of choroidal neovascular
membranes (CNV). Medical and surgical strategies are discussed. Despite all proven
and innovative care strategies of therapy, functional and cosmetic outcome of fire
work induced eye injuries might be impaired. In cases of severe injuries, social security
coverage and rehabilitation must be considered early on.
Schlüsselwörter
Augenverletzung - Feuerwerksverletzung - Explosionsverletzung - Verätzung - Verbrennung
- Bulbuseröffnung - stumpfe Verletzung - fire works - blunt eye trauma - explosive
eye injury - thermal burn - chemical burn - open globe eye injury
