Abstract
Background: Complications associated with the use of extra-oral traction devices (orthodontic headgear or facebow) including facial and ocular injuries, are considered infrequent. Methods: We describe the case of a 12-year-old boy who was inadvertently injured by the metallic bow of orthodontic headgear during sleep and developed blinding intra-ocular infection (endophthalmitis). Results: The injury resulted in corneal perforation. Visual acuity at presentation was 20/60 but deteriorated rapidly to light perception despite prompt medical and surgical treatment for endophathalmitis. Sympathetic ophthalmia developed and was controlled with systemic corticosteroids and imuran. Bacterial cultures showed mixed infection by Gram-negative bacilli and Streptococcus viridans. In 10 (91%) out of the 11 eyes that were reported including our case, the visual acuity was hand movement perception or less. Conclusions: The increase in case reports of such injuries should prompt the establishment of a standard policy regarding the use of orthodontic headgear and increase awareness of orthodontists and ophthalmologists to the blinding potential of even trivial and minor ocular injuries by orthodontic headgear. Intervention should be one step ahead compared with ocular injuries from other foreign bodies.
| Original language | English |
|---|---|
| Pages (from-to) | 253-258 |
| Number of pages | 6 |
| Journal | Graefe's Archive for Clinical and Experimental Ophthalmology |
| Volume | 244 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 2006 |
| Externally published | Yes |
Bibliographical note
Funding Information:This work has been supported by “Fondazione Telethon Italia” grant 297/bi, the Italian Ministry of Health, “Ricerca Finalizzata, 1996,” and the Medical Research Council of Canada (MRC). We are grateful to patients and families who provided samples for our analysis. The authors would also like to acknowledge Peter Heutink, Carol Stayton, Massimiliano Agnelli, Silvia Presi, Elena Rossi, Roberta Cinti, and the PRIMM Sequencing Facility, for technical support, and Drs. Jean Michel Guys, Armando Cama, Margherita Lerone, Romeo Carrozzo, Victoria Maria Siu, and Hironao Numabe, for clinical evaluation. L.-C. T. is a Senior Scientist, and S.W.S. is a Scholar, of the MRC.
Funding
This work has been supported by “Fondazione Telethon Italia” grant 297/bi, the Italian Ministry of Health, “Ricerca Finalizzata, 1996,” and the Medical Research Council of Canada (MRC). We are grateful to patients and families who provided samples for our analysis. The authors would also like to acknowledge Peter Heutink, Carol Stayton, Massimiliano Agnelli, Silvia Presi, Elena Rossi, Roberta Cinti, and the PRIMM Sequencing Facility, for technical support, and Drs. Jean Michel Guys, Armando Cama, Margherita Lerone, Romeo Carrozzo, Victoria Maria Siu, and Hironao Numabe, for clinical evaluation. L.-C. T. is a Senior Scientist, and S.W.S. is a Scholar, of the MRC.
| Funders | Funder number |
|---|---|
| Fondazione Telethon Italia | |
| Ministero della Salute | |
| Medical Research Council Canada |
Keywords
- Blindness
- Endophthalmitis
- Extra-oral traction device
- Facebow
- Foreign body
- Headgear
- Mixed infection
- Orthodontic
- Penetrating injury
- Sympathetic ophthalmia