Perforating eye injuries in KwaZulu.

Data on 100 consecutive perforating eye injuries treated at Edendale Hospital, Pietermaritzburg, were collected in order to evaluate some of the features of this condition seen in KwaZulu, and also to assess the outcome of current management. Fifty-six of the injuries were due to assault and 44 were accidental. Fifty injuries involved the anterior segment only, and 50 involved the posterior segment. Only 6 eyes achieved a final visual acuity of 6/12 or better, and 44 eyes ended up with no light perception. Factors contributing to the poor visual results in this Third-World situation include the severity of the injuries and the inadequacy of surgical management within the constraints imposed by limited facilities and expertise. More care is needed in selecting patients with posterior segment injuries, in whom useful ambulatory vision may be salvageable, for vitrectomy and retinal detachment repair. The criteria for such selection should include the nature of the injury, the visual acuity, the presence or absence of an afferent pupil defect, the extent of the injury found at the time of repair, the presence and extent of vitreous haemorrhage, and the findings on ultrasonography.