Penetrating and perforating eye injuries during brushcutter work despite wearing of head protection

Background Protective clothing is prescribed concerning gloves, shoes, prot ective trousers and a helmet for protection of hearing and the face during brushcutter work. Patients and methods Seven patients were observed in a time period from 199 4 to 1998. Mostly a nylon head protection had been used. The side of the he lmet has no protection shield. The 1- to 4-mm large foreign bodies passed t he head protection shield from the side or by entering through the holes of the nylon mesh which may be not small enough to stop the foreign body. A p ars plana vitrectomy with foreign body removal was performed after primary wound repair. Results An endophthalmitis was diagnosed in two patiens after primary wound treatment. In these cases, a pars plana vitrectomy and antibiotic instilla tion was performed. In 5 patients visual acuity increased postoperatively. We measured a postoperative visual acuity from 1/50 to 1.6. The development of proliferative vitreoretinopathy with retinal detachment in 4 patients w as the main complication observed after pars plana vitrectomy. Conclusion A cosmeticly satisfactory appearance of the injured eye was reac hed by pars plana vitrectomy in all patients. Anatomic and functional succe ss was reached in most of the patients. For prophylaxis, a head-protection seems not safe enough. The additional usage of eye protection glasses may b e imperative for the prevention of these eye injuries.