title: Traumatic rupture of the globe caused by cow horns.
abstract: OBJECTIVE
  We investigated the epidemiology, clinical findings and functional outcome of open-globe injuries caused by cow horns over a 50-year period in eastern Switzerland.
  
  
  METHODS
  We retrospectively evaluated the files of cases with ruptures of the globe caused by cow horns between 1950 and 1999.
  
  
  RESULTS
  We found 59 cases with ruptures of the globe by cow horns, accounting for 5% of all open-globe injuries. The incidence of these accidents did not change during the observation period. Twenty-two eyes (37%) were enucleated. Only 7 eyes (12%) retained a vision of > or = 0.1. Between 1950 and 1989 only 2/43 eyes (5%) reached a vision of > or = 0.1. In the 1990's, with the introduction of vitreous surgery 5/16 eyes (31%) had a vision of > or = 0.1. Four patients (7%) had blinding eye disease in the partner eye, and three (5%) had a second open-globe trauma.
  
  
  CONCLUSIONS
  In rural regions, with cattle breeding, open-globe injuries by cow horns are relatively common and the frequency is still the same as 50 years ago. The visual prognosis of these eyes is still guarded, but functional results have improved with the introduction of vitreous surgery. Patients who have had a rupture of the globe appear to have an increased risk for partner eye trauma. Therefore, all efforts are justified to preserve even limited vision in severely injured eyes.
authors.affiliation: Department of Ophthalmology, Kantonsspital St. Gallen, Switzerland. horst.helbig@kssg.ch
authors.forename: H
authors.initials: H
authors.lastname: Helbig
authors.forename: H P
authors.initials: HP
authors.lastname: Iseli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D015353:Eye Enucleation; D015807:Eye Injuries, Penetrating / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D005260:Female; D006733:Horns / Q000293:injuries*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000293:injuries*; D011379:Prognosis; D012189:Retrospective Studies; D012421:Rupture; D013557:Switzerland / Q000453:epidemiology; D014792:Visual Acuity