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Killeen OJ, Waselewski E, Vorias T, Sridhara R, Mubeen A, Waselewski M, Freedman SF, Wang GM, Chang T. US youth perspectives on eye trauma and eye protection. J AAPOS 2024:103949. [PMID: 38866322 DOI: 10.1016/j.jaapos.2024.103949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/26/2024] [Accepted: 03/31/2024] [Indexed: 06/14/2024]
Abstract
Eye injuries from sports, activities, and work are a leading cause of vision loss in youth. Most eye injuries can be prevented with protective eyewear. An open-ended survey on youth perspectives on eye trauma and protection was administered to the MyVoice Text Message Cohort of US youth ages 14-24 years. Qualitative, text message responses were coded using thematic analysis. The survey was distributed to 798 recipients; 641 (80.3%) responded. Many youth were concerned about the impact of excessive screen use (n = 278 [43.8%]) and sunlight or UV exposure (n = 239 [37.6%]) on their eye health. Fewer were concerned about injury from sports and activities (n = 115 [18.1%]) or job-related eye risks (n = 77 [12.1%]). The most common actions that youth took to protect their eyes included sun protection (eg, sunglasses; n = 300 [47.2%]), refractive correction (eg, glasses, contacts; n = 195 [30.7%]) and screen protection (eg, blue light blocking glasses; n = 159 [25.0%]). Fewer wore eye protection for sports or activities (n = 54 [8.5%]) or work (n = 41 [6.5%]). Youth concerns about eye injury from screens and sunlight are misaligned with the main causes of vision loss in this population, suggesting that public health education is needed to promote optimal eye safety.
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Affiliation(s)
- Olivia J Killeen
- Department of Ophthalmology, University of Michigan, Ann Arbor, Michigan; Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan.
| | - Eric Waselewski
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan; Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Theodora Vorias
- College of Literature, Science, and Arts, University of Michigan, Ann Arbor, Michigan
| | - Rhea Sridhara
- College of Literature, Science, and Arts, University of Michigan, Ann Arbor, Michigan
| | - Amani Mubeen
- College of Literature, Science, and Arts, University of Michigan, Ann Arbor, Michigan
| | - Marika Waselewski
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan
| | - Sharon F Freedman
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Grace M Wang
- Department of Ophthalmology, University of Michigan, Ann Arbor, Michigan
| | - Tammy Chang
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan; Department of Family Medicine, University of Michigan, Ann Arbor, Michigan
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Maldoddi R, Gella L. Eye injuries in badminton - players' perspective toward the usage of personal protective equipment. PHYSICIAN SPORTSMED 2024; 52:46-51. [PMID: 36533330 DOI: 10.1080/00913847.2022.2159564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE We conducted a survey between April to September 2021 to understand the perspective of badminton players on the usage of personal protective equipment to avoid eye injuries. METHODS The survey was conducted online. It was disseminated through various social media platforms and via e-mail. The survey was initially shared with university-level badminton players. Both recreational and professional players were included. They were further encouraged to circulate the survey questionnaire among their colleagues. RESULTS In total, the survey received 372 responses. After removing possible duplicates and incomplete responses (n = 28), 92.5% (n = 344) of the responses were included in the final analysis. Among the 344 included responses, recreational and professional players accounted for 77.6% (n = 267) and 22.4% (n = 77), respectively. The mean age ± SD of the recreational and professional players were 24.1 ± 6.3 years (range 14-60 years) and 25.7 ± 6.0 years (range 14-61 years), respectively. A significant difference was noted for self-reported eye injuries between recreational and professional players while playing badminton (χ2 value = 5.321, p = 0.02). Among the recreational and professional players, 93.6% (n = 250) and 88.3% (n = 68) did not use protective eyewear while playing badminton. Professional players were at higher risk of eye injuries than recreational players (OR = 2.9, 95% CI = 1.1-7.8). CONCLUSION The majority of badminton players in both groups agreed that PPE usage would lower the risk of sustaining eye injuries; however, they are ambiguous about the usage of protective eyewear. In contrast, players with self-reported eye injuries were aware of its impacts and encouraged the usage of PPEs associated with badminton. Further studies are warranted to understand and educate badminton players about the causes and impacts of eye injuries in badminton.
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Affiliation(s)
- Rakesh Maldoddi
- Department of Optometry and Vision Sciences, School of Medical Sciences, University of Hyderabad, Hyderabad, India
| | - Laxmi Gella
- Department of Optometry and Vision Sciences, School of Medical Sciences, University of Hyderabad, Hyderabad, India
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Andoh JE, Miguez S, Andoh SE, Mehta S, Mir TA, Chen EM, Jain S, Teng CC, Nwanyanwu K. Epidemiologic trends of domestic violence-related ocular injuries among pediatric patients: data from the Nationwide Emergency Department Sample 2008-2017. J AAPOS 2023; 27:335.e1-335.e8. [PMID: 37931837 PMCID: PMC10859911 DOI: 10.1016/j.jaapos.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 09/05/2023] [Accepted: 09/26/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE To study the epidemiology of all domestic violence (DV)-related ocular injuries among pediatric emergency department (ED) patients in the United States. METHODS This is a retrospective, cross-sectional study of isolated children (<18 years of age) with a diagnosis of DV and primary or secondary diagnosis of ocular injuries in the Nationwide Emergency Department Sample, 2008-2017. We calculated annual incidence of DV-related ocular injuries and prevalence by demographic variables, including age, sex, and income quartile. Median charges, median length of inpatient hospital stay, and factors associated with hospitalization were also measured. RESULTS From 2008 to 2017, there were 4,125 ED encounters, with an average incidence of 0.56 per 100,000 population (males, 50.0%; mean age [SE], 9.2 [0.3]). Patients in the lowest income quartile (42.6%) and with Medicaid insurance (63.2%) were the most prevalent. The most common known perpetrator was a family member (29.4%). Most ED encounters took place at southern regional (28.6%), metropolitan teaching (67.1%) and designated trauma hospitals (57.8%). Contusion of the eye/adnexa and being struck by or against an object were the most common ocular diagnosis and known mechanism of injury, respectively. An estimated 12.4% of patients were admitted with a median hospital stay of 4 (IQR, 2-6). Median charges during the study period were $27,415.10 (IQR, $13,142.70-$54,454.90). CONCLUSIONS DV-related ocular injuries were most prevalent among patients with a low socioeconomic status. Given the historical underreporting of DV, future studies are warranted to identify more specific social determinants of health that contribute to such presentations.
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Affiliation(s)
- Joana E Andoh
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
| | - Sofia Miguez
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut
| | - Sarah E Andoh
- University of Vermont, Larner College of Medicine, UVMMC, Burlington, Vermont
| | - Sumarth Mehta
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut
| | - Tahreem A Mir
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Evan M Chen
- Department of Ophthalmology, School of Medicine, University of California, San Francisco, San Francisco, California
| | - Srimathy Jain
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
| | - Christopher C Teng
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut
| | - Kristen Nwanyanwu
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut
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Li S, Wang X, Dou Z, Zhang J, Jia J. Study on maintenance of eyeball morphology by foldable capsular vitreous body in severe ocular trauma. BMC Ophthalmol 2023; 23:463. [PMID: 37974090 PMCID: PMC10655399 DOI: 10.1186/s12886-023-03209-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVES To explore the feasibility and safety of using a foldable capsular vitreous body (FCVB) in managing severe ocular trauma and silicone oil-dependent eyes. METHODOLOGY This is a retrospective study of 61 ocular trauma patients (61 eyes) who presented to the Department of Eye Emergency, Hebei Eye Hospital from May 1, 2018, to May 31, 2019, including 51 male patients (51 eyes) and 10 female patients (10 eyes) with an average age of 44.98 ± 14.60 years old. The oldest patient was 75 years old, and the youngest was 8 years old. These cases represented 51 eyes with severe eyeball rupture and 10 eyes with severe, complicated ocular trauma, which became silicone oil-dependent after the operation. These patients received FCVB implants, and data regarding their visual acuity, intraocular pressure, changes in eye axis, cornea, retina, and FCVB state were recorded after the operation. RESULTS In all patients, the FCVB was properly positioned and well supported with the retina. All 61 patients cleared a follow-up window of 1-36 months with no reports of important changes in their visual acuity. Among the patients, 91.8% reported normal intraocular pressure, the retinal reattachment rate reached 100%, and the eyeball atrophy control rate reached 100%. There was no report of rupture of the FCVB, allergies to silicone, intraocular infection, intraocular hemorrhage, silicone oil emulsification, or sympathetic ophthalmia. CONCLUSIONS Foldable capsular vitreous bodies (FCVBs) designed to mimic natural vitreous bodies are suitable as long-term ocular implants that can provide sustained support for the retina without the need for any special postoperative postures. Their barrier function may effectively prolong the retention time of the tamponade and prevent various complications caused by direct contact of the eye tissues with the tamponade.
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Affiliation(s)
- Shanyu Li
- Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Hebei Eye Hospital, 054000, Xingtai, Hebei, China
| | - Xiaoxuan Wang
- Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Hebei Eye Hospital, 054000, Xingtai, Hebei, China.
| | - Zhixia Dou
- Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Hebei Eye Hospital, 054000, Xingtai, Hebei, China
| | - Jie Zhang
- Xingtai Third Hospital, 054000, Xingtai, Hebei, China
| | - Jinchen Jia
- Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Hebei Eye Hospital, 054000, Xingtai, Hebei, China
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Al Ghadeer H, Khandekar R. Characteristics, Etiological Factors, and Visual Outcomes of Pediatric Open Globe Injuries in Central Saudi Arabia: A 22-Year Retrospective Study. Clin Ophthalmol 2023; 17:2909-2917. [PMID: 37818287 PMCID: PMC10561276 DOI: 10.2147/opth.s430394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 09/25/2023] [Indexed: 10/12/2023] Open
Abstract
Purpose To discuss the characteristics, etiological factors, and visual outcomes of open globe injuries (OGIs) in children at a tertiary eye hospital in Riyadh, Central Saudi Arabia. Methods This was a hospital-based cohort study conducted in 2021. Children aged ≤16 years with OGI based on the Birmingham Eye Trauma Terminology classification were included. The age, gender, type, cause of OGI, and vision were recorded, as well as uncorrected and best corrected visual acuity (UCVA and BCVA, respectively). There was a change in the UCVA and BCVA one year after management. BCVA following management was linked to a variety of factors. Results There were 664 eyes with OGI. [median age 5.1, 461 (69.6%) boys]. UCVA at presentation was <20/400 in 525 (79%) of eyes with OGI. Injuries were mainly due to metallic objects in 195 (29.4%), glass in 102 (15.4%), and fireworks in 62 (9.4%). The Change in visual impairment grade in UCVA and BCVA after management compared to the initial presentation was significant (p < 0.001). Improvement of two lines of BCVA was noted in 345 (52%), no change in (<± 2 lines) 299 (45%) and deteriorated in 10 (1.5%). Conclusion OGI was identified as a leading cause of unilateral blindness. Children with OGIs who receive standard treatment have better outcomes. Many children could not achieve normal, functional vision despite the intervention of skilled care providers.
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Affiliation(s)
- Huda Al Ghadeer
- Emergency Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Rajiv Khandekar
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Department of Ophthalmology and Vision Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Sharifi A, Parvaz P, Sharifi H, Farsi M, Akbari Z. Ocular Trauma in Children: An Epidemiological Study. Pediatr Emerg Care 2023; 39:672-675. [PMID: 37463197 DOI: 10.1097/pec.0000000000003016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
OBJECTIVES This study aimed to determine the epidemiology of eye injuries in children and the influential factors involved. METHODS Eighty cases of confirmed ocular trauma were included in this cross-sectional study. Data were obtained via a checklist containing demographic information, site of the insult, the interval between the injury and physician visit, trauma mechanism, and medical history, including previous history of ocular trauma. RESULTS Among 80 children with ocular trauma, 72.5% (n = 58) were boys. A marked preponderance (46.2%) of injuries was seen in the age group younger than 6 years. The youngest patient was a 1-year-old, and the oldest was aged 17. Most (76.25%) of the incidents occurred indoors. A total of 67.5% of accidents were induced by sharp objects (knife and glass). Most accidents occurred in spring, whereas the least number of accidents occurred in winter. The corneoscleral laceration was the most common manifestation, followed by the laceration of the iris, uveal prolapse, hyphema, and cataracts. Furthermore, rare cases of retinal detachment, hypopyon, and corneal epithelial defects were seen. CONCLUSIONS The highest incidents of ocular trauma occurred in boys, especially those younger than 6 years. The high number of sharp object injuries is also concerning. These findings provide us with evidence that further educational interventions and supervision are required in these groups to minimize the possible devastating injuries before the opportunity even arises.
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Affiliation(s)
- Ali Sharifi
- From the Department of Ophthalmology, Shafa Hospital, Afzalipoor School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Parinaz Parvaz
- Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Farsi
- From the Department of Ophthalmology, Shafa Hospital, Afzalipoor School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Zahra Akbari
- Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
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Kinoshita M, Ihara T, Mori T. Characteristics of pediatric ocular trauma in a pediatric emergency department in Japan. Am J Emerg Med 2023; 70:75-80. [PMID: 37224708 DOI: 10.1016/j.ajem.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 05/26/2023] Open
Abstract
INTRODUCTION Pediatric ocular trauma is a common complaint in pediatric emergency departments (ED) and is a major cause of acquired monocular blindness. However, data on its epidemiology and management in the ED are lacking. The objective of this study was to describe the characteristics and management of pediatric ocular trauma patients who visited a Japanese pediatric emergency department (ED). METHODS The present, retrospective, observational study was conducted in a pediatric ED in Japan between March 2010 and March 2021. Children younger than 16 years who visited our pediatric ED and received the diagnosis of ocular trauma were included. ED visits for follow-up examinations for the same complaint were excluded. The patients' sex, age, arrival time, mechanism of injury, signs and symptoms, examinations, diagnosis, history of urgent ophthalmological consultation, outcomes, and ophthalmological complications were extracted from electronic medical records. RESULTS In total, 469 patients were included; of these, 318 (68%) were male, and the median age was 7.3 years. The incident leading to trauma occurred most frequently at home (26%) and most often involved being struck in the eye (34%). In 20% of the cases, the eye was struck by some body part. Tests performed in the ED included visual acuity testing (44%), fluorescein staining (27%), and computed tomography (19%). Thirty-seven (8%) patients underwent a procedure in the ED. Most patients had a closed globe injury (CGI), with only two (0.4%) having an open globe injury (OGI). Eighty-five (18%) patients required an urgent ophthalmological referral, and 12 (3%) required emergency surgery. Ophthalmological complications occurred in only seven patients (2%). CONCLUSION Most cases of pediatric ocular trauma seen in the pediatric ED were CGI, with only a few cases leading to emergency surgery or ophthalmological complications. Pediatric ocular trauma can be safely managed by pediatric emergency physicians.
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Affiliation(s)
- Masakazu Kinoshita
- Division of Pediatric Emergency Medicine, Department of Pediatric Emergency and Critical Care Medicine, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo 183-8561, Japan.
| | - Takateru Ihara
- Division of Pediatric Emergency Medicine, Department of Pediatric Emergency and Critical Care Medicine, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo 183-8561, Japan; Department of Pediatrics, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki-shi, Hyogo 660-8550, Japan
| | - Takaaki Mori
- Division of Pediatric Emergency Medicine, Department of Pediatric Emergency and Critical Care Medicine, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo 183-8561, Japan; Department of Emergency Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore
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Kaur K, Gurnani B, Gupta I, Narayana S. Retrospective multifactorial analysis of ocular firecracker injuries and review of literature. TRAUMA-ENGLAND 2023. [DOI: 10.1177/14604086221147359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Purpose To analyse demographics, risk factors, clinical features, functional, anatomical outcomes, and prevalence of blindness in firecracker injury patients presenting to a tertiary eye care centre. Methodology A retrospective analysis of ocular firecracker injuries patients who presented to our hospital from April 2018 to March 2019 was performed. A total of 114 patients with a minimum follow-up of 3 months were included. The parameters recorded were demographics, mode of injury, type of cracker, baseline and last follow up best-corrected visual acuity (BCVA), anterior and posterior segment findings, seidel's test, intraocular pressure, gonioscopy, treatment, functional and anatomical outcomes. Investigations in form of B Scan, X-ray, or CT scan were undertaken whenever indicated. Results A total of 132 eyes of 114 patients were analysed. The mean (SD) age was 18.96 +/−15.4 years (range 3–71 years). Seventy-four (64.91%) patients were ≤ 18 years of age. The male-to-female ratio was 4:1. The ratio of right: left eye involvement was 1:1. Eighteen patients (15.79%) had bilateral involvement. A total of 125 eyes had closed globe injury, 7 eyes had open globe injury and 17 patients needed hospital admission for management. The mean (SD) baseline BCVA was 0.54(+/−0.75). The mean (SD) final BCVA improved to 0.23(+/−0.62) till the last follow-up. The final outcome was good in most patients, except 5 eyes (3.78%) which resulted in near/total blindness. Conclusion Firecracker injuries are a major cause of irreversible blindness, especially among the younger age group. Prompt diagnosis with meticulous management can prevent devastating sequelae.
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Affiliation(s)
- Kirandeep Kaur
- Department of Pediatric Ophthalmology and Strabismus, Aravind Eye Hospital, Pondicherry, India
| | - Bharat Gurnani
- Department of Cataract, Cornea and Refractive Surgery, Aravind Eye Hospital, Pondicherry, India
| | - Isha Gupta
- DO Ophthalmology, DNB Resident, Aravind Eye Hospital, Pondicherry, India
| | - Shivananda Narayana
- MS Ophthalmology, Head of Department, Cornea and Refractive Services, Aravind Eye Hospital, Pondicherry, India
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Mori T, Kinoshita M, Nomura O, Ihara T. Risk factors of pediatric ocular trauma related to ophthalmic complications. Pediatr Int 2023; 65:e15558. [PMID: 37368572 DOI: 10.1111/ped.15558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/21/2023] [Accepted: 05/02/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Ocular injury is a leading cause of monocular blindness in children. However, data on the association of injury type with ophthalmological complications are lacking. This study aimed to investigate the risk factors of pediatric ocular injuries related to ophthalmological complications. METHODS This retrospective, observational study was conducted in a pediatric emergency department (ED) in Japan from March 2010 to March 2021. Patients aged less than 16 years presenting with ocular trauma, diagnosed on the basis of the International Classification of Diseases 10: S05, 0-9, were enrolled. Emergency department follow-up visits for the same complaint were excluded. The patients' sex, age, arrival time, injury mechanism, symptoms, examinations, diagnosis, history of urgent ophthalmological consultation, outcomes, and ophthalmological complications were investigated. The primary endpoints were the odds ratio (OR) and 95% confidence interval (CI) of the incidence of ophthalmological complications, defined as any new acute complaint or worsening/persistence of an initial complaint following or resulting from ocular trauma. RESULTS In total, 469 patients were analyzed. The median age was 7.3 years; the interquartile range (IQR) was 3.1-11.5 years. The most common diagnosis was contusion (79.3%), followed by lamellar laceration (11.7%). Seven patients (1.5%) had ophthalmological complications during follow up. Bivariate analysis demonstrated that daytime ED visit, impact with a sharp object, animal-related injury, visual impairment, decreased visual acuity, and open globe injury were factors significantly associated with ophthalmological complications. CONCLUSION Daytime ED visit, impact with a sharp object, animal-related injury, visual impairment, decreased visual acuity, and open globe injury were independent factors of ophthalmological complications.
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Affiliation(s)
- Takaaki Mori
- Division of Pediatric Emergency Medicine, Department of Pediatric Emergency and Critical Care Medicine, Tokyo Metropolitan Children's Medical Center, Fuchu, Japan
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore City, Singapore
| | - Masakazu Kinoshita
- Division of Pediatric Emergency Medicine, Department of Pediatric Emergency and Critical Care Medicine, Tokyo Metropolitan Children's Medical Center, Fuchu, Japan
| | - Osamu Nomura
- Department of Emergency and Disaster Medicine, Hirosaki University, Aomori, Japan
| | - Takateru Ihara
- Division of Pediatric Emergency Medicine, Department of Pediatric Emergency and Critical Care Medicine, Tokyo Metropolitan Children's Medical Center, Fuchu, Japan
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Ocular trauma in the pediatric age group: a systematic review. EGYPTIAN PEDIATRIC ASSOCIATION GAZETTE 2022. [DOI: 10.1186/s43054-022-00125-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Abstract
Abstract
Background
Ocular traumas are the leading cause of acquired unilateral blindness in the pediatric age group. The aim of this study is to determine the incidence of pediatric ocular injuries, the etiological factors that cause them, and to make some preventive recommendations.
Methods
This was a retrospective observational study of pediatric ocular trauma (age < 18 years) presented to the pediatric emergency unit of our tertiary university hospital between January 2016 and December 2020. Demographic data such as age, gender, season, duration of admission, trauma etiology, and type of injury were recorded. Patients with missing medical records were excluded from the study.
Results
Two hundred two patients aged a mean of 107.4 ± 40.7 months including 87 females (43.07%) and 115 males (56.93%) were included in the study. Most of the patients (n = 135, 66.83%) were in the 7–11 years of age group. The vast majority of the study population lived in the urban area (n = 119, 58.91%). Most injuries were seen in the summer (n = 108, 53.47%). 59.41% of all patients had closed globe injuries. Hyphema (32.5%) and endophthalmitis (26.6%) were the most common in closed globe injuries. Of the open globe injuries, 39 were penetrating (47.5%), 12 were perforated (14.6%), and 23 were intraocular foreign body injuries (28%). It was determined that the places where the injury occurred were mostly in situations where family control was reduced, such as weddings, holidays, and playgrounds (80.69%). The most common causes of injury were toy guns (35.15%), stones (28.71%), and fireworks (16.34%).
Conclusion
This analysis is the first study to provide data on childhood ocular trauma in Aksaray. Most of the childhood ocular injuries can be prevented with simple precautions. For this purpose, effective and preventive strategies should be developed such as raising public awareness, providing parental control, and early intervention.
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Tian B, Zeng L, Lin L, Lao HY, Xu Y, Zhang Y, Ou Z, Zhou J, Yi Y, Chen M, Gu J. Pediatric Chemical and Thermal Ocular Injuries Requiring Hospitalization in South China. Semin Ophthalmol 2022:1-7. [DOI: 10.1080/08820538.2022.2140012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Bishan Tian
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Liangbo Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Lixia Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Hubert Yuenhei Lao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Yuwei Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Yuying Zhang
- Department of Ophthalmology, Guangdong Women and Children Hospital, Guangzhou, China
| | - Zhancong Ou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Jin Zhou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Yuhuan Yi
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Miao Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Jianjun Gu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
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AlGhadeer H, Khandekar R. Clinical Profile, Etiology, and Management Outcomes of Pediatric Ocular Trauma in Saudi Arabia. Pediatr Emerg Care 2022; 38:e1626-e1630. [PMID: 36173435 DOI: 10.1097/pec.0000000000002581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate cases of pediatric ocular trauma at a tertiary eye hospital in central Saudi Arabia and determine the demographics, causes, ocular injuries, and visual status before and after management. METHODS A retrospective review was performed of health records of children younger than 16 years with ocular trauma managed from January 1998 to December 2019. Data were collected on patient demographics, eye involved, cause of trauma, the presenting and final vision, and the duration of follow-up. Best-corrected visual acuity at the last follow-up was compared between open and closed eye injury groups. The Birmingham Eye Trauma Terminology was used to classify the ocular injuries. RESULTS Among 1003 patients, 728 (72.6%) had open globe and 275 (27.4%) had closed globe injuries. The main causes of trauma were unsafe playing-related activities (n = 394; 39.3%), unsafe home environment (n = 158;15.8%) and injury by metallic objects (n = 166; 16.6%). Gunshot-related ocular trauma was noted in 62 (6.2%) children. Presenting vision less than 20/400 was noted in 292 (40.1%) eyes with open globe injuries and 110 (40%) eyes with closed globe injuries (P = 0.4). After a median follow-up of 13.3 months, best-corrected visual acuity was 20/20 to 20/200 in 393 (53%) eyes with open globe injuries and 137 (49.8%) eyes with closed globe injuries (P = 0.03). CONCLUSIONS Despite proper management, children in this study sustained significant permanent visual loss secondary to ocular trauma. Public health efforts in Saudi Arabia are needed to reduce preventable injury-related childhood blindness.
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PİRHAN D, SUBASİ S, DEMİRCİ KUCUK K. Pediatrik Hastalarda Oküler Travmaların Etiyolojik Özellikleri ve Görsel Sonuçları. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2022. [DOI: 10.30934/kusbed.1150458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Amaç: Açık glob yaralanması (AGY) nedeni ile acil kliniğimize başvuran, tedavi ve takibi yapılan 60 pediatrik olgunun demografik özelliklerini ve prognozu etkileyen faktörleri araştırmak.
Yöntem: Kliniğimizde 2010-2021 yılları arasında AGY nedeni ile ameliyat edilip, en az bir yıl takip yapılmış olan 16 yaş ve altı 69 olgunun dosya kayıtları retrospektif olarak incelendi. Kayıtlardan AGY’nin tipi, oluş nedeni, eşlik eden muayene bulguları, hastaneye başvuru zamanı ile ilk ve son görme keskinlikleri (GK), ek cerrahileri kaydedildi.
Bulgular: Olguların ortalama yaşı 11±5 yıl idi. %17,4’si kız %82,6’sı erkek idi. AGY’nin şekli en sık korneal kesi, en sık etiyolojik nedeni kesici ve delici aletler (%65,1) oluşturmakta idi. Olguların %87 sinde sadece bölge 1, %40,6 sında bölge 2, %13 ünde bölge 3 etkilenmişti. Olguların %37,7 sinde relatif afferent pupil defekti (RAPD) vardı. %5,8’i rüptür, %8,7’si retina dekolmanı, %2,9’u endoftalmi, %4,3’ü perforan yaralanma idi. Olguların başvuru anında %7’sinde GK değerlendirilemezken, %60’ında 0.1 ve daha altında, %25,7’sinde 0.1-0,6. %4,3’ünde ise 0.6’dan daha iyi GK’ya sahipti. Olguların takiplerinde 6. ayda ise %2,9’ unda GK değerlendirilemezken (inop), %11,4’ ünde 0.1 ve daha altında, %25,7’sinde 0.1-0.6 ve %60’ında ise 0.6’dan daha iyi GK’ya sahipti. Oküler travma skoru (OTS) 74±16, pediatrik oküler travma skoru (POTS) 64±19 idi. OTS başlangıçtaki GK ile orta derecede ilişkili (r=0,687, p<0,001), takipteki GK ile orta derecede ilişkili (r=0,611, p<0,001) idi. Pediatrik oküler travma skorunun korelasyon değerleri ise daha düşük bulundu (başlangıç GK ile r=0,574, p<0,001).
Sonuç: Pediatrik AGY’de görsel prognozu tahmin edebilmek için RAPD değerlendirilemediğinde bile OTS güvenilir bir araçtır.
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Affiliation(s)
- Dilara PİRHAN
- KOCAELİ ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, GÖZ HASTALIKLARI ANABİLİM DALI
| | - Sevgi SUBASİ
- KOCAELİ ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, GÖZ HASTALIKLARI ANABİLİM DALI
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Epidemiological Characteristics of Pediatric Ocular Trauma in China: A Multicenter Retrospective Hospital-Based Study. J Ophthalmol 2022; 2022:4847027. [PMID: 35847351 PMCID: PMC9279087 DOI: 10.1155/2022/4847027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 06/15/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose The objective of the study was to obtain the incidence characteristics of pediatric ocular trauma in mainland China and provide some feasible suggestions of prevention. Methods The patients with pediatric ocular injuries, who were (≤14) hospitalized between January 1, 2019, and December 31, 2020, were included. Patient demographics (age and sex), injury natural characteristics (causes, site, and types), geographic location, and interval of hospital admission were analyzed. Results A total of 13525 cases were identified, and 1973 (14.6%) occurred in children (male accounts 70.9%) with a mean (SD) age of 6.5 (3.4) years. Cases among minors in 2020 dropped by 8.3% compared to 2019, while the former vulnerability to eye injuries has been shifted from the outdoors to home (51.4%, 1015/1973). The main causes of injury are flying objects (31.9%), traffic injury (23.5%), and blunt injury (21.8%), which lead to the main types of injury such as penetrating injury (48.3%), rupture of the globe (18.1%), and contusion trauma (13.1%). If the VA after injury is above CF, the VA after discharge is more likely to be above CF (OR 18.3, 11.9–28.1; p < 0.001). Similarly, age (OR 2.0, 1.3–3.1; p=0.001) and intraocular pressure after injury (OR 0.9, 0.9–1.0; p=0.009) also affect the intraocular pressure at discharge. Conclusions In mainland China, the main injury types are penetrating injury and rupture of the globe with home being the most dangerous place. Prevention strategies should focus on parents' education and protective measures indoors. Visual acuity after injury can be used as a predictor of visual acuity after treatment.
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Spectrum of ophthalmic diseases in children hospitalized in a tertiary ophthalmology hospital in China from 2010 to 2019. BMC Ophthalmol 2022; 22:314. [PMID: 35854241 PMCID: PMC9297649 DOI: 10.1186/s12886-022-02533-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 07/07/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Describing the pattern of pediatric eye diseases is necessary for appropriate eye care in children. This study explored the spectrum and characteristics of pediatric ophthalmic diseases in a typical tertiary ophthalmology hospital in China. METHODS A retrospective study was conducted at a tertiary ophthalmology hospital between 2010 and 2019 in Guangzhou, China. This study included 44,552 inpatients who were younger than 18 years old. Demographic and diagnostic data were collected from the electronic medical record system. Multiphase regression analysis was used to estimate trends in the annual percentages of ten common ophthalmic diseases. RESULTS From 2010 to 2019, 44,552 inpatients met the inclusion criteria. The majority were male (61.9%), aged 7 to 12 years (30.3%) and self-paying (56.6%). The top ten conditions were refractive error (41.2%), strabismus (36.1%), cataract (13.6%), trauma (11.8%), congenital ptosis (8.8%), tumor (8.1%), amblyopia (7.1%), glaucoma (7.0%), entropion and trichiasis of eyelid (7.0%), and retinal detachment (6.5%). The annual percentage changes (APCs) for refractive error, strabismus, and retinal detachment were 9.3% (95% CI, 8.1-10.5%), 4.7% (95% CI, 3.8-5.6%) and - 2.8% (95% CI, - 5.1% to - 0.4%) respectively. For trauma, the average APC (AAPC = -9.2%, (95% CI, - 12.1% to - 6.2%) decreased gradually from 2010 to 2015 (APC = -4.2% (95% CI, - 8.8-0.7%)) and decreased rapidly from 2015 to 2019 (APC = -15.1% (95% CI, - 21.0% to - 8.7%)). CONCLUSIONS Pediatric ophthalmic diseases are common in China. Preventive strategies and health education aimed at the prevention of refractive error, strabismus, and entropion and trichiasis of eyelid will be crucial in reducing the burden of pediatric ophthalmic diseases on health care systems and human development.
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Stuart KV, Dold C, Van der Westhuizen DP, De Vasconcelos S. The epidemiology of ocular trauma in the Northern Cape, South Africa. AFRICAN VISION AND EYE HEALTH 2022. [DOI: 10.4102/aveh.v81i1.710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: Ocular trauma represents a significant public health burden and has considerable global epidemiological variation. The epidemiology of ocular trauma in the Northern Cape province of South Africa has not been previously described.Aim: This study aimed to quantify the burden and describe the distribution and determinants of ocular trauma in the Northern Cape province.Setting: The Northern Cape province is the largest, but least populous, of the nine South African provinces. Published data on the health of the Northern Cape population are scarce. Robert Mangaliso Sobukwe Hospital (RMSH) is the only public ophthalmic referral centre in the province.Methods: Hospital record review of all adult cases of acute ocular trauma seen at RMSH over a period of one year (August 2018 – July 2019).Results: Young men comprised the majority of the 240 included cases. Ocular injuries were most likely to occur in the home (n = 115, 47.9%) and on the weekend (n = 159, 66.3%). More than half (n = 135, 56.3%) of all trauma was non-accidental in nature and significantly associated with alcohol use. Accidental trauma (n = 105, 43.8%), predominantly as a result of occupational injuries sustained at work (n = 47, 44.8%) and in the home (n = 45, 42.9%), was deemed largely preventable. Differences in the timing, location and severity of non-accidental and accidental ocular injuries were observed.Conclusion: Ocular trauma in South Africa follows distinct epidemiological trends and is largely because of interpersonal violence, which places strain on limited state healthcare resources.
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The clinical features and the factors affecting visual prognosis in pediatric open-globe ınjuries. Int Ophthalmol 2022; 42:3589-3600. [PMID: 35579769 DOI: 10.1007/s10792-022-02359-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 04/24/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To investigate clinical features and factors affecting visual prognosis after pediatric open-globe injuries. METHODS Retrospective study of 223 children with open-globe injury was conducted. Children with final logMAR visual acuity (LVA) > 0.70 were determined as poor-vision group (group 1, n = 108) and those with final LVA ≤ 0.70 as good-vision group (group 2, n = 115). Demographic characteristics (age, gender, and damaged eye), time between trauma and surgery, ocular trauma score (OTS), follow-up time, injury size, initial and final visual acuity levels, injury type (penetrating injury, globe rupture, perforating injury, and intraocular foreign body injury), injury localization (zone 1 = within the corneal and/or limbal area, zone 2 = within the scleral area extending 5 mm back from the limbus, and zone 3 = within the area posterior to zone 2), injury cause [metal objects (fork, knife, needle), broken glass, blunt objects (ball, punch), pen-pencil, and unidentified objects], and accompanying ocular findings of the groups were detected, and comparisons were done. Additionally, effects of age, time between trauma and surgery, OTS, injury size, follow-up time, initial LVA, injury type, and injury zone on final LVA were analyzed in both groups. RESULTS Mean age was 9.1 ± 2.0 years. There were 151 males and 72 females. Compared to group 1, group 2 had better initial and final visions (1.21 ± 0.26 vs 0.60 ± 0.28, p < 0.001 for initial LVA; 1.00 ± 0.32 vs 0.30 ± 0.13, p < 0.001 for final LVA), greater OTS (1.72 ± 0.53 vs 3.73 ± 0.61, p = 0.025), and smaller injury size (10.4 ± 3.5 vs 5.8 ± 2.4 mm, p = 0.002). Globe rupture (p = 0.015) and relative afferent pupillary defect (RAPD) (p = 0.037) were higher in group 1, while penetrating injury (p = 0.044), zone 1 involvement (p = 0.038), and metal object injury (p = 0.041) were higher in group 2. Based on multivariate analysis, the presences of globe rupture (p = 0.024) and RAPD (p = 0.035), the involvement without zone 1 (p = 0.042), and the injury without metal object (fork, knife, needle) (p = 0.046) were associated with poor final vision. Final LVA (for group 1 and group 2) was negatively correlated with OTS (r = - 0.398, p = 0.037; r = - 0.369, p = 0.040), while positively correlated with injury size (r = 0.412, p = 0.031; r = 0.318, p = 0.046) and initial LVA (r = 0.335, p = 0.043; r = 0.402, p = 0.034). CONCLUSION In our study, poor prognostic factors affecting final vision were low OTS, poor initial vision, the presences of globe rupture and RAPD, the large injury size, the involvement without zone 1, and the injury without metal object (fork, knife, needle).
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Guo Y, Guo Y, Gu R, Yang Q, Zhu K, Shu Q, Gan D. Characteristics and visual prognosis of pediatric open globe injury in Shanghai, China. Ophthalmic Res 2022; 65:328-334. [PMID: 35231917 DOI: 10.1159/000523814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 02/17/2022] [Indexed: 11/19/2022]
Abstract
Introduction To describe the characteristics of open globe injury and the relationship between the complications and visual outcomes in children with this type of injury. Methods This was a retrospective chart review of 1664 children, under the age of 16 years, who were hospitalized for open globe injury between January 1, 2007, and December 31, 2015. Each patient's age, sex, cause and agent of injury, complications, visual acuity, and classification of ocular trauma were collected for review and analysis. Results The mean age was 5.6 ± 3.4 years. Right eyes were particularly vulnerable to injury (right eye:left eye ratio = 1.2:1). Traumatic cataract was the most common complication. The average initial and final best-corrected visual acuity (BCVA) were logMAR 2.04 ± 0.78 and logMAR 1.74 ± 0.88, respectively. Logistic regression analysis showed that hyphema (OR = 1.850), iris prolapse (OR = 1.702), vitreous hemorrhage (OR = 9.703), retinal detachment (OR = 11.938), endophthalmia (OR = 5.377), intraocular foreign body (OR = 3.346), and initial visual acuity < 0.05 (OR = 9.017) were risk factors for visual acuity < 0.05 at hospital discharge. Conclusion Open globe injury was most frequent in preschool children and boys. Right eyes were more vulnerable than left eyes. Poor visual outcomes were associated with hyphema, iris prolapse, vitreous hemorrhage, retinal detachment, endophthalmia, intraocular foreign body, and an initial visual acuity < 0.05.
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Affiliation(s)
- Yue Guo
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China,
| | - Yu Guo
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Ruiping Gu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Qian Yang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Ke Zhu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Qinmeng Shu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Dekang Gan
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- Key Laboratory of Myopia of State Health Ministry, Shanghai, China
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Alali N, ALBalawi HB, Albazei A, Magliyah M, Usman M, Alamin F, Ahmed O, Hazzazi MA, Albalawi R, Alzahrani R, Khokhar T, Alatawi A, ALDarrab A. Epidemiological Characteristics and Outcome of Open Globe Injuries in Tabuk City, Kingdom of Saudi Arabia: Retrospective Cohort Study. Ophthalmol Ther 2022; 11:759-769. [PMID: 35152357 PMCID: PMC8927566 DOI: 10.1007/s40123-022-00475-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 01/26/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Naif Alali
- Division of Ophthalmology, Department of Surgery, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia
| | - Hani B ALBalawi
- Division of Ophthalmology, Department of Surgery, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia.
- Department of Ophthalmology, University of Tabuk, Al- Douba Street, PO Box 7191, Tabuk, 11462, Kingdom of Saudi Arabia.
| | - Alanuad Albazei
- Department of Medical Education, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Moustafa Magliyah
- Department of Ophthalmology, Prince Mohammed Medical City, Aljouf, Saudi Arabia
| | - Muhammad Usman
- Department of Ophthalmology, King Fahd Specialist Hospital, Tabuk, Saudi Arabia
| | | | - Omar Ahmed
- Department of Ophthalmology, King Khalid Hospital, Tabuk, Saudi Arabia
| | - Mohammed A Hazzazi
- Division of Ophthalmology, Department of Surgery, National Guard Hospital, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Raghad Albalawi
- Department of Ophthalmology, Ministry of Health, Riyadh, Saudi Arabia
| | - Rawan Alzahrani
- Department of Ophthalmology, Ministry of Health, Riyadh, Saudi Arabia
| | - Taiba Khokhar
- Department of Ophthalmology, King Khalid Hospital, Tabuk, Saudi Arabia
| | - Alhanouf Alatawi
- Department of Ophthalmology, Ministry of Health, Riyadh, Saudi Arabia
| | - Abdulrahman ALDarrab
- Department of Surgery, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
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Abdelazeem K, Al-Hussaini AK, El-Sebaity DM, Kedwany SM. Epidemiology, Etiologies, and Complications of Playtime Open Globe Injuries in Children. J Pediatr Ophthalmol Strabismus 2021; 58:385-389. [PMID: 34851791 DOI: 10.3928/01913913-20210426-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To study the epidemiology, etiologies, and complications of playtime open globe injuries in children at the Assiut University Hospital, Egypt. METHODS This prospective cross-sectional study enrolled children with open globe injury who were admitted to Assiut University Hospital during a 6-month period (January to July 2016). All causes of trauma that occurred during playtime (at home, outside home, at the club, or at school) were recorded and analyzed. RESULTS Eighty-one children (age = 18 years and younger; mean ± standard deviation age = 8.35 ± 4.84 years) were admitted with open globe injury, and 32 of them (39.51%) sustained ocular trauma during playtime. The majority of children were boys (n = 23, 71.88%). The causes of trauma during playtime were: playing with sharp objects (n = 11; 34.38%), playing with a wooden stick (n = 7; 21.88%), falling on the ground (n = 5; 15.63%), trauma by a stone (n = 2; 6.25%), trauma during running (n = 1; 3.13%), playing with a plastic toy (n = 1; 3.13%), and unknown causes (n = 5; 15.63%). The sites of globe perforation were corneal (n = 23; 71.88%), corneoscleral (n = 8; 25%), and scleral (n = 1; 3.13%). CONCLUSIONS Playtime trauma that causes open globe injury and visual disability is avoidable and constituted approximately half of the open globe injuries in this study population. Corneal involvement occurred in almost all open globe injuries. Parental supervision for children during playtime is crucial to injury prevention. Children should avoid playing with sharp, dangerous objects and desist from playing or running on unsafe ground. [J Pediatr Ophthalmol Strabismus. 2021;58(6):385-389.].
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Hoskin AK, Low R, Sen P, Mishra C, Kamalden TA, Woreta F, Shah M, Pauly M, Rousselot A, Sundar G, Natarajan S, Keay L, Gunasekeran DV, Watson SL, Agrawal R. Epidemiology and outcomes of open globe injuries: the international globe and adnexal trauma epidemiology study (IGATES). Graefes Arch Clin Exp Ophthalmol 2021; 259:3485-3499. [PMID: 34173879 DOI: 10.1007/s00417-021-05266-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To detail the methodology for a novel ocular trauma registry and utilize the registry to determine the demographics, nature of injury, and associations of severe visual loss for open globe injuries (OGI). METHODS Thirteen hospitals in 7 countries used International Globe and Adnexal Trauma Epidemiology Study (IGATES) platform. Patients presenting between April 2009 and 2020 with OGI (with or without) adnexal involvement or intraocular foreign body (IOFB) were included. RESULTS Analyses of presenting and final VA, using "severe vision loss" (VA ≤ 6/60) and "no severe loss" (VA > 6/60), were performed. Four hundred fifty-four (64%) patients had VA < 6/60 at presentation and 327 (44.8%) at final follow-up, with a highly significant association between presenting and final VA (p < 0.0001). From the cohort of 746 patients, 37 were missing VA at presentation and 16 at follow-up and complete clinical data was available for 354 patients. The male to female ratio is 6:1, and mean age 36.0 ± 20.0 years old. Relative afferent pupillary defect (RAPD), zone III injury, IOFB, and eyelid injury at presentation were recorded in 50 (6.7%), 55 (7.8%), 97 (13%), and 87 (11.7%) patients, respectively, and were significantly associated with VA < 6/60 at follow-up. Older age, ≥ 61 years, was associated with 3.39 times (95% CI: 1.95-5.89) higher risk than ≤20-year-old patients (p < 0.0001) and males 0.424 times (95% CI: 0.27-0.70) lower risk than female (p = 0.0001) of severe vision loss (SVL). CONCLUSION In OGIs from 13 hospitals, female gender, older age, zone III injury, eyelid injury, and IOFB were associated with higher risk of visual outcome of SVL.
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Affiliation(s)
- Annette K Hoskin
- Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Lions Eye Institute, The University of Western Australia, Perth, Australia
| | - Rebecca Low
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Novena, 308433, Singapore.,School of Medicine, National University of Singapore, Kent Ridge, Singapore
| | | | | | | | - Fasika Woreta
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mehul Shah
- Drashti Nethralaya Eye Hospital, Dahod, India
| | | | - Andres Rousselot
- Consultorios Oftalmológicos Benisek Ascarza, Capital Federal, Buenos Aires, Argentina
| | | | | | - Lisa Keay
- School of Optometry and Vision Science, UNSW, Sydney, Australia.,The George Institute for Global Health, UNSW, Sydney, Australia
| | | | - Stephanie L Watson
- Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Rupesh Agrawal
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Novena, 308433, Singapore.
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22
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D'Antone V, Flórez DCP, García CJL, Manrique FDMC, Barbosa NL. Epidemiological findings of childhood ocular trauma in a public hospital in Colombia. BMC Ophthalmol 2021; 21:248. [PMID: 34088276 PMCID: PMC8178914 DOI: 10.1186/s12886-021-02014-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 05/10/2021] [Indexed: 12/04/2022] Open
Abstract
Background Eye injury is a serious worldwide public health problem that may cause blindness. In children, blindness has functional impact and psychosocial implications. As indicated in many worldwide studies, identification of risk factors associated with the socio-cultural context may prevent eye injuries. The objetive of the study is to describe the sociodemographic and epidemiological characteristics of pediatric eye injury and its effects on ocular structures in a public hospital from Colombia. Method A retrospective cross-sectional study was carried out between January 1, 2015, and December 31, 2017, in a tertiary public hospital of a medium-sized city located in the Northeast of Colombia. Children under 15 years old with trauma to the eyeball or its adnexa were included. The Birmingham Eye Trauma Terminology System (BETTS) was used. Eye burns and Ocular adnexa were also included. Results 61 cases of eye injuries were recorded, 67.21% (41 cases) of which were males. 57.37% (35 cases) corresponded to closed-globe injuries both contusion and lamellar laceration. Visual acuity fluctuated between 20/20 and 20/40. 14.75% (9 cases) were open-globe injuries while 50% (4 cases) were penetrating trauma. 27.86% of the injuries (17 cases) did not directly compromise the eyeball, 58.82% (10 of these cases) of which corresponded to eyelid wounds, and neither of those had visual acuity information. Conclusion The study showed that the majority of eye injuries in children under 15 years old, from a public hospital in the Northeast of Colombia, are closed globe, caused by blows, and occur in males.
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Affiliation(s)
- Valeria D'Antone
- Specialized in Anterior Segment, Optometry School, Saint Thomas University, Bucaramanga, Colombia
| | - Diana Cristina Palencia Flórez
- Specialized in Anterior Segment, Optometry School, Saint Thomas University, Bucaramanga, Colombia. .,Saint Thomas University, Bucaramanga, Health division, Faculty of Optometry, Cra 27 No 180-395, Bucaramanga, Colombia.
| | | | | | - Nahyr López Barbosa
- Public Health Department, Universidad Industrial de Santander, Bucaramanga, Colombia
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Bothun ED, Repka MX, Dean TW, Gray ME, Lenhart PD, Li Z, Morrison DG, Wallace DK, Kraker RT, Cotter SA, Holmes JM. Visual Outcomes and Complications After Lensectomy for Traumatic Cataract in Children. JAMA Ophthalmol 2021; 139:647-653. [PMID: 33956055 DOI: 10.1001/jamaophthalmol.2021.0980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance The Pediatric Eye Disease Investigator Group Cataract Registry provides a multicenter assessment of visual outcomes and complications after lensectomy for traumatic pediatric cataract. Objective To report visual acuity (VA) and the cumulative proportion with strabismus, glaucoma, and other ocular complications by 15 months after lensectomy for traumatic cataract among children younger than 13 years at the time of surgery. Design, Setting, and Participants From June 18, 2012, to July 8, 2015, 1266 eyes of 994 children from 33 pediatric eye care practices seen within 45 days after lensectomy were enrolled in a multicenter, prospective observational registry. Of these, 74 eyes of 72 participants undergoing lensectomy for traumatic cataract were included in a cohort study. Follow-up was completed by November 2, 2015, and data were analyzed from March 20, 2018, to July 7, 2020. Exposures Lensectomy after ocular trauma. Main Outcomes and Measures Best-corrected VA from 9 to 15 months after lensectomy for traumatic cataract (for those 3 years or older) and the cumulative proportion with strabismus, glaucoma, and other ocular complications by 15 months. Results Of 994 participants in the registry, 84 (8%) had traumatic cataract. The median age at lensectomy for 72 participants examined within 15 months after surgery was 7.3 (range, 0.1-12.6) years; 46 (64%) were boys. An intraocular lens was placed in 57 of 74 eyes (77%). In children 3 years or older at outcome, the median best-corrected VA was 20/250 (range, 20/20 to worse than 20/800) in 6 eyes with aphakia and 20/63 (range, 20/20 to 20/200) in 26 eyes with pseudophakia. Postoperative visual axis opacification was reported in 18 of 27 eyes with pseudophakia without primary posterior capsulotomy (15-month cumulative proportion, 77%; 95% CI, 58%-92%). The cumulative proportion with strabismus was 43% (95% CI, 31%-58%) in 64 participants with ocular alignment data; exotropia was present in 14 of 23 participants (61%). The cumulative proportion with glaucoma was 6% (95% CI, 2%-16%). Conclusions and Relevance Trauma was not a common cause of pediatric cataract requiring surgery. For children with traumatic cataract, substantial ocular morbidity including permanent vision loss was found, and long-term eye and vision monitoring are needed for glaucoma, strabismus, and capsular opacification.
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Affiliation(s)
| | - Erick D Bothun
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota
| | - Michael X Repka
- Department of Ophthalmology, Wilmer Eye Institute, Baltimore, Maryland
| | | | - Michael E Gray
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | - Zhuokai Li
- Jaeb Center for Health Research, Tampa, Florida
| | - David G Morrison
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - David K Wallace
- Department of Ophthalmology, Indiana University, Indianapolis
| | | | - Susan A Cotter
- Southern California College of Optometry at Marshall B. Ketchum University, Fullerton
| | - Jonathan M Holmes
- Department of Ophthalmology and Vision Science, University of Arizona, Tucson
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Zhuang X, Jiang R, Xu G, Sun Z. Pediatric open globe injury in left-behind children treated by pars plana vitrectomy in China. Transl Pediatr 2021; 10:1346-1354. [PMID: 34189093 PMCID: PMC8192994 DOI: 10.21037/tp-21-162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND To analyze the clinical features of pediatric open globe injury (OGI) in left-behind children (LBC) and in non-left-behind children (non-LBC) prospectively. METHODS Patients diagnosed with OGI were included and divided into 2 groups: LBC and non-LBC. A complete ophthalmological examination was performed. Primary wound repair was completed within 8 hours from initial administration. Pars plana vitrectomy (PPV) was subsequently performed for retained intraocular foreign body (IOFB), endophthalmitis, retinal detachment, or non-clearing vitreous hemorrhage. RESULTS A total of 96 patients (4 to 15 years old) were recruited, including 54 LBC and 42 non-LBC. Rupture of the eyeball (P<0.001), endophthalmitis (P<0.001), primary hospitalization time (PHT) over 24 hours (PHT >24 h) (P=0.016), traumatic cataract (P=0.013), vitreous hemorrhage (P=0.040), numbers of surgeries (P<0.001), and lower OTS scores and grades (P<0.001) predisposed patients to poorer final visual acuity (VA). Compared with non-LBC, LBC were significantly younger (P<0.001), had lower OTS scores (P=0.020), had longer PHT (P<0.001), and worse baseline (P=0.011) and final VA (P<0.001). The 3 most common injury sources were pencils (20 cases, 20.8%), knives (11 cases, 11.5%), and iron wire (7 cases, 7.3%). Pencils were the major injury source for IOFB (14 cases, 53.8%). LBC were significantly more likely to be injured by instruments which should be routinely kept away from children (P=0.009). CONCLUSIONS The prognosis of pediatric OGI was worse in LBC than in non-LBC. It is necessary to improve the guardianship of LBC. Many tragedies may be avoided if adult instruments are properly stored and if children are educated to properly use writing devices.
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Affiliation(s)
- Xiaonan Zhuang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Rui Jiang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Gezhi Xu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Zhongcui Sun
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
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Iftikhar M, Mir T, Seidel N, Rice K, Trang M, Bhowmik R, Chun J, Goldberg MF, Woreta FA. Epidemiology and outcomes of hyphema: a single tertiary centre experience of 180 cases. Acta Ophthalmol 2021; 99:e394-e401. [PMID: 33124159 DOI: 10.1111/aos.14603] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/21/2020] [Accepted: 08/01/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE To characterize the epidemiology and outcomes of hyphema. METHODS Retrospective case series. Medical records from patients with traumatic and spontaneous hyphema seen at the Wilmer Eye Institute, Johns Hopkins, from 2011 through 2017 were evaluated. Aetiology, demographics, clinical characteristics, complications, management and outcomes were ascertained. Multivariable logistic regression was used to identify factors associated with elevated intraocular pressure (IOP), rebleeding and poor outcome (final visual acuity ≤ 20/40) in traumatic hyphema. A safe frequency of follow-up was retrospectively determined. RESULTS Traumatic hyphema (n = 152) was more common in males (78%) and adults (55%), with sports/recreational activities being the most frequent cause (40%). Elevated IOP was the most common complication (39%). Rebleeding occurred in seven patients (5%) and was more likely with a higher IOP on presentation (OR:1.1; p = 0.004). Thirty-seven patients (24%) had a poor outcome, mostly due to traumatic sequelae such as cataract (32%) or posterior segment involvement (30%). A poor outcome was more likely with worse presenting visual acuity (OR: 9.1; p = 0.001), rebleeding (OR: 37.5; p = 0.035) and age > 60 years (OR: 16.0; p = 0.041). Spontaneous hyphema (n = 28) did not have a gender predominance and was more common in adults > 60 years (71%). The most common cause was iris neovascularization (61%). Complications and visual outcomes were worse compared with traumatic hyphema. CONCLUSIONS Traumatic hyphema continues to be common in young males engaging in sports, necessitating increased awareness for preventive eyewear. Older age and rebleeding can lead to poor outcomes. Elevated IOP at presentation predisposes to rebleeding and warrants frequent follow-up. Otherwise, routine follow-up at days 1, 3, 5, 7 and 14 is sufficient for uncomplicated cases.
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Affiliation(s)
- Mustafa Iftikhar
- Wilmer Eye Institute Johns Hopkins University School of Medicine Baltimore MD USA
| | - Tahreem Mir
- Wilmer Eye Institute Johns Hopkins University School of Medicine Baltimore MD USA
| | - Natalie Seidel
- Wilmer Eye Institute Johns Hopkins University School of Medicine Baltimore MD USA
| | - Katya Rice
- Wilmer Eye Institute Johns Hopkins University School of Medicine Baltimore MD USA
| | - Michelle Trang
- Wilmer Eye Institute Johns Hopkins University School of Medicine Baltimore MD USA
| | - Ryan Bhowmik
- Wilmer Eye Institute Johns Hopkins University School of Medicine Baltimore MD USA
| | - Justin Chun
- Wilmer Eye Institute Johns Hopkins University School of Medicine Baltimore MD USA
| | - Morton F. Goldberg
- Wilmer Eye Institute Johns Hopkins University School of Medicine Baltimore MD USA
| | - Fasika A. Woreta
- Wilmer Eye Institute Johns Hopkins University School of Medicine Baltimore MD USA
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Yardley AE, Hoskin AK, Hanman K, Sanfilippo PG, Lam GC, Mackey DA. Paediatric ocular and adnexal injuries requiring hospitalisation in Western Australia. Clin Exp Optom 2021; 100:227-233. [DOI: 10.1111/cxo.12486] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 05/31/2016] [Accepted: 08/11/2016] [Indexed: 11/28/2022] Open
Affiliation(s)
- Anne‐marie E Yardley
- Lions Eye Institute, Perth, Western Australia, Australia,
- Princess Margaret Hospital for Children, Perth, Western Australia, Australia,
- The University of Western Australia, Centre for Ophthalmology and Visual Science, Perth, Western Australia, Australia,
| | - Annette K Hoskin
- Lions Eye Institute, Perth, Western Australia, Australia,
- The University of Western Australia, Centre for Ophthalmology and Visual Science, Perth, Western Australia, Australia,
| | - Kate Hanman
- Lions Eye Institute, Perth, Western Australia, Australia,
- Princess Margaret Hospital for Children, Perth, Western Australia, Australia,
| | - Paul G Sanfilippo
- The University of Western Australia, Centre for Ophthalmology and Visual Science, Perth, Western Australia, Australia,
- Centre for Eye Research Australia, The University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia,
| | - Geoffrey C Lam
- Princess Margaret Hospital for Children, Perth, Western Australia, Australia,
- The University of Western Australia, Centre for Ophthalmology and Visual Science, Perth, Western Australia, Australia,
| | - David A Mackey
- Lions Eye Institute, Perth, Western Australia, Australia,
- Princess Margaret Hospital for Children, Perth, Western Australia, Australia,
- The University of Western Australia, Centre for Ophthalmology and Visual Science, Perth, Western Australia, Australia,
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Ocular trauma in the pediatric emergency departments, characteristics and risk factors of immediate sequelae. An Pediatr (Barc) 2021. [DOI: 10.1016/j.anpede.2020.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Ramsay C, Murchison AP, Bilyk JR. Pediatric Eye Emergency Department Visits: Retrospective Review and Evaluation. J Pediatr Ophthalmol Strabismus 2021; 58:84-92. [PMID: 34038266 DOI: 10.3928/01913913-20201118-01] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess the epidemiology of pediatric ocular conditions presenting to an ophthalmic emergency department and analyze the incidence of ocular trauma and other ophthalmic diagnoses. METHODS A retrospective review was performed of all patients seen in an urban eye emergency department over a 1-year period. The following variables were examined: visit date, demographics, diagnosis, mechanism of injury, and level of patient care. RESULTS Analysis was performed on 1,136 pediatric visits spanning 1 year. Trauma was the most common etiology, seen in 44.4% of patients, followed by infection in 19.3%. The largest volume of pediatric use was in the spring and early summer, with the peak of trauma in the spring. Most admissions of pediatric patients were due to trauma (76.4%), of which the most common diagnoses were ruptured globe (27.3%), eyelid laceration (18.2%), and orbital fracture (10.9%). Sporting activities were the most frequent broad cause of trauma seen in pediatric patients, accounting for 30.9% of all trauma, whereas the highest singular cause of trauma was injury by air guns (9.5%). CONCLUSIONS Pediatric ophthalmic emergency department visits in this urban setting are most often due to trauma, with increased use in the spring and early summer. A majority of the more serious conditions leading to admission can be attributed to trauma, which is often preventable. Knowledge of patterns of visits could improve planning of ophthalmology physician coverage. [J Pediatr Ophthalmol Strabismus. 2021;58(2):84-92.].
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Truong T, Sobol EK, Parsikia A, Mbekeani JN. Ocular injury in pediatric patients admitted with major trauma. Can J Ophthalmol 2021; 56:335-337. [PMID: 33493460 DOI: 10.1016/j.jcjo.2020.12.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 12/12/2020] [Accepted: 12/20/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Timothy Truong
- Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA
| | - Ethan K Sobol
- Department of Ophthalmology, Mount Sinai Medical Center, Icahn School of Medicine, New York, NY
| | - Afshin Parsikia
- Research Services, University of Pennsylvania, Philadelphia, PA; Department of Surgery (Trauma), Jacobi Medical Center, Bronx, NY
| | - Joyce N Mbekeani
- Department of Surgery (Ophthalmology), Jacobi Medical Center, Bronx, NY; Department of Ophthalmology & Visual Sciences, Albert Einstein College of Medicine, Bronx, NY.
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30
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Sun Z, Zhuang X, Xu G, Jiang R. Clinical analysis of posterior segment injury in left-behind children in China. BMC Ophthalmol 2020; 20:40. [PMID: 32005139 PMCID: PMC6993498 DOI: 10.1186/s12886-020-1317-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 01/17/2020] [Indexed: 11/23/2022] Open
Abstract
Background We aimed to evaluate the severity and prognosis of posterior segment injury between left-behind children (LBC) and guarded children (NLBC). Methods A retrospective, controlled analysis of a case series was performed. Patients diagnosed with posterior segment injury in Department of vitreous and retinal, the Affiliated Ophthalmology and Otolaryngology Hospital of Fudan University were included in this study. Patients were divided into two groups, including LBC group (n = 48) and NLBC group (n = 44). All the children underwent 25G transconjunctival sutureless pars plana vitrectomy. Results Compared with NLBC, LBC had delayed treatment, worse baseline vision and visual prognosis, lower OTS rating, more times of vitrectomies, more complicated surgical procedures, and higher rate of lens removal and silicone oil tamponade. Conclusions Due to lack of care and delayed treatment, posterior segment ocular trauma in the LBC was more severe, more common complicated with infectious endophthalmitis, and had worse visual prognosis. It was urgent to enforce the guardianship in LBC.
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García Mancebo J, Ferrero García-Loygorri C, Romero AI, Vázquez López P. [Ocular trauma in the Pediatric Emergency Departments, characteristics and risk factors of immediate sequelae]. An Pediatr (Barc) 2020; 94:161-172. [PMID: 32912750 DOI: 10.1016/j.anpedi.2020.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/15/2020] [Accepted: 07/10/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This study assesses the clinical characteristics and epidemiology of children with eye trauma presenting to the Emergency Department in Spain and analyze the risk factors associated with immediate sequelae. METHODS A multicentric prospective case series study conducted during 24 months of patients presenting to the Pediatric Emergency Departments in five hospitals collaborating with the Spanish Pediatric Emergency Research Group. Data were collected from October 2016 through September 2018, including all patients up to the age of 16 years old presenting to the Emergency Department with an ocular trauma. All injuries were classified by Birmingham Eye Trauma Terminology. RESULTS A total of 242,134 visits to the Emergency Departments took place during the study period, being 1,007 ocular traumas (0.42%; IC 95% 0.40-0.45) and 858 were included in the study. Most commonly, injuries occurred while playing (54.7%), except in the 15 or more-age group, in which sports activities were more common (23.1%). The place of the trauma varied depending on the age group, being home (34.7%) and schools or sports areas (34.3%) the most recurrent. Blunt objects were the most frequent mechanism of trauma (48.6%). Most of the injuries were classified as closed globe (85.5%), mainly contusions (52.7%). Fifty-eight patients (6.8%) presented with immediate sequelae, being the impairment of visual acuity the most common (70.7%). The risk factors associated with immediate sequelae were the 10 or more-age group, the preexisting refractive errors, the open globe injuries and the injuries with blunt objects. CONCLUSIONS Ocular trauma is a frequent chief complaint in the Pediatric Emergency Departments in Spain. Increasing awareness of the serious nature of ocular injuries and the study of the risk factors will help to develop a comprehensive plan for educating both parents and children to minimize preventable eye injuries sequelae.
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Affiliation(s)
- Julia García Mancebo
- Servicio de Urgencias Pediátricas, Hospital General Universitario Gregorio Marañón, Madrid, España.
| | | | - Ana Isabel Romero
- Servicio de Urgencias Pediátricas, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - Paula Vázquez López
- Servicio de Urgencias Pediátricas, Hospital General Universitario Gregorio Marañón, Madrid, España
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- Servicio de Urgencias Pediátricas, Hospital General Universitario Gregorio Marañón, Madrid, España
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Engelhard SB, Salek SS, Justin GA, Sim AJ, Woreta FA, Reddy AK. Malpractice Litigation in Ophthalmic Trauma. Clin Ophthalmol 2020; 14:1979-1986. [PMID: 32764863 PMCID: PMC7367728 DOI: 10.2147/opth.s260226] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 06/08/2020] [Indexed: 01/23/2023] Open
Abstract
Objective To report and analyze the causes and outcomes of malpractice litigation in ophthalmic trauma. Methods The Westlaw® database was reviewed for ophthalmology litigation in the United States between 1930 and 2014. All ophthalmic trauma cases were included and compared to non-traumatic ophthalmology malpractice cases. Results Forty-four ophthalmic trauma cases were included. Of these cases, 90.9% of ophthalmic trauma plaintiffs were male compared to 54.8% of plaintiffs in ophthalmology as a whole (P=<0.001); 34.1% of cases involved minor plaintiffs compared to 6.4% in ophthalmology as a whole (P=<0.001). Cases involving minors were more likely to be resolved in favor of the plaintiff than cases involving adult plaintiffs (53.3% vs 37.9%); however, this was not found to statistically significant (P=0.35). Overall, 54.5% of cases were resolved in favor of defendants; 40.9% of cases were resolved via jury trial with 50.0% resulting in payments to plaintiffs compared to the 29.6% rate of plaintiff verdicts in ophthalmology as a whole. Open globe injuries represented 61.4% of cases; 55.6% of these cases had intraocular foreign bodies and 37.0% developed endophthalmitis. Most cases (63.6%) alleged insufficient intervention. Of these cases, 31.8% of cases involved surgical or procedural claims, and 4.5% involved medical claims only. Conclusion Males and minors were overrepresented among plaintiffs in ocular trauma litigation. Most cases involved open globe injuries, often complicated by retained intraocular foreign bodies and endophthalmitis. Analysis of malpractice litigation in ophthalmic trauma calls attention to commonly litigated scenarios to improve clinical practice and to inform risk management.
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Affiliation(s)
- Stephanie B Engelhard
- Department of Ophthalmology, New York-Presbyterian/Weill Cornell Medical College, New York, NY, USA
| | - Sherveen S Salek
- Department of Ophthalmology, Kaiser Permanente Washington, Silverdale, WA, USA
| | - Grant A Justin
- Department of Ophthalmology, Brooke Army Medical Center, San Antonio, TX, USA
| | - Austin J Sim
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Fasika A Woreta
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Ashvini K Reddy
- Athena Eye Institute, San Antonio, TX, USA.,Department of Ophthalmology, University of Texas Health Science Center, San Antonio, TX, USA
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Xue C, Yang LC, Kong YC. Application of pediatric ocular trauma score in pediatric open globe injuries. Int J Ophthalmol 2020; 13:1097-1101. [PMID: 32685398 DOI: 10.18240/ijo.2020.07.13] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 11/08/2019] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate the predictive value of pediatric penetrating ocular trauma score (POTS) on the visual outcome in children with open globe injury. METHODS A retrospective study in 90 children (60 males and 30 females) aged 1-15y (average, 7.48±2.86y) with penetrating ocular trauma was performed. Each patient's POTS was calculated. The effects of POTS on final visual acuity (FVA) were examined. Correlation between factors affecting POTS and the FVA was established. RESULTS All patients presented with single-eye trauma. The follow-up time was 3-21mo (average, 10.23±3.54mo). Among the 90 cases of penetrating wounds, 71 eyes (78.89%) were injured in Zone I (wound involvement limited to the cornea, including the corneoscleral limbus), 17 eyes (18.89%) were injured in Zone II (wound involving the sclera and no more posterior than 5 mm from the corneoscleral limbus), and 2 eyes (2.22%) were injured in Zone III (wound involvement posterior to the anterior 5 mm of the sclera). Analysis of POTS and FVA showed important correlation between them (r=0.414, P=0.000). Initial visual acuity (P=0.00), age (P=0.02), injury location (P=0.002), traumatic cataract (P=0.00), vitreous hemorrhage (P=0.027), retinal detachment (P=0.003), and endophthalmitis (P=0.03) were found to be statistically significant factors for the FVA outcome. CONCLUSION Ocular trauma presents serious consequences and poor prognosis in children. The POTS may be a reliable prognostic tool in children with open globe injury.
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Affiliation(s)
- Chao Xue
- Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute; Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, China
| | - Li-Chun Yang
- Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute; Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, China
| | - Yi-Chun Kong
- Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute; Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, China.,Tianjin NanKai Hospital, Tianjin Medical University NanKai Hospital, Nankai University Affiliated Nankai Hospital, Tianjin 300100, China
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Lee JS, Chen WM, Huang LH, Chung CC, Yu KH, Kuo CF, See LC. Epidemiology of outpatient and inpatient eye injury in Taiwan: 2000, 2005, 2010, and 2015. PLoS One 2020; 15:e0235208. [PMID: 32609736 PMCID: PMC7329064 DOI: 10.1371/journal.pone.0235208] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 06/10/2020] [Indexed: 12/29/2022] Open
Abstract
Purpose To estimate the incidence rate of eye injuries (EI) requiring inpatient and outpatient treatment in Taiwan and compare the epidemiologic characteristics of EI (age, sex, treatment setting, seasonality, occupation, external cause, diagnosis, and surgery) in the years 2000, 2005, 2010, and 2015. Methods We analyzed four random samples of 1,000,000 beneficiaries each from 2000, 2005, 2010, and 2015 of the Taiwan National Health Insurance Program. The direct age-standardized rate, with 95% confidence interval (CI), was used to compare EI rates for the four calendar years. The chi-square test and chi-square test for trend were used to compare data for the four calendar years. Results Annual EI incidence rates were between 2.57% in 2000 and 3.28% in 2015. The age-standardized rates were 2.73% (95% CI, 2.70%–2.76%) in 2000, 3.37% (95% CI, 3.33%–3.41%) in 2005, 3.31% (95% CI, 3.28%–3.35%) in 2010, and 3.02% (95% CI, 2.99%–3.06%) in 2015. Manual workers had the highest EI incidence rate, followed by non-manual workers and civil servants. The proportion of EI requiring inpatient treatment declined from 1.34% in 2000 to 0.63% in 2015 (P <0.0001). Analysis of seasonality showed a consistent decrease in February in the four sampling years; however, this decrease in EI was only seen in outpatients, not in EI requiring hospitalization. The proportion of outpatients requiring surgery significantly decreased, from 2.53% in 2000 to 1.2% in 2015 (P<0.0001). However, the proportion of inpatients requiring surgery for EI as the principal diagnosis increased from 69.32% in 2000 to 83.02% in 2015 (P = 0.29), and the proportion of inpatients requiring surgery for EI as a secondary diagnosis increased from 54.86% in 2000 to 71.6% in 2015 (P = 0.0019). Among inpatients with EI, the most common cause of EI was a traffic accident (44.79%, especially motorcycles), followed by falls (9.75%) and homicide (6.05%). Conclusion In Taiwan, the annual EI incidence rate slightly increased from 2000 to 2005 and then decreased through 2015. The proportion of EI patients requiring hospitalization decreased from 1.34% in 2000 to 0.63% in 2015, but the percentage of inpatients requiring surgery increased. Traffic accidents (especially those involving motorcyclists) remained the predominant external cause of EI requiring hospitalization during the study period.
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Affiliation(s)
- Jiahn-Shing Lee
- Department of Ophthalmology, Chang Gung Memorial Hospital & College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wei-Min Chen
- Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Lu-Hsiang Huang
- Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Chi Chung
- Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kuang-Hui Yu
- Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Chang-Fu Kuo
- Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Lai-Chu See
- Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Biostatistics Core Laboratory, Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
- Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- * E-mail:
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35
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Characteristics of paediatric patients hospitalised for eye trauma in 2007-2015 and factors related to their visual outcomes. Eye (Lond) 2020; 35:945-951. [PMID: 32518396 DOI: 10.1038/s41433-020-1002-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 05/08/2020] [Accepted: 05/21/2020] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE To analyse the epidemiological characteristics and clinical features of children under the age of 16 years with ocular trauma at the Eye and Ear, Nose and Throat Hospital of Fudan University (Shanghai, China) and to investigate the preventive measurements taken to avoid vision-threatening eye trauma. METHODS The inpatient medical records of children <16 years old treated for ocular trauma between January 2007 and December 2015 were collected. The age, sex, type of trauma, cause of injury, complications and visual acuity on admission and discharge were analysed statistically. RESULTS A total of 2211 patients (2231 eyes) were enroled. Of these, 73.7% were male, and 61.2% were children aged 0-6 years. Mechanical ocular trauma was present in 75.3% of eyes, and penetrating injuries in 59.8%. The top three offending objects were scissors (16.3%), firecrackers (8%) and pencils (4.9%). Iris prolapse (odds ratio [OR] = 2.27), retinal detachment (OR = 2.91), endophthalmitis (OR = 2.25) or an intraocular foreign body (OR = 2.80) was associated with the same or worse visual prognosis among all the subjects. Traumatic cataract (OR = 0.37) was associated with final visual improvement. CONCLUSIONS An efficient strategy for preventing eye injury should focus on male children during preschool years. Our root cause analysis showed specific environmental patterns of vision-devastating objects. Specific preventive measures are proposed to reduce the incidence of paediatric eye injuries.
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AlMahmoud T, Elhanan M, Alshamsi HN, Al Hadhrami SM, Almahmoud R, Abu-Zidan FM. Surgical management of pediatric eye injuries. Oman J Ophthalmol 2020; 13:84-88. [PMID: 32792803 PMCID: PMC7394076 DOI: 10.4103/ojo.ojo_285_2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/21/2020] [Accepted: 04/26/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND: Eye injury is a leading cause of unilateral childhood blindness. The purpose of this research was to study the management and visual outcome of pediatric eye injuries necessitating hospitalization and surgical repair. MATERIALS AND METHODS: This is a retrospective study of children having eye injury that needed surgical repair over the period of 2012 and 2017. Demographic data, place of occurrence, activity at the time of injury, place and cause of injury, presenting signs, surgical interventions, visual acuity (VA) before and after surgery, and causes for vision limitations were studied. RESULTS: Thirty-nine eyes of children were surgically treated. The mean (range) age of the patients was 3 years (1–15 years). Nearly 61.5% were males. Almost 80% of injuries occurred at home and while playing (71.8%). Trauma with sharp objects (35.8%) was the most common cause of injury. Majority presented to the hospital in <6 h (89%), mainly with eye pain (95%). Corneal laceration (53.8%), traumatic cataract (15.3%), and foreign body (15.3%) were the most common clinical findings. Twenty-one (53.8%) eyes sustained open-globe injuries. Fifteen percent had vision of 20/200 or worse at follow-up. The VA improved significantly at follow-up (P < 0.05). The major cause of vision limitation was the cornea (33%). CONCLUSIONS: Eye injury is a major cause of vision loss in children. Despite early presentation to our hospital and prompt interventions, significant number of our pediatric patients sustained limited VA in ruptured globe injuries.
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Affiliation(s)
- Tahra AlMahmoud
- Department of Surgery, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.,Department of Ophthalmology, Al-Ain Hospital, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Mohamed Elhanan
- Department of Ophthalmology, Al-Ain Hospital, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Hanan N Alshamsi
- Department of Ophthalmology, Al-Ain Hospital, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Sameeha M Al Hadhrami
- Department of Ophthalmology, Al-Ain Hospital, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Rabah Almahmoud
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Fikri M Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
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Archambault C, Mekliche A, Isenberg J, Fallaha N, Hamel P, Superstein R. Pediatric Ocular Injuries: A 3-Year Follow-up Study of Patients Presenting to a Tertiary Care Clinic in Canada. J Pediatr Ophthalmol Strabismus 2020; 57:185-189. [PMID: 32453852 DOI: 10.3928/01913913-20200326-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 02/19/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To identify age groups or activities at risk for ocular injuries to provide parents, sports teams, schools, and hospitals with the appropriate tools for prevention strategies. METHODS A retrospective chart review was conducted of all trauma-related cases from 2013 to 2015 and data were obtained with the use of an electronic medical record. All patients younger than 18 years who presented to the ophthalmology clinic with traumatic ocular injuries were included. RESULTS A total of 409 patients met the inclusion criteria and all were included in this study. The mean age was 7.74 years. Boys were injured more frequently than girls (60.4%). Most ocular injuries occurred between the ages of 2 and 9 years (51.8%). The most common sport was soccer, followed by ball/ice hockey, which differs from previous study findings. This may highlight the increasing popularity of soccer and the risk it may entail. Injuries occurred at home in 23.2% of cases. Final visual acuity was 20/40 or better in 77% of patients. CONCLUSIONS These findings are comparable to the authors' previous data and to those of the only other Canadian study done on this subject, with the exception of an increased incidence of soccer-related injuries in the current cohort, highlighting an area important to future prevention strategies. [J Pediatr Ophthalmol Strabismus. 2020;57(3):185-189.].
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Boret C, Brehin C, Cortey C, Chanut M, Houzé-Cerfon CH, Soler V, Claudet I. Pediatric ocular trauma: Characteristics and outcomes among a French cohort (2007–2016). Arch Pediatr 2020; 27:128-134. [DOI: 10.1016/j.arcped.2020.01.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 11/07/2019] [Accepted: 01/25/2020] [Indexed: 12/09/2022]
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Ozturk T, Cetin Dora G, Ayhan Z, Kaya M, Arikan G, Yaman A. Etiology and Visual Prognosis in Open Globe Injuries: Results of A Tertiary Referral Center in Turkey. Sci Rep 2019; 9:17977. [PMID: 31784641 PMCID: PMC6884622 DOI: 10.1038/s41598-019-54598-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 11/12/2019] [Indexed: 12/02/2022] Open
Abstract
We aimed to analyse the clinical characteristics of OGI and evaluate the correlation between baseline ocular trauma score (OTS) and visual outcomes in cases with OGI. The charts of 257 OGI patients who had at least six months of follow-up were reviewed retrospectively. Demographics, data about the etiology, localization and size of the OGI, baseline and final best-corrected visual acuity (BCVA) were noted. At the time of approval OTS was calculated and compared with final BCVA. All analysis was performed in both entire study population and our pediatric subgroup. A total of 261 eyes of 257 patients with a mean age of 34.9 ± 19.8 years were enrolled. Globe injury with a mean size of 6.7 ± 4.5 mm was within zone I in 46.7% of the eyes. Older age (p < 0.001, OR = 1.029, 95% CI = 1.015–1.043), higher baseline logMAR BCVA scores (p < 0.001, OR = 4.460, 95% CI = 2.815–7.065), bigger wound size (p < 0.001, OR = 1.159, 95% CI = 1.084–1.240), relative afferent pupillary defect (RAPD) positiveness (p < 0.001, OR = 0.021 95% CI = 0.005–0.087), lower OTS (p < 0.001, OR = 27.034, 95% CI = 6.299–116.021), presence of concomitant retinal detachment (p < 0.001, OR = 0.157, 95% CI = 0.080–0.306), and endophthalmitis (p = 0.045, OR = 0.207, 95% CI = 0.044–0.962) were found to be related to poor visual prognosis. Cases with OGI caused by a sharp object (p = 0.007, OR = 0.204, 95% CI = 0.065–0.641) and those injured by a glass (p = 0.039, OR = 0.229, 95% CI = 0.056–0.931) had more favorable final vision. This study highlights that baseline BCVA, wound size, RAPD, retinal detachment, and OTS were the most significant markers for poor visual outcomes in both the entire population and pediatric subgroup. In cases with OGI, OTS was also found effective in predicting visual prognosis.
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Affiliation(s)
- Taylan Ozturk
- Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
| | - Golgem Cetin Dora
- Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Ziya Ayhan
- Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Mahmut Kaya
- Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Gul Arikan
- Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Aylin Yaman
- Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey
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Wallace HB, Ferguson RA, Sung J, McKelvie J. New Zealand adult ocular trauma study: A 10‐year national review of 332 418 cases of ocular injury in adults aged 18 to 99 years. Clin Exp Ophthalmol 2019; 48:158-168. [DOI: 10.1111/ceo.13667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 09/04/2019] [Accepted: 10/20/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Henry B. Wallace
- Department of OphthalmologyAuckland Hospital Auckland New Zealand
- Department of OphthalmologyUniversity of Auckland Auckland New Zealand
| | - Reid A. Ferguson
- Department of OphthalmologyAuckland Hospital Auckland New Zealand
| | - Justin Sung
- Department of OphthalmologyUniversity of Auckland Auckland New Zealand
| | - James McKelvie
- Department of OphthalmologyAuckland Hospital Auckland New Zealand
- Department of OphthalmologyUniversity of Auckland Auckland New Zealand
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Zhao H, Wang W, Hu Z, Chen B. Long-term outcome of scleral-fixated intraocular lens implantation without conjunctival peritomies and sclerotomy in ocular trauma patients. BMC Ophthalmol 2019; 19:164. [PMID: 31357978 PMCID: PMC6664580 DOI: 10.1186/s12886-019-1172-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 07/22/2019] [Indexed: 12/02/2022] Open
Abstract
Background To investigate the long-term outcomes and complications of scleral-fixated intraocular lens (SFIOL) implantation without conjunctival peritomies and sclerotomy in patients with a history of ocular trauma with inadequate capsular support during primary pars plana vitrectomy or silicone oil removal. Methods Records of ocular trauma patients who underwent implantation of SFIOL without conjunctival peritomies and sclerotomy during primary pars plana vitrectomy or silicone oil removal. Results Sixty-nine eyes of 69 patients were included in this study. The median follow-up period was 34 months (range, 6–99 months). The average patient age at the time of surgery was 44 years old (range, 4–80 years). At the end of follow-up, the preoperative mean of best corrected visual acuity (BCVA) was 0.79 ± 0.86 log of the minimum angle of resolution (logMAR), which improved 0.20 ± 0.26 logMAR postoperatively (P = 0.01). BCVA improved or remained unchanged in 64 eyes (92.8%), VA decreased two lines in five eyes (7.2%). Early postoperative complications included transient corneal edema in seven eyes (10.1%), minor vitreous hemorrhage in four eyes (5.8%), transient elevated intraocular pressure (IOP) in one eye (1.4%), and hypotony in three eyes (4.3%). Late postoperative complications included persistent elevated IOP in five eyes (7.2%), epiretinal membrane formation in three eyes (4.3%), and cystoid macular edema noted in one eye (1.4%). Conclusions Use of a scleral-fixated intraocular lens implantation without conjunctival peritomies and sclerotomy in ocular trauma patients during either primary pars plana vitrectomy or second silicone oil removal is a valuable approach for the management of traumatic aphakia in the absence of capsular support. Electronic supplementary material The online version of this article (10.1186/s12886-019-1172-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Han Zhao
- Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, Hunan Province, China
| | - Wanpeng Wang
- Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Zhengping Hu
- Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.,Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Baihua Chen
- Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China. .,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, Hunan Province, China.
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Barry RJ, Sii F, Bruynseels A, Abbott J, Blanch RJ, MacEwen CJ, Shah P. The UK Paediatric Ocular Trauma Study 3 (POTS3): clinical features and initial management of injuries. Clin Ophthalmol 2019; 13:1165-1172. [PMID: 31360061 PMCID: PMC6625602 DOI: 10.2147/opth.s201900] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 05/22/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose Worldwide, as many as 6 million children annually sustain ocular trauma, with up to a quarter of a million children requiring hospitalization. Management of pediatric ocular trauma differs from that in adults, both in terms of initial assessment and acute intervention, with significant variation in practice between different centers. Patterns of healing and long-term outcomes are also very different for children compared to adults. In order to develop effective protocols for management, it is first necessary to understand current trends in presentation and treatment. Methods We conducted a prospective, observational study of pediatric ocular trauma presenting to UK-based ophthalmologists over a one-year period; reporting cards were distributed by the British Ophthalmic Surveillance Unit, and clinicians were asked to report cases of acute orbital and ocular trauma in children aged 16 years or less requiring inpatient or day-case admission. A validated, standardized questionnaire was sent to reporting ophthalmologists to collect data on clinical features and initial management of injury. Results Eighty-six episodes of pediatric ocular trauma were reported. Trauma involving the globe was reported in 66/86 patients (76.7%), of which 40/66 (60.1%) were open-globe. Trauma to the anterior segment was reported in 57/86 (66.3%), and posterior segment in 23/86 patients (26.7%). Twenty-five of 86 (29.1%) patients sustained severe trauma defined as having best-corrected visual acuity worse than 6/60 Snellen (incidence 0.19 per 100,000 population). Conclusions There has been no improvement in the incidence or severity of pediatric ocular injury rates over the past 25 years. Eye-care providers must be able to provide the necessary services for assessment and management of severe pediatric ocular trauma in the emergency setting.
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Affiliation(s)
- Robert J Barry
- Department of Ophthalmology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Freda Sii
- Department of Ophthalmology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Birmingham Institute for Glaucoma Research, Institute of Translational Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Alice Bruynseels
- Department of Ophthalmology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Joseph Abbott
- Department of Ophthalmology, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - Richard J Blanch
- Department of Ophthalmology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.,Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Dundee, UK
| | - Caroline J MacEwen
- Department of Ophthalmology, Ninewells Hospital and Medical School, Dundee, UK
| | - Peter Shah
- Department of Ophthalmology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Birmingham Institute for Glaucoma Research, Institute of Translational Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,University College London , London, UK.,Centre for Health and Social Care Improvement, School of Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK
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Kalamkar C, Mukherjee A. Incidence, clinical profile, and short-term outcomes of post-traumatic glaucoma in pediatric eyes. Indian J Ophthalmol 2019; 67:509-514. [PMID: 30900584 PMCID: PMC6446624 DOI: 10.4103/ijo.ijo_655_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose: To report the incidence, modes of injury, treatment, and short-term outcomes in eyes with post-traumatic elevated intraocular pressure (IOP). Methods: This was a 5-year hospital-based retrospective study of children ≤16 years who presented with open (OGI) or closed globe injury (CGI) and developed elevated IOP >21 mmHg. Those with a minimum follow up of 3 months were included. Analysis of various parameters such as influence of demographics, mode of injury, IOP, best-corrected visual acuity (BCVA), and effect of medical and surgical treatment on IOP and BCVA was done. Results: Out of 205 pediatric eyes with ocular trauma, 121 (59%) had CGI and the remaining 84 (41%) had OGI. Thirty-two eyes (15.6%) developed elevated IOP. The incidence of elevated IOP following CGI [25 eyes (20.6%)] was significantly higher than that following OGI [7 eyes (8.3%, P = 0.02)]. Hyphema (37.5%) and lens-related mechanisms (18.75%) were the most common causes of elevated IOP. The mean IOP at the time of diagnosis was 29.8 + 6.3 mmHg and reduced to 16.2 ± 2.2 mmHg at last follow up (P < 0.001). Surgical management was required in 12 eyes (37%) and significantly more eyes with CGI required trabeculectomy (24% in CGI vs. 0% in OGI, P = 0.03). Poor baseline vision and vitreoretinal involvement [0.67 line decrement, 95% confidence interval (CI) =0.1–1.25 lines, P = 0.025] increased risk of poor visual outcome. Conclusion: Post-traumatic IOP elevation occurred in 15% pediatric eyes, was more common with CGI compared to OGI and nearly one-fourth of eyes with CGI required glaucoma filtering surgery for IOP control. Overall, medical management was needed in 63% eyes and 37% required surgical management. Visual acuity was poor in eyes with OGI due to posterior segment involvement.
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Affiliation(s)
- Charudutt Kalamkar
- Glaucoma Unit, Shri Ganesh Vinayak Eye Hospital, Raipur, Chhattisgarh, India
| | - Amrita Mukherjee
- Glaucoma Unit, Shri Ganesh Vinayak Eye Hospital, Raipur, Chhattisgarh, India
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Hussain AHME, Ferdoush J, Mashreky SR, Rahman AKMF, Ferdausi N, Dalal K. Epidemiology of childhood blindness: A community-based study in Bangladesh. PLoS One 2019; 14:e0211991. [PMID: 31173584 PMCID: PMC6555501 DOI: 10.1371/journal.pone.0211991] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 04/30/2019] [Indexed: 11/24/2022] Open
Abstract
This study aimed to investigate the prevalence and causes of childhood blindness in a rural area of Bangladesh. We adopted a cross-sectional quantitative study design for this study, which was performed in three unions (sub-districts) located in Raiganj Upazila of the Sirajganj district in Bangladesh. Using a validated tool, a screening program was conducted at the household level. After initial screening, a team of ophthalmologists confirmed the diagnoses by clinical examinations. The prevalence of childhood blindness was observed to be 6.3 per 10,000 children, whereas the rate of uniocular blindness was 4.8 per 10,000 children. Congenital problems were the major causes of both uniocular and binocular blindness (uniocular blindness: 84% and binocular blindness: 92%). The whole globe was the site responsible for binocular blindness (28.0%, 95% confidence interval [CI]: 13.1, 47.7), whereas the cornea was responsible for uniocular blindness (57.8%, 95% CI: 35.3, 78.1). Childhood blindness is a public health problem in Bangladesh and is highly prevalent, regardless of sex. The major causes of childhood blindness are congenital.
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Affiliation(s)
| | - Junnatul Ferdoush
- Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh
| | - Saidur Rahman Mashreky
- Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh
- Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - A. K. M. Fazlur Rahman
- Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh
- Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | | | - Koustuv Dalal
- School of Health and Education, University of Skövde, Skovde, Sweden
- Higher School of Public Health, Al-Farabi Kazakh National University, Almaty, Kazakhstan
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Wangsathaporn K, Tsui I. Commotio Retinae Resulting From Rubber Band Injury in Two Girls. Ophthalmic Surg Lasers Imaging Retina 2019; 50:309-313. [DOI: 10.3928/23258160-20190503-08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 06/04/2018] [Indexed: 11/20/2022]
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Ferguson RA, Sung J, McKelvie J. New Zealand childhood ocular trauma study: Analysis of 75 601 cases of ocular injury from 2007 to 2016. Clin Exp Ophthalmol 2019; 47:718-725. [DOI: 10.1111/ceo.13489] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 02/06/2019] [Accepted: 02/10/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Reid A. Ferguson
- Department of Ophthalmology; Auckland Hospital; Auckland New Zealand
| | - Justin Sung
- Department of Ophthalmology; University of Auckland; Auckland New Zealand
| | - James McKelvie
- Department of Ophthalmology; Auckland Hospital; Auckland New Zealand
- Department of Ophthalmology; University of Auckland; Auckland New Zealand
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Pediatric ocular injuries: a 3-year review of patients presenting to an emergency department in Canada. Can J Ophthalmol 2019; 54:83-86. [DOI: 10.1016/j.jcjo.2018.02.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 02/05/2018] [Accepted: 02/06/2018] [Indexed: 11/21/2022]
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Gise R, Truong T, Parsikia A, Mbekeani JN. A comparison of pediatric ocular injuries based on intention in patients admitted with trauma. BMC Ophthalmol 2019; 19:37. [PMID: 30696405 PMCID: PMC6352334 DOI: 10.1186/s12886-018-1024-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 12/28/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose Pediatric ocular trauma is a major source of morbidity and blindness and the number of epidemiological studies is incommensurate with its significance. We sought to determine differences in epidemiologic patterns of pediatric ocular injuries based on intention. Methods A retrospective review of the National Trauma Data Bank (2008–2014) was performed and patients < 21 years old, admitted with trauma and ocular injury, were identified using ICD-9CM codes. Demographic data, types of injury and external circumstances including intention were tabulated and analyzed with students’ t and chi-squared tests and logistic regression. Statistical significance was set at p < 0.05. Results Fifty-eight thousand seven hundred sixty-five pediatric patients were admitted for trauma and ocular injuries. The mean(SD) age was 11.9(6.9) years. Most patients were male (68.7%) and White (59.1%). Unintentional injuries (76.3%) were mostly associated with falls (OR = 13.4, p < 0.001), assault (16.3%) with firearms (OR = 9.15, p < 0.001) and self-inflicted trauma (0.7%) also with firearms (OR = 44.66, p < 0.001). There was increasing mean(SD) age from unintentional, 12.9(6.6) years and assault 12.3(8.1) years to self-inflicted trauma, 17(3.4) years. The 0-3 year age group had highest odds of open adnexa wounds (OR = 30.45, p < 0.001) from unintentional trauma, and traumatic brain injury (TBI) (OR = 5.77, p < 0.001) and mortality (OR = 8.52, p < 0.001) from assault. The oldest 19-21 year group, had highest odds visual pathway injuries (OR = 8.34, p < 0.001) and TBI (OR = 1.54, p = 0.048) from self-inflicted trauma and mortality (OR = 2.08, p < 0.001) from unintentional trauma. Conclusion Sight-threatening injuries were mostly associated with unintentional trauma in the youngest group and self-inflicted trauma in the oldest group. Patterns emerged of associations between demographic groups, mechanisms, types of injury and associated TBI with intention of trauma. Electronic supplementary material The online version of this article (10.1186/s12886-018-1024-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ryan Gise
- Department of Ophthalmology & Visual Sciences, Montefiore Medical Center/Albert Einstein College of Medicine, 3332 Rochambeau Avenue, 3rd floor Ophthalmology Offices, Bronx, NY, 10467, USA.
| | - Timothy Truong
- Montefiore Medical Center, Albert Einstein College of Medicine, 3332 Rochambeau Avenue, 3rd floor Ophthalmology Offices, Bronx, NY, 10467, USA
| | - Afshin Parsikia
- Department of Surgery (Trauma), Jacobi Medical Center, 1400 Pelham Parkway, Bronx, NY, 10461, USA
| | - Joyce N Mbekeani
- Department of Ophthalmology & Visual Sciences, Montefiore Medical Center/Albert Einstein College of Medicine, 3332 Rochambeau Avenue, 3rd floor Ophthalmology Offices, Bronx, NY, 10467, USA.,Department of Surgery (Ophthalmology), Jacobi Medical Center, 1400 Pelham Parkway, Bronx, NY, 10461, USA
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Isolated Superior Rectus Muscle Hematoma Following Blunt Orbital Trauma. J Craniofac Surg 2019; 30:e125-e127. [DOI: 10.1097/scs.0000000000005007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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50
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An Uncommon Meridional Globe Rupture due to Blunt Eye Trauma. Case Rep Emerg Med 2018; 2018:1808509. [PMID: 30319823 PMCID: PMC6167593 DOI: 10.1155/2018/1808509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 06/21/2018] [Accepted: 08/16/2018] [Indexed: 11/18/2022] Open
Abstract
Open globe injury (OGI) is a severe form of eye trauma. It is an important cause of monocular blindness worldwide. Ruptures from blunt trauma are most common at the sites where the sclera is thinnest, at the insertions of the extraocular muscles, and at the limbus. Most often, rupture is equatorial. We present a unique case of open globe injury due to blunt ocular trauma from a thrown rock that resulted in a meridional rupture of the eye. The pertinent literature is reviewed.
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