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Cavaillé M, Martin G, Poignet B, Chapron T, Dureau P, Metge F, Caputo G. Intraocular foreign bodies in children: A retrospective case series. J Fr Ophtalmol 2024; 47:104188. [PMID: 38636198 DOI: 10.1016/j.jfo.2024.104188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/21/2023] [Accepted: 12/15/2023] [Indexed: 04/20/2024]
Abstract
INTRODUCTION Open globe injuries are a major cause of visual impairment in children, related to the severity of the trauma or secondary to induced amblyopia. Intraocular foreign bodies (IOFB) have been reported in approximately one third of cases of open globe injuries. As clinical presentation and management may differ between adults and children, data is lacking about IOFBs in children under 18years of age. The purpose of this study was to assess the clinical characteristics and visual prognosis of ocular trauma associated with intraocular foreign bodies in children. MATERIALS AND METHODS This single-center retrospective study included patients under 18years of age treated for ocular trauma with IOFB. Demographic characteristics, complete initial and final ophthalmological examination, imaging data and details of medical and surgical management were collected. RESULTS Fourteen patients were included (78.6% boys), with a mean age of 10.3years (min 7months-max 17years). In 92.9% of cases, patients were found to have a single IOFB, mostly metallic (71.4%). Posterior segment IOFBs were found in 50% of cases, anterior segment IOFBs in 28.6% and orbital IOFBs in 21.4%. The clinical examination permitted detection of the IOFBs in 50% of cases, while they were visible on CT scan in all cases. The mean initial visual acuity was 20/320, and the mean final visual acuity was 20/125. Endophthalmitis occurred in 2 cases (14%). DISCUSSION Open globe injuries associated with IOFB are severe and sight-threatening. Localization of the IOFB in the posterior segment has a worse prognosis. CT scan is mandatory, especially in children, as the trauma history is often missing. Retinal detachment and endophthalmitis appear to be the main prognostic factors requiring urgent specialized pediatric ophthalmology management.
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Affiliation(s)
- M Cavaillé
- Ophthalmology Department, Rothschild Foundation Hospital, 75019 Paris, France.
| | - G Martin
- Ophthalmology Department, Rothschild Foundation Hospital, 75019 Paris, France
| | - B Poignet
- Ophthalmology Department, Hôpital Pitié-Salpêtrière, Paris, France
| | - T Chapron
- Ophthalmology Department, Rothschild Foundation Hospital, 75019 Paris, France
| | - P Dureau
- Ophthalmology Department, Rothschild Foundation Hospital, 75019 Paris, France
| | - F Metge
- Ophthalmology Department, Rothschild Foundation Hospital, 75019 Paris, France
| | - G Caputo
- Ophthalmology Department, Rothschild Foundation Hospital, 75019 Paris, France
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Aksu-Ceylan N, Turgay Özbilen K, Karakiraz A. Characteristics of pediatric open globe injuries in preschool-aged and school-aged children. CANADIAN JOURNAL OF OPHTHALMOLOGY 2023; 58:559-564. [PMID: 36368410 DOI: 10.1016/j.jcjo.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/30/2022] [Accepted: 10/15/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To evaluate the characteristics and outcomes of pediatric open globe injuries in preschool- and school-aged children. METHOD Medical records of 93 children were reviewed. Patients were categorized in 2 groups: preschool-aged group (0-7 years) and school-aged group (8-15 years). Demographic data, characteristics of trauma, Ocular Trauma Score (OTS), and initial and final best-corrected visual acuity (BCVA) were recorded and compared between groups. RESULTS The preschool-aged group consisted of 54 patients (mean age 4.6 ± 1.8 years), and the school-aged group consisted of 39 patients (mean age 11.5 ± 2.7 years). Most of the injuries were penetrating and caused by nonmetalic sharp objects in both groups. A corneal injury was detected in 45 patients (83.3%) in the preschool-aged group and 29 patients (74.4%) in school-aged group. Localization of the corneal wound was mostly central (46.7%) in the preschool-aged group and peripheral (48.3%) in school-aged group (p = 0.045). Mean corneal wound length was significantly longer in the preschool-aged group (p = 0.018). Most of the cases in the preschool-aged group were OTS group 2 (50%), whereas most of the cases in the school-aged group were OTS group 3 (38.5%). Poor visual outcome was significantly correlated with the following factors in both groups: lower OTS, worse initial BCVA, central corneal wound, longer corneal and total wound length, and presence of lens damage, retinal detachment, and hypotonia (p < 0.05 for all). Poor final BCVA also was significantly correlated with a longer scleral wound in the school-aged group and the presence of vitreous hemorrhage and uveal tissue prolapse in the posterior segment in the preschool-aged group (p < 0.05). CONCLUSIONS Localization and length of the corneal wound is closely associated with visual outcome in children with open globe injuries. Especially in preschool-aged children, mostly central localization of a corneal wound can be a challenging factor for visual rehabilitation.
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Affiliation(s)
- Nihan Aksu-Ceylan
- Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
| | - Kemal Turgay Özbilen
- Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Arzu Karakiraz
- Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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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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Wang S, Li F, Jin S, Zhang Y, Yang N, Zhao J. Biomechanics of open-globe injury: a review. Biomed Eng Online 2023; 22:53. [PMID: 37226242 DOI: 10.1186/s12938-023-01117-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/19/2023] [Indexed: 05/26/2023] Open
Abstract
Open-globe injury is a common cause of blindness clinically caused by blunt trauma, sharp injury, or shock waves, characterised by rupture of the cornea or sclera and exposure of eye contents to the environment. It causes catastrophic damage to the globe, resulting in severe visual impairment and psychological trauma to the patient. Depending on the structure of the globe, the biomechanics causing ocular rupture can vary, and trauma to different parts of the globe can cause varying degrees of eye injury. The weak parts or parts of the eyeball in contact with foreign bodies rupture when biomechanics, such as external force, unit area impact energy, corneoscleral stress, and intraocular pressure exceed a certain value. Studying the biomechanics of open-globe injury and its influencing factors can provide a reference for eye-contact operations and the design of eye-protection devices. This review summarises the biomechanics of open-globe injury and the relevant factors.
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Affiliation(s)
- Songtao Wang
- Department of Ophthalmology, The Second Hospital of Jilin University, No. 4026, Yatai Street, Nanguan District, Changchun, Jilin, China
| | - Fuqiang Li
- Department of Ophthalmology, The Second Hospital of Jilin University, No. 4026, Yatai Street, Nanguan District, Changchun, Jilin, China
| | - Siyan Jin
- Department of Ophthalmology, The Second Hospital of Jilin University, No. 4026, Yatai Street, Nanguan District, Changchun, Jilin, China
| | - Yu Zhang
- Department of Ophthalmology, The Second Hospital of Jilin University, No. 4026, Yatai Street, Nanguan District, Changchun, Jilin, China
| | - Ning Yang
- Department of Ophthalmology, The Second Hospital of Jilin University, No. 4026, Yatai Street, Nanguan District, Changchun, Jilin, China
| | - Jinsong Zhao
- Department of Ophthalmology, The Second Hospital of Jilin University, No. 4026, Yatai Street, Nanguan District, Changchun, Jilin, China.
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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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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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Junn S, Pharr C, Chen V, Williams K, Alexander J, Park HJ, Kraus C, Levin MR. Sensorimotor Outcomes in Pediatric Patients With Ocular Trauma in Baltimore. J Pediatr Ophthalmol Strabismus 2022; 59:303-309. [PMID: 35192378 DOI: 10.3928/01913913-20220126-01] [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: 11/20/2022]
Abstract
PURPOSE To evaluate sensorimotor outcomes following traumatic open globe injuries in the pediatric population. METHODS A retrospective cohort of 80 pediatric patients aged 0.4 to 17.7 years (mean age: 9.3 years, median age: 8.3 years) presenting with traumatic open globe injury to the Johns Hopkins and University of Maryland Medical Centers was evaluated between January 2006 and January 2020. Parameters included the mechanism of injury, length of time of visual deprivation, initial and final visual acuity, additional eye pathologies, and demographic factors such as age and sex. RESULTS Among children with more than 6 months of follow-up, 77.4% developed poor stereopsis and 50% developed strabismus. Children who developed strabismus had a lower Pediatric Ocular Trauma Score (POTS), indicating greater severity of injury, than children who did not develop strabismus (P = .005, chi-square test). A higher POTS, indicating less severe ocular injury, significantly correlated to a better stereoacuity (P = .001, chi-square test). CONCLUSIONS The findings indicate that strabismus and poor stereopsis are common in pediatric open globe injuries, occurring in more than half of children with pediatric open globe trauma. These outcomes are associated with poor presenting visual acuity, more severe ocular trauma, and a lower presenting POTS. [J Pediatr Ophthalmol & Strabismus. 2022;59(5):303-309.].
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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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Chen H, Zhang X, Han J, Jin X. Pediatric Open Globe Injury in Central China. Front Med (Lausanne) 2022; 8:762477. [PMID: 35141239 PMCID: PMC8818780 DOI: 10.3389/fmed.2021.762477] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 12/22/2021] [Indexed: 11/15/2022] Open
Abstract
Purpose To describe the characteristics, managements, and outcomes of pediatric open globe injury (OGI) in central China. Methods Retrospective chart review of pediatric diagnosis in patients with OGI between 2017 and 2020 at Henan Eye Hospital. Four hundred and one eyes of the patients younger than 17 years were included in this study. Open globe injury was classified according to the Birmingham Eye Trauma Terminology system (BETT). Age, sex, history, cause, month of trauma, treatment received, and outcomes were recorded. Visual acuity was documented according to standard visual acuity chart (decimals). Results Four hundred and one eyes of patients were included in the study. The mean age was 6.6 ± 3.4 years with the range from 8 months to 16 years. Open globe injuries (OGIs) occurred most frequently in the 2–8 year age and significant male predominance was noted (70.8%). The incidence of pediatric OGIs was lowest in summer months while it increased in the winter months. The most common type of pediatric OGI was penetration (89%). Scissors/knife accounted for 22%, followed by pen/pencil (15.2%), and wood/bamboo sticks (14.5%) of all the pediatric OGIs. Among the injuries, the most frequently involved is the zone I (76.1%). Initially, 70.8% of the eyes received primary debridement and wound closure without any additional intervention, while only one eye has no possibility of anatomical reconstruction when it received an evisceration. After the initial management, 198 eyes received subsequent operation, including 44 eyes that underwent cataract removal + intraocular lens (IOL) implantation, and 24 eyes underwent IOL implantation. Finally, over 6 months of follow-up, 129 eyes (32.2%) got visual acuity (VA) of 0.3–1.5 and, 63 eyes (15.7%) got VA of 0.01–0.25, while 11 eyes (2.7%) were eviscerated. Conclusion This study showed that pediatric OGIs in central China are most seen in 2–8-year age group with significant male predominance. Scissors/knife, pen/pencil, and wood/bamboo sticks accounted for over half of all cases. Pediatric OGIs often result in significant vision loss. In some severe cases (2.7%), evisceration was ultimately performed. We should call on the public to pay more attention to their children and build a safer environment for them.
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Affiliation(s)
- Hongling Chen
- Department of Ophthalmology, Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Hongling Chen
| | - Xianliang Zhang
- Department of Ophthalmology, Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Junjun Han
- Department of Ophthalmology, Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Xuemin Jin
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Khatri A, Shrestha SM, Kuhn F, Subramanian P, Hoskin AK, Pradhan E, Agrawal R. Ophthalmic Trauma Correlation Matrix (OTCM): a potential novel tool for evaluation of concomitant ocular tissue damage in open globe injuries. Graefes Arch Clin Exp Ophthalmol 2021; 260:1773-1778. [PMID: 34792638 DOI: 10.1007/s00417-021-05491-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/29/2021] [Accepted: 11/04/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To introduce a novel tool to investigate the correlation between concomitant injuries and primary open globe injury (OGI) in the setting of ophthalmic trauma, the "Ophthalmic Trauma Correlation Matrix" (OTCM). METHODS Retrospective cohort review, performed at a tertiary referral eye care center in Eastern Nepal, involving all eyes with OGI meeting the inclusion criteria from 2015-2018. Clinical data including details of primary injury, concurrent injuries, and clinical course were noted from hospital medical records. A correlation matrix chart was devised using matrix correlation and Pearson's correlation coefficient. This chart was then used to evaluate the association of the various injuries in the setting of OGI. RESULTS A total of 109 eyes with OGI were included. Majority of the eyes (78, 71.6%) had zone I injuries, while most of the eyes (66, 60.6%) had penetrating injury. The most frequent concomitant injuries in all zones of OGI were traumatic lens injury (77, 70.64%), followed by hyphema (48, 44.03%), and vitreous hemorrhage (35, 32.11%). The most common concomitant injury associated with zone I was hyphema (0.873), while traumatic subluxation/cataract (0.894) and vitreous hemorrhage (0.972) were commonly associated with zone II and III, respectively. CONCLUSIONS OTCM could be a useful tool to manage injuries related to the primary ocular injury. This additional information will aid in the prognostication, planning, and management of OGI and potentially prevent repeat surgeries and inadequate treatments.
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Affiliation(s)
- Anadi Khatri
- Department of Vitreoretinal Services, Birat Eye Hospital, Biratnagar, Nepal. .,Department of Ophthalmology, Birat Medical College and Teaching Hospital, Biratnagar, Nepal.
| | | | - Ferenc Kuhn
- Helen Keller Foundation for Research and Education, Birmingham, USA.,Department of Ophthalmology, University of Pécs Medical School, Pécs, Hungary.,International Society of Ocular Trauma, Birmingham, USA
| | - Prem Subramanian
- Colorado School of Medicine, Aurora, CO, USA.,Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Annette K Hoskin
- Save Sight Institute, University of Sydney, Sydney, Australia.,Lions Eye Institute, University of Western Australia, Perth, Australia
| | - Eli Pradhan
- Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | - Rupesh Agrawal
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore.,Singapore Eye Research Institute, Singapore, Singapore.,Moorfields Eye Hospital, NHS Foundation Trust, London, UK
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Zhang J, Zhu X, Sun Z, Wang J, Sun Z, Li J, Huang Y, Wang T, Xie R, Han H, Zhao X, Song Y, Guo M, Yang T, Zhang H, He K, Li Y, Lei Y, Zhu Y, Cui B, Miao Y, Huang B, Brant R, Yan H. Epidemiology of Sports-Related Eye Injuries Among Athletes in Tianjin, China. Front Med (Lausanne) 2021; 8:690528. [PMID: 34604250 PMCID: PMC8481368 DOI: 10.3389/fmed.2021.690528] [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] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 08/18/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: To investigate the incidence, characteristics, and risk factors of sports-related eye injuries among athletes in Tianjin, China. Methods: A cross-sectional study was carried out from March 2018 to October 2018. In this study, the athletes from Tianjin University of Sports, Tianjin Vocational College of Sports, and Tianjin provincial sports teams were selected for general investigation. In total, 1,673 athletes were invited and 1,413 participated in the study (response rate of 84.5%). Results: In total, 1,413 athletes were enrolled; 151 had suffered from sports-related eye injuries, with an incidence of 10.7% (95% CI: 9.1–12.0%). Handball (38.5%) was the sport with the highest incidence of eye injuries, followed by water polo (36.4%) and diving (26.7%). Overall, 42.4% of the athletes were injured by ball and 22.5% of injuries came from teammates. The eye injuries usually occurred during training (64.2%) and competitions (14.6%). Adnexa wound (51.7%) was the most common type of injury. About 11.9% of the athletes with eye injuries had the impaired vision; 66.7% failed to see doctors on time. The athletes <18 years of age had a higher risk of eye injuries (odds ratio [OR] =1.60, 95% CI: 1.06–2.40). The athletes with lower family income (<1,000 RMB) were at risk population for sports-related eye injuries (OR = 3.91, 95% CI: 2.24–6.82). Training >4 h a day increased the risk of eye injuries (OR = 2.21, 95% CI: 1.42–3.43). Conclusion: The incidence of sports-related eye injuries among athletes was 10.7% in Tianjin, China. Handball, water polo, and diving were the most common activities of injury. Age, family income, and training time were the risk factors for sports-related eye injuries.
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Affiliation(s)
- Jingkai Zhang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xinlei Zhu
- Shandong Eye Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Qingdao, China
| | - Zhiyong Sun
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jiaxing Wang
- Department of Ophthalmology, Emory University, Atlanta, GA, United States
| | - Zhuoyu Sun
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jianan Li
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yunli Huang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Tian Wang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Ruotian Xie
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Han Han
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiao Zhao
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yinting Song
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Miao Guo
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Tiantian Yang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Haokun Zhang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Kai He
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yiming Li
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yi Lei
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yanfang Zhu
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Bohao Cui
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yuyang Miao
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Bo Huang
- Department of Ophthalmology, University of Mississippi Medical Center, Jackson, MS, United States
| | - Rodrigo Brant
- Department of Ophthalmology and Visual Sciences, Federal University of São Paulo, São Paulo, Brazil
| | - Hua Yan
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
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12
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Liu Y, Hoskin AK, Watson SL. Epidemiology, aetiology and outcome of paediatric ocular trauma in Sydney. J Paediatr Child Health 2021; 57:1479-1484. [PMID: 33913216 DOI: 10.1111/jpc.15531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 03/28/2021] [Accepted: 04/17/2021] [Indexed: 10/21/2022]
Abstract
AIM Report epidemiology, aetiology and outcomes of eye injuries in children 0-16 years treated at quaternary referral and paediatric hospitals in Sydney, Australia. METHODS A retrospective review of cases January 2009 to December 2015 using hospital diagnostic and International Classification of Diseases, 10th Revision codes. Medical records confirmed open globe injury (OGI) or closed globe injury (CGI) diagnosis and demographic, injury mechanism, ocular and best-corrected visual acuities (BCVA) before and after treatment. RESULTS A total of 295 patients, 298 eyes were included (96 OGIs, 202 CGIs.) Injuries were commonest in males (72%) with OGI peaks in 3-5-, and CGI, 12-14-year-old males. A projectile was the commonest mechanism (106, 36%) then being struck (101, 34%). Commonest agents were sporting equipment (13%), toys (10%) and sticks (10%). Another child was involved in 32.9% OGI and 27.6% CGI. Initial BCVA was a good predictor of final BCVA. Poor prognostic factors included lens injury, vitreous haemorrhage and relative afferent pupillary defect. Final BCVA 6/12 or better was achieved in 69% cases, including 40% of OGIs and 85% of CGIs. Enucleation and evisceration rates were both 1% (n = 3). CONCLUSION Paediatric ocular trauma most commonly occurred in males from projectiles or being struck, with injuries commonly occurring from sporting equipment, toys and sticks. Vision was poorer with open than closed globe injuries.
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Affiliation(s)
- Ying Liu
- Discipline of Ophthalmology, Sydney Medical School, The University of Sydney, Save Sight Institute, Sydney, New South Wales, Australia.,St George Hospital, Kogarah, New South Wales, Australia
| | - Annette K Hoskin
- Discipline of Ophthalmology, Sydney Medical School, The University of Sydney, Save Sight Institute, Sydney, New South Wales, Australia.,Genetics and Epidemiology, Lions Eye Institute, Perth, Western Australia, Australia.,Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Western Australia, Australia
| | - Stephanie L Watson
- Discipline of Ophthalmology, Sydney Medical School, The University of Sydney, Save Sight Institute, Sydney, New South Wales, Australia.,Sydney Eye Hospital, Sydney, New South Wales, Australia.,Sydney Children's Hospital, Sydney, New South Wales, Australia
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13
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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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14
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Liu W, Yu B, Bursztyn L, Malvankar-Mehta MS. Eye injuries sustained during protests due to non-lethal weaponry: a systematic review. EXPERT REVIEW OF OPHTHALMOLOGY 2021. [DOI: 10.1080/17469899.2021.1931124] [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: 10/21/2022]
Affiliation(s)
- Winnie Liu
- Schulich School of Medicine & Dentistry, The University of Western Ontario, Ontario, Canada
| | - Brian Yu
- Schulich School of Medicine & Dentistry, The University of Western Ontario, Ontario, Canada
| | - Lulu Bursztyn
- Department of Ophthalmology, Schulich School of Medicine & Dentistry, the University of Western Ontario, Ontario, Canada
| | - Monali S. Malvankar-Mehta
- Department of Ophthalmology, Schulich School of Medicine & Dentistry, the University of Western Ontario, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, the University of Western Ontario, Ontario, Canada
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15
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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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16
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Mir TA, Canner JK, Zafar S, Srikumaran D, Friedman DS, Woreta FA. Characteristics of Open Globe Injuries in the United States From 2006 to 2014. JAMA Ophthalmol 2020; 138:268-275. [PMID: 31971539 DOI: 10.1001/jamaophthalmol.2019.5823] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance Open globe injuries can lead to substantial visual morbidity and lifelong sequelae. Interventions to reduce the burden of open globe injuries in the United States require a better understanding of these injuries through well-designed epidemiologic investigations. Objective To examine the incidence, common injury mechanisms, and economic burden of open globe injuries in the United States. Design, Setting, and Participants This retrospective, cross-sectional study of US nationwide emergency department (ED) data assessed all ED visits of patients with a primary diagnosis of open globe injury in the Nationwide Emergency Department Sample (NEDS) from January 1, 2006, to December 31, 2014. Data analysis was performed from August 29, 2018, to November 11, 2019. Main Outcomes and Measures Annual incidence of open globe injuries by age, sex, mechanism of injury, and concomitant diagnosis, as well as median charges associated with open globe injuries and variables associated with hospitalization. Results A total of 124 989 ED visits for open globe injuries were assessed, with an incidence of 4.49 per 100 000 population in the United States from 2006 to 2014 (mean [SD] age of study participants, 37.7 [22.5] years; 94 078 [75.3%] male). The incidence was highest in 2006 (5.88 per 100 000 population) and decreased by 0.3% per month between 2006 and 2014 (incidence rate ratio, 0.99; 95% CI, 0.99-0.99; P < .001). Open globe injuries occurred in 37 060 individuals (30.6%) of low socioeconomic status. The most common injury mechanism was being struck by or against an object or person (40 119 of all 124 989 injury mechanisms [32.1%]). Open globe injuries associated with falls increased 6.6% between 2006-2010 and 2011-2015 (95% CI, 1.04-1.08; P < .001) and were the most common injury mechanism in individuals older than 70 years. The total cost associated with open globe injuries was $793 million. The cost of ED visits increased from $865 during 2006-2010 to $1557 during 2011-2015. Inpatient costs similarly increased from $21 527 during 2006-2010 to $30 243 during 2011-2015. Conclusions and Relevance The incidence of open globe injuries in the United States decreased from 2006 to 2014. Although the data are from 5 to 13 years ago, these findings appear to provide valuable information for targeting preventive measures toward individuals at highest risk; targeting young men with lower socioeconomic status and individuals 70 years or older at an increased risk of falls may help lower the incidence of open globe injuries.
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Affiliation(s)
- Tahreem A Mir
- West Virginia University School of Medicine, Morgantown
| | - Joseph K Canner
- Johns Hopkins Surgery Center for Outcomes Research, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sidra Zafar
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Divya Srikumaran
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - David S Friedman
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Fasika A Woreta
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
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17
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Dorman A, O'Hagan S, Gole G. Epidemiology of severe ocular trauma following the implementation of alcohol restrictions in Far North Queensland. Clin Exp Ophthalmol 2020; 48:879-888. [DOI: 10.1111/ceo.13811] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/25/2020] [Accepted: 06/14/2020] [Indexed: 01/24/2023]
Affiliation(s)
- Andrew Dorman
- Department of Ophthalmology Cairns Hospital Cairns Queensland Australia
- University of Queensland Brisbane Queensland Australia
| | - Stephen O'Hagan
- Department of Ophthalmology Cairns Hospital Cairns Queensland Australia
- James Cook University Cairns Queensland Australia
| | - Glen Gole
- Department of Ophthalmology Cairns Hospital Cairns Queensland Australia
- Discipline of Paediatrics and Child Health University of Queensland, Queensland Children's Hospital Brisbane Queensland Australia
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18
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Uppuluri A, Zarbin MA, Bhagat N. Risk Factors for Post–Open-Globe Injury Endophthalmitis. JOURNAL OF VITREORETINAL DISEASES 2020; 4:353-359. [PMID: 37008290 PMCID: PMC9979028 DOI: 10.1177/2474126420932322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: The objective of our project is to use the National Inpatient Sample Database to identify risk factors for endophthalmitis in cases of open-globe injury (OGI). Methods: This is a cross-sectional observational study of 48 627 cases of OGI from the National Inpatient Sample Database. We performed regression analysis using IBM SPSS Statistics 23. Codes from the International Classification of Disease, Ninth Revision were used to identify ocular findings and conditions. Variables with P values less than .05 on univariate analysis were included in the multivariable regression model; Bonferroni correction was applied to these results. Results: Of the 48 627 cases of OGI, 37 440 (77.0%) occurred in the adult group (21 years and older). Overall, 1018 (2.1%) cases developed posttraumatic endophthalmitis, with 74.5% cases in the adult group. Endophthalmitis developed in 293 (4.5%) eyes with an intraocular foreign body (IOFB). Results of binary logistic regression showed the clinical findings of traumatic cataracts, hypopyon, vitreous inflammation, corneal ulcers, or IOFBs were associated with an increased risk of developing endophthalmitis after OGI. Conversely, orbital fractures, rupture-type injuries, and intraocular tissue prolapse were associated with a decreased likelihood of being diagnosed with endophthalmitis. Conclusions: Endophthalmitis developed in 2.4% of pediatric OGIs and 2.0% of adult OGIs. Traumatic cataract, hypopyon, vitreous inflammation, corneal ulcer, keratitis, retinal detachment, IOFB, and diabetes increased the risk of post-open-globe endophthalmitis.
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Affiliation(s)
| | - Marco A. Zarbin
- Rutgers New Jersey Medical School, Newark, NJ, USA
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Neelakshi Bhagat
- Rutgers New Jersey Medical School, Newark, NJ, USA
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
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19
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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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20
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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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21
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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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22
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Matsa E, Shi J, Wheeler KK, McCarthy T, McGregor ML, Leonard JC. Trends in US Emergency Department Visits for Pediatric Acute Ocular Injury. JAMA Ophthalmol 2019; 136:895-903. [PMID: 29879287 DOI: 10.1001/jamaophthalmol.2018.2062] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance There is a lack of literature describing the incidence of pediatric acute ocular injury and associated likelihood of vision loss in the United States. Understanding national pediatric eye injury trends may inform future efforts to prevent ocular trauma. Objective To characterize pediatric acute ocular injury in the United States using data from a stratified, national sample of emergency department (ED) visits. Design, Setting, and Participants A retrospective cohort study was conducted. Study participants received care at EDs included in the 2006 to 2014 Nationwide Emergency Department Sample, comprising 376 040 children aged 0 to 17 years with acute traumatic ocular injuries. Data were analyzed from June 2016 to March 2018. Exposures International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes and external-cause-of-injury codes identified children with acute ocular injuries. Main Outcomes and Measures Demographic and clinical characteristics of children with acute traumatic ocular injuries were collected and temporal trends in the incidence of ocular injuries by age, risk of vision loss, and mechanism of injury were explored. Results In 2014, there were an estimated 163 431 (95% CI, 151 235-175 627) ED visits for pediatric acute ocular injury. Injured children were more often male (63.0%; 95% CI, 62.5-63.5) and in the youngest age category (birth to 4 years, 35.3%; 95% CI, 34.4-36.2; vs 10-14 years, 20.6%; 95% CI, 20.1-21.1). Injuries commonly resulted from a strike to the eye (22.5%; 95% CI, 21.3-23.8) and affected the adnexa (43.7%; 95% CI, 42.7-44.8). Most injuries had a low risk for vision loss (84.2%; 95% CI, 83.5-85.0), with only 1.3% (95% CI, 1.1-1.5) of injuries being high risk. Between 2006 and 2014, pediatric acute ocular injuries decreased by 26.1% (95% CI, -27.0 to -25.0). This decline existed across all patient demographic characteristics, injury patterns, and vision loss categories and for most mechanisms of injury. There were increases during the study in injuries related to sports (12.8%; 95% CI, 5.4-20.2) and household/domestic activities (20.7%; 95% CI, 16.2-25.2). The greatest decrease in high-risk injuries occurred with motor vehicle crashes (-79.8%; 95% CI, -85.8 to -74.9) and guns (-68.5%; 95% CI, -73.5 to -63.6). Conclusions and Relevance This study demonstrated a decline in pediatric acute ocular injuries in the United States between 2006 and 2014. However, pediatric acute ocular injuries continue to be prevalent, and understanding these trends can help establish future prevention strategies.
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Affiliation(s)
| | - Junxin Shi
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Krista K Wheeler
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Tara McCarthy
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Mary Lou McGregor
- The Ohio State University College of Medicine, Columbus.,Department of Ophthalmology, Nationwide Children's Hospital, Columbus, Ohio
| | - Julie C Leonard
- The Ohio State University College of Medicine, Columbus.,Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
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23
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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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24
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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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Richards MD, Barnes K, Yardley AME, Hanman K, Lam GC, Mackey DA. Traumatic hyphaema in children: a retrospective and prospective study of outcomes at an Australian paediatric centre. BMJ Open Ophthalmol 2019; 4:e000215. [PMID: 31179388 PMCID: PMC6528766 DOI: 10.1136/bmjophth-2018-000215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objective This study aims to evaluate the presenting characteristics, management, outcomes and complications for paediatric traumatic hyphaema in Western Australia. Methods and Analysis A retrospective review of medical records was conducted for consecutive patients ≤16 years of age admitted for traumatic hyphaema to Princess Margaret Hospital for Children (Perth, Australia) between January 2002 and December 2013 (n=82). From this sample, a cohort whose injury occurred ≥5 years prior attended a prospective ocular examination (n=16). Hospital records were reviewed for patient demographics, injury details, management, visual outcomes and complications. The prospective cohort underwent examination for visual and structural outcomes. Results Most injuries (72%) resulted from projectile objects. Angle recession was present in 53% and was associated with projectiles (p=0.002). Most eyes (81%) achieved a final visual acuity of 0.3 logarithm of the minimum angle of resolution (logMAR) (20/40) or better. Age ≤5 years and posterior segment injury were significant predictors of final visual acuity poorer than 0.3 logMAR. At ≥5 years post-trauma, injured eyes had greater intraocular pressure (IOP) (p=0.024) and anterior chamber depth (ACD) (p=0.022) compared with sound eyes. IOP asymmetry was associated with angle recession (p=0.008) and ACD asymmetry (p=0.012). Conclusion Poorer visual outcomes are associated with younger age at injury and posterior segment injury. Angle recession and ACD asymmetry are associated with IOP asymmetry 5-12 years after injury.
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Affiliation(s)
- Michael D Richards
- Lions Eye Institute, Perth, Western Australia, Australia.,Department of Ophthalmology, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Kate Barnes
- Lions Eye Institute, Perth, Western Australia, Australia.,Department of Ophthalmology, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Anne-Marie E Yardley
- Lions Eye Institute, Perth, Western Australia, Australia.,Department of Ophthalmology, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Kate Hanman
- Lions Eye Institute, Perth, Western Australia, Australia.,Department of Ophthalmology, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Geoffrey C Lam
- Department of Ophthalmology, Perth Children's Hospital, Perth, Western Australia, Australia.,Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia
| | - David A Mackey
- Lions Eye Institute, Perth, Western Australia, Australia.,Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia
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AlDahash F, Mousa A, Gikandi PW, Abu El-Asrar AM. Pediatric open-globe injury in a university-based tertiary hospital. Eur J Ophthalmol 2018; 30:269-274. [PMID: 30539664 DOI: 10.1177/1120672118818013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND To investigate epidemiology, etiology, and outcomes after repair of pediatric open-globe injury. METHODS We retrospectively reviewed medical records of patients ⩽18 years who underwent primary open-globe repair. RESULTS A total of 213 patients were identified. Male-female ratio was 1.44:1. Type of injury was penetration in 157 (74.4%) cases, rupture in 52 (24.4%) cases, and perforation in 2 (0.9%) cases. Knife injuries were the most common cause, affecting 38/196 (19.4%), followed by metallic object in 37/196 (18.9%) patients, glass in 26/196 (13.3%) patients, and pen or pencil in 24/196 (12.8%). Predictors of good visual outcome defined as (⩾20/40) were good initial visual acuity (⩾20/40; p < 0.0001), time from injury to arrival at the emergency room >24 h (p = 0.038), size of wound less than 10 mm (p < 0.0001), absence of iris prolapse (p < 0.0001), deep anterior chamber at presentation (p < 0.0001), absence of hyphema (p = 0.043), intact lens (p < 0.0001), and no retinal detachment during follow-up (p < 0.0001). A total of 27 (12.7%) cases were documented to have retinal detachment at any time during follow-up period. Predictors of retinal detachment were perforation and rupture (p < 0.0001), whereas penetration was not associated with development of retinal detachment, size of the wound ⩾10 mm (p < 0.0001), initial visual acuity ⩽20/200 (p < 0.0001), lens injury (p < 0.0001), and development of endophthalmitis (p < 0.027). Eight (3.7%) eyes had the clinical diagnosis of posttraumatic endophthalmitis. CONCLUSIONS The most common type of injury was penetration and the most common tool was knife. Visual outcome was affected by the initial presentation. Retinal detachment was a significant predictor of a worse final visual outcome.
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Affiliation(s)
- Faisal AlDahash
- Department of Ophthalmology, King Abdulaziz University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Mousa
- Department of Ophthalmology, King Abdulaziz University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Priscilla W Gikandi
- Department of Ophthalmology, King Abdulaziz University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed M Abu El-Asrar
- Department of Ophthalmology, King Abdulaziz University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Dr. Nasser Al-Rashid Research Chair in Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Tabatabaei SA, Soleimani M, Naderan M, Ahmadraji A, Rajabi MB, Jafari H, Safizade M. A survey of incidental ocular trauma by pencil and pen. Int J Ophthalmol 2018; 11:1668-1673. [PMID: 30364156 DOI: 10.18240/ijo.2018.10.15] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 05/17/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To determine characteristic features of ocular trauma resulted from self-trauma by writing instruments among pediatric population. METHODS Thirty-six children who suffered from self-inflicted ocular trauma with a writing instrument were included in this prospective cross-sectional study. RESULTS The mean age was 5.6±2.7y with male: female ratio of 1.77. The right eye was involved two times more than the left eye. The superomedial (55.5%) and inferomedial (30.6%) quadrants were the most common sites of injury. The leading culprit was colored pencils (44.4%). During surgical exploration, no foreign body (FB) was found in 25 (69.4%) patients while an FB was found in 11 (30.5%) patients. Brain injury was present in two patients (5.6%) and only in superomedial quadrant injuries. Zone 1 was the most common site for ocular trauma associated with penetrating injury. The mean ocular trauma score (OTS) in penetrating injuries was 3.8±1.2. The best corrected visual acuity (BCVA) was 0.3±0.6 upon admittance and 0.08±0.21 after one year. The final BCVA was significantly correlated with the entrance site, better final BCVA was found in nasal entrance site (P<0.05). CONCLUSION The ophthalmologists should keep a high index of suspicion to rule out penetrating eye injuries related to writing instruments in a young uncooperative child. Brain injury is a life-threatening event that should be ruled out by appropriate imaging. Medial canthal area as the most common site needs an especial attention in writing instrument injuries.
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Affiliation(s)
- Seyed Ali Tabatabaei
- Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| | - Mohammad Soleimani
- Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| | - Morteza Naderan
- Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| | - Aliasghar Ahmadraji
- Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| | - Mohammad Bagher Rajabi
- Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| | - Hajar Jafari
- Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| | - Mona Safizade
- Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
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Fujikawa A, Mohamed YH, Kinoshita H, Matsumoto M, Uematsu M, Tsuiki E, Suzuma K, Kitaoka T. Visual outcomes and prognostic factors in open-globe injuries. BMC Ophthalmol 2018; 18:138. [PMID: 29884145 PMCID: PMC5994054 DOI: 10.1186/s12886-018-0804-4] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 05/30/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ocular trauma is an important cause of visual loss worldwide. Improvements in our knowledge of the pathophysiology and management of ocular trauma during the past 30 years, in conjunction with advances in the instrumentation and techniques of ocular surgery, have improved the efficacy of vitreoretinal surgery in injured eyes. The aim of the current study was to determine the visual outcomes and prognostic factors of open-globe injuries in the Japanese population. METHODS Retrospective study of 59 eyes of 59 patients presented with open globe injuries between September 2008 and March 2014 at Nagasaki University Hospital was conducted. Demographic factors including age, gender, and clinical data such as cause of injury, presenting visual acuity (VA), location of injury, type of injury, lens status, presence of intraocular foreign body, types of required surgeries, and final VA were recorded. According to the classification of Ocular Trauma Classification Group, wound location was classified into three zones. Chi-square test was used to compare presented data. RESULTS Out of the 59 patients, 46 were placed in the Light Perception (LP) group, and 13 were placed in the No Light Perception (NLP) group. Work-related trauma was the most common cause (27 eyes) followed by falls (19eyes). Work-related trauma was common in males (P = 0.004), while falls was significantly common in females (P = 0.00001). Zone III injuries had statistically significantly poor prognostic factor compared to other zones (P = 0.04). All cases of NLP group (100%) presented with rupture globe. Poor VA at first visit (P = 0.00001), rupture globe (P = 0.026), history of penetrating keratoplasty (PK) (P = 0.017), retinal detachment (RD) (P = 0.0001), vitreous hemorrhage (VH) (P = 0.044), and dislocation of crystalline lens (P = 0.0003) were considered as poor prognostic factors. CONCLUSION Poor VA at first visit, rupture globe, zone III injuries, history of penetrating keratoplasty, RD, VH, and dislocation of crystalline lens were found to be poor prognostic factors. PPV had a good prognostic value in open globe injuries associated with posterior segment involvement.
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Affiliation(s)
- Azusa Fujikawa
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan
| | - Yasser Helmy Mohamed
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan. .,Department of Ophthalmology, EL-Minia University Hospital, EL-Minia, Egypt.
| | - Hirofumi Kinoshita
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan
| | - Makiko Matsumoto
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan
| | - Masafumi Uematsu
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan
| | - Eiko Tsuiki
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan
| | - Kiyoshi Suzuma
- Department of Ophthalmology and Visual Sciences, Graduate School of Medicine Kyoto University, Kyoto, Japan
| | - Takashi Kitaoka
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan
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Puodžiuvienė E, Jokūbauskienė G, Vieversytė M, Asselineau K. A five-year retrospective study of the epidemiological characteristics and visual outcomes of pediatric ocular trauma. BMC Ophthalmol 2018; 18:10. [PMID: 29347941 PMCID: PMC5774107 DOI: 10.1186/s12886-018-0676-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 01/10/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pediatric trauma can lead to serious visual impairment as a result of the trauma itself or secondary to amblyopia. Precise data on epidemiological characteristics and visual outcomes of pediatric ocular injuries are valuable for the prevention of monocular blindness. METHODS A total of 268 cases of pediatric ocular trauma admitted to the Department of Ophthalmology of the Lithuanian University of Health Sciences Hospital from January 2008 to December 2013 were retrospectively reviewed. Data analysed included age, sex, cause, type and treatment of injury, initial and final visual acuity (VA) and tissues involvement. Eye injuries were classified by Birmingham Eye Trauma Terminology (BETT) and Ocular Trauma Classification System (OTCS). RESULTS The age of children ranged from 6 months to 17.5 years. Boys were more likely to suffer ocular injury than girls. Home was the leading place of eye injury (60.4%), followed by outdoors (31.7%), school (5.2%) and sporting area (2.2%). The highest percentage of eye injuries in children were caused by blunt (40.3%) and sharp objects (29.9%), followed by burns (9.3%), falls (6.7%), explosions (4.5%), fireworks (4.1%), gunshots (1.9%) and traffic accidents (0.7%). Closed globe injury (CGI) was the most common type of eye injury (53.4%). CGI were noted to be higher in children aged 13-18 years, while open globe injury (OGI) were higher in the pre-school age group. Injury of grade 4 and grade 5 were more common in OGI, while grade 1 and grade 2 predominated in cases of CGI. Hypotony, traumatic cataract, iris laceration, vitreous prolapse and uveitis were the most common presentations of OGI, while hyphema, secondary glaucoma and retinal edema were significantly related with CGI. Final diagnoses contributing to poor final visual outcome such as corneal scar corneal opacity, hypotony, aphakia, and retinal detachment were statistically significant related only with OGI. Overall, 65.63% of children regained good visual acuity (VA ≥ 0.5), but for 18.4% of them, the trauma resulted in severe visual impairment (VA ≤ 0.1). CONCLUSION Ocular trauma in children still remains an important preventable cause of ocular morbidity. This study provides data indicating that ophthalmological injuries are a significant cause of visual impairment in children.
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Affiliation(s)
- Edita Puodžiuvienė
- Eye clinic, Lithuanian University of Health Sciences, Eivenių 2, Kaunas, Lithuania
| | - Giedrė Jokūbauskienė
- Eye clinic, Lithuanian University of Health Sciences, Eivenių 2, Kaunas, Lithuania
| | - Monika Vieversytė
- Eye clinic, Lithuanian University of Health Sciences, Eivenių 2, Kaunas, Lithuania
| | - Kirwan Asselineau
- Ophthalmology department, Centre Hospitalier Universitaire de Limoges, 2, avenue Martin Luther King, Limoges, France
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Beshay N, Keay L, Dunn H, Kamalden TA, Hoskin AK, Watson SL. The epidemiology of Open Globe Injuries presenting to a tertiary referral eye hospital in Australia. Injury 2017; 48:1348-1354. [PMID: 28438416 DOI: 10.1016/j.injury.2017.04.035] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Revised: 04/14/2017] [Accepted: 04/15/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Open globe injuries (OGIs) account for 44% of the cost of ocular trauma within Australia. It is estimated that 90% of ocular trauma is preventable. However, there have been few epidemiological studies within Australia that have identified groups at risk of OGIs specifically. The aim of our study was to review the epidemiology of OGIs presenting to a tertiary referral eye hospital in Australia. METHODS The Birmingham Eye Trauma Terminology (BETT) system was used to classify injuries as globe ruptures, penetrating eye injuries (PEIs), intraocular foreign bodies (IOFBs) or perforating injuries. Demographic data, past ocular history, mechanism of trauma, ocular injuries, and best-corrected visual acuity (BCVA) before and after treatment were recorded. RESULTS The 205 OGIs included 80 globe ruptures, 71 PEIs, 48 IOFBs and six perforating injuries. Falls predominated in older age groups compared to the other mechanisms of injury (p<0.0001). A fall was responsible for 33 globe ruptures and 82% of these had a history of previous intraocular surgery. Globe rupture and perforating injuries had poorer visual outcomes (p<0.05), consistent with previous studies. Alcohol was implicated in 20 cases of OGI, with 11 of these due to assault. PEIs and IOFBs commonly occurred while working with metal. BCVA was significantly worse following removal of an intraocular foreign body. We found presenting BCVA to be a good predictor of BCVA at the time of discharge. CONCLUSIONS The causes of OGI varied in association with age, with older people mostly incurring their OGI through falls and younger adults through assault and working with metal. Globe ruptures occurring after a fall often had a history of intraocular surgery. The initial BCVA is useful for non-ophthalmologists who are unfamiliar with the ocular trauma score to help predict the BCVA following treatment.
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Affiliation(s)
- Nader Beshay
- Save Sight Institute, University of Sydney, 8 Macquarie Street, Sydney NSW 2000, Australia; Royal North Shore Hospital, Reserve Road, St Leonards, NSW, 2065, Australia.
| | - Lisa Keay
- Save Sight Institute, University of Sydney, 8 Macquarie Street, Sydney NSW 2000, Australia
| | - Hamish Dunn
- Save Sight Institute, University of Sydney, 8 Macquarie Street, Sydney NSW 2000, Australia; Royal North Shore Hospital, Reserve Road, St Leonards, NSW, 2065, Australia
| | - Tengku A Kamalden
- UM Eye Research Centre, Department of Ophthalmology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Annette K Hoskin
- Lions Eye Institute, 2 Verdun Street, Nedlands, WA 6009, Australia; Centre for Ophthalmology and Visual Science, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia
| | - Stephanie L Watson
- Save Sight Institute, University of Sydney, 8 Macquarie Street, Sydney NSW 2000, Australia; Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW 2000, Australia
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31
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Miller KE. Pediatric Ocular Trauma: an Update. CURRENT OPHTHALMOLOGY REPORTS 2017. [DOI: 10.1007/s40135-017-0130-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hoskin AK, Yardley AME, Hanman K, Lam G, Mackey DA. Sports-related eye and adnexal injuries in the Western Australian paediatric population. Acta Ophthalmol 2016; 94:e407-10. [PMID: 26647756 DOI: 10.1111/aos.12911] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 09/16/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE To identify the causes of sports-related eye and adnexal injuries in children in Perth, Western Australia, to determine which sporting activities pose the highest risk of eye and adnexal injury to children. METHODS We performed a 12-year retrospective review of children admitted to hospital from 2002 to 2013 with sports-related ocular and adnexal eye injuries. The main outcome measures were the cause and type of ocular and adnexal injuries, age and gender risk factors. RESULTS A total of 93 cases of sports-related ocular and adnexal injury were identified in the 12-year time period. A peak in injuries occurred for 12- to 14-year-olds with a second peak in 6- to 8-year-olds; the median age was 8.82 years (range = 1.59-16.47). Cycling, football (including soccer and Australian Rules Football), tennis, trampolining, fishing and swimming were the sports responsible for the greatest number of injuries, a total of 63%. More than one-third (35%) of injuries resulted from being struck by a blunt object, and more than a quarter (26%) were as a result of contact with a blunt projectile. CONCLUSION Serious ocular and adnexal injuries have occurred in children as a result of participating in sports, with cycling and football being the largest contributors in the 12-year period we assessed. As we continue to encourage children to spend more time participating in sports and recreational activities, identifying associated risk factors will help us develop injury prevention strategies to promote eye safety for children.
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Affiliation(s)
- Annette K. Hoskin
- Lions Eye Institute; Perth Western Australia Australia
- Centre for Ophthalmology and Visual Science; University of Western Australia; Perth Western Australia Australia
| | - Anne-Marie E. Yardley
- Lions Eye Institute; Perth Western Australia Australia
- Princess Margaret Hospital for Children; Perth Western Australia Australia
| | - Kate Hanman
- Lions Eye Institute; Perth Western Australia Australia
- Princess Margaret Hospital for Children; Perth Western Australia Australia
| | - Geoffrey Lam
- Centre for Ophthalmology and Visual Science; University of Western Australia; Perth Western Australia Australia
- Princess Margaret Hospital for Children; Perth Western Australia Australia
| | - David A. Mackey
- Lions Eye Institute; Perth Western Australia Australia
- Centre for Ophthalmology and Visual Science; University of Western Australia; Perth Western Australia Australia
- Princess Margaret Hospital for Children; Perth Western Australia Australia
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An Important Cause of Blindness in Children: Open Globe Injuries. J Ophthalmol 2016; 2016:7173515. [PMID: 27247799 PMCID: PMC4877484 DOI: 10.1155/2016/7173515] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 04/10/2016] [Accepted: 04/19/2016] [Indexed: 11/17/2022] Open
Abstract
Objective. Our aim was to present and evaluate the predictive factors of visual impairment and blindness according to WHO criteria in pediatric open globe injuries. Methods. The medical records of 94 patients younger than 18 years who underwent primary repair surgery were reviewed retrospectively. The initial and final visual acuity, anterior and posterior segment findings, and zone of injury were noted. The patients were classified as blindness in one eye or visual impairment in one eye. Results. Of 412 patients who presented with open globe injury, 94 (23%) were under 18 years old. Fifty-four (16 females, 38 males) children were included. The mean age of the children was 7.1 ± 4.1 years. According to WHO criteria, 19 of 54 patients (35%) had unilateral blindness and 8 had unilateral visual impairment (15%). There was no significant relationship between final visual acuity and gender and injured eye. In visually impaired and blind patients, presence of preoperative hyphema, retinal detachment, and zone 2 and zone 3 injuries was significantly higher. Conclusion. Presence of hyphema and zone 2 and zone 3 injuries and retinal detachment may end up with visual impairment and/or blindness in children.
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Hoskin AK, Philip SS, Yardley AME, Mackey DA. Eye Injury Prevention for the Pediatric Population. Asia Pac J Ophthalmol (Phila) 2016; 5:202-11. [PMID: 27183290 DOI: 10.1097/apo.0000000000000193] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Each year an estimated 3.3 to 5.7 million pediatric eye injuries occur worldwide. It is widely reported that 90% of ocular injuries are preventable. Our aim was to identify legislation and policies, education, and mandatory eye protection strategies that have successfully contributed to reducing rates of children's eye injuries. A literature search was conducted using the terms "pediatric" or "children" or "adolescent" and "ocular" or "eye" and "protection" or "injury prevention." Articles were retrieved based on titles and abstracts and assessed in the context of our research question. Strategies identified aimed at reducing ocular trauma fell into 3 broad categories: legislation and policies, education, and personal eye protection. Policies including restrictions on the sale and supply of certain consumer products, mandatory vehicle seatbelts, and laminated windscreens in vehicles have assisted in reducing children's eye injuries. Educational tools aimed at children and their caregivers have been effective in changing attitudes to eye health and safety. Effective pediatric eye injury prevention systems require a multifactorial approach combining legislation, policies, standards, education, and personal eye protection to limit exposure to ocular hazards. A paucity of standardized measurement and lack of funding have limited advances in the field of children's eye injury prevention. Improved eye injury surveillance and research funding along with collaboration with health care providers are important components for strategies to prevent pediatric ocular trauma.
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Affiliation(s)
- Annette K Hoskin
- From the *Lions Eye Institute, Perth; †Centre for Ophthalmology and Visual Science, University of Western Australia, Crawley; and ‡Princess Margaret Hospital for Children, Perth, Western Australia, Australia
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Abstract
Open globe injury (OGI) is a severe form of eye trauma estimated at 2-3.8/100,000 in the United States. Most pediatric cases occur at home and are the result of sharp object penetration. The aim of this article is to review the epidemiology, diagnosis, management, and prognosis of this condition by conducting a systematic literature search with inclusion of all case series on pediatric OGI published between 1996 and 2015. Diagnosis of OGI is based on patient history and clinical examination supplemented with imaging, especially computed tomography when indicated. Few prospective studies exist for the management of OGI in pediatric patients, but adult recommendations are often followed with success. The main goals of surgical management are to repair the open globe and remove intraocular foreign bodies. Systemic antibiotics are recommended as medical prophylaxis against globe infection, or endophthalmitis. Other complications are similar to those seen in adults, with the added focus of amblyopia therapy in children. Severe vision decline is most likely due to traumatic cataracts. The ocular trauma score, a system devised to predict final visual acuity (VA) in adults, has proven to be of prognostic value in pediatric OGI as well. Factors indicating poor visual prognosis are young age, poor initial VA, posterior eye involvement, long wound length, globe rupture, lens involvement, vitreous hemorrhage, retinal detachment, and endophthalmitis. A thorough understanding of OGI and the key differences in epidemiology, diagnosis, management, and prognosis between adults and children is critical to timely prevention of posttraumatic vision loss early in life.
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Affiliation(s)
- Xintong Li
- Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Marco A Zarbin
- Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Neelakshi Bhagat
- Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, NJ, USA
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Abstract
PURPOSE To evaluate the demographic, etiologic, and clinical characteristics of open globe injuries in preschool children. METHODS The medical files of preschool children who had an operation for an open globe injury from January 2003 to January 2013 were retrospectively analyzed. The patients' demographics and injury characteristics were recorded. RESULTS The study consisted of 44 preschool children with an open globe injury. The mean age was 4.38 ± 1.39 years. Most of the injuries occurred in boys (32/44). All patients were followed up for at least 3 months (mean, 8.47 ± 6.38 months; range, 3-24 months). The mean time between injury and operation was 10.40 ± 5.94 hours. Injuries happened most frequently at home (45.4%), and the most common cause of injury was kitchen items (25%). The final visual acuity could be evaluated only in 21 patients, and 90.4% of them had residual vision deficit. CONCLUSIONS Because open globe injuries occur most frequently at home or in the immediate surroundings of the house, higher awareness of parents and child care providers is extremely important to prevent these injuries in preschool children.
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Zhu L, Wu Z, Dong F, Feng J, Lou D, Du C, Ren P. Two kinds of ocular trauma score for paediatric traumatic cataract in penetrating eye injuries. Injury 2015; 46:1828-33. [PMID: 25935359 DOI: 10.1016/j.injury.2015.04.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 03/22/2015] [Accepted: 04/11/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare the ocular trauma score (OTS) and the paediatric penetrating ocular trauma score (POTS) as prognostic model for visual outcome in paediatric traumatic cataract cases after penetrating eye injuries. METHODS All children younger than 16 years with unilateral traumatic cataract following penetrating trauma between 2007 and 2012 were retrospectively reviewed. Univariate chi-square analysis was conducted to identify the variables associated with profound visual loss. The area under the receiver-operating characteristic curves (AUROC) was used to assess the predictive ability of the two models. RESULTS The study group comprised 65 boys and 37 girls. The variables associated with profound visual loss were: a relative afferent papillary defect (RAPD) (P<0.001), poor initial vision (P=0.01), vitreous haemorrhage (P<0.001), retinal detachment (P<0.001), posterior penetrating site (P<0.001), hyphema (P<0.001), no intraocular len implantation (P<0.001) and endophthalmitis (P=0.001). OTS could not be calculated in 21 patients (20.6%) without clinical data on initial visual acuity and RAPD. For the patients with complete clinical data, POTS was similar to OTS in predicting poor vision (AUROC 0.904 vs 0.924) and in predicting good vision (AUROC 0.766 vs 0.736). For all the samples, POTS was a robust predictor of poor vision (AUROC 0.910) and had a moderate ability to predict good vision (AUROC 0.764). CONCLUSION OTS has high ability to predict visual outcome for paediatric traumatic cataract following penetrating ocular trauma. POTS is also a reliable prognostic model for very young child without initial vision or RAPD, but is only for penetrating eye injuries.
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Affiliation(s)
- Lili Zhu
- Department of Ophthalmology, The First Affiliated Hospital, Medical College, Zhejiang University, China
| | - Zhencheng Wu
- Department of Ophthalmology, The First Affiliated Hospital, Medical College, Zhejiang University, China
| | - Feng Dong
- Department of Ophthalmology, The First Affiliated Hospital, Medical College, Zhejiang University, China
| | - Jia Feng
- Department of Ophthalmology, The Children's Hospital, Medical College, Zhejiang University, China
| | - Dinghua Lou
- Department of Ophthalmology, The First Affiliated Hospital, Medical College, Zhejiang University, China.
| | - Chixin Du
- Department of Ophthalmology, The First Affiliated Hospital, Medical College, Zhejiang University, China
| | - Peifang Ren
- Department of Ophthalmology, The First Affiliated Hospital, Medical College, Zhejiang University, China
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Yardley AME, Hoskin AK, Hanman K, Wan SL, Mackey DA. Animal-inflicted ocular and adnexal injuries in children: A systematic review. Surv Ophthalmol 2015; 60:536-46. [PMID: 26022273 DOI: 10.1016/j.survophthal.2015.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 05/16/2015] [Accepted: 05/18/2015] [Indexed: 11/17/2022]
Abstract
Eye injury remains the leading cause of monocular blindness in children despite 90% of injuries being potentially preventable. Children interact with animals in a variety of situations, and the associated dangers may be underestimated. Animals are capable of causing ocular and adnexal injuries that are cosmetically and visually devastating. We examine the current literature regarding the nature and severity of animal-inflicted ocular and adnexal injuries in children.
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Affiliation(s)
- Anne-Marie E Yardley
- Princess Margaret Hospital for Children, Perth, Western Australia, Australia; Lions Eye Institute, Perth, Western Australia, Australia; Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia.
| | - Annette K Hoskin
- Lions Eye Institute, Perth, Western Australia, Australia; Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia
| | - Kate Hanman
- Princess Margaret Hospital for Children, Perth, Western Australia, Australia; Lions Eye Institute, Perth, Western Australia, Australia
| | - Sue L Wan
- Lions Eye Institute, Perth, Western Australia, Australia; Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia
| | - David A Mackey
- Princess Margaret Hospital for Children, Perth, Western Australia, Australia; Lions Eye Institute, Perth, Western Australia, Australia
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Philip SS, Hoskin AK. Children's protective eyewear: the challenges and the way forward. Med J Aust 2014; 201:87-8. [DOI: 10.5694/mja13.00132] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 04/01/2014] [Indexed: 11/17/2022]
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Characteristics and outcomes of pediatric open globe injury. Int Ophthalmol 2013; 34:839-44. [PMID: 24362710 DOI: 10.1007/s10792-013-9890-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 12/08/2013] [Indexed: 10/25/2022]
Abstract
To describe the epidemiology, mechanism of injury, and final visual and anatomical outcomes of pediatric patients with open globe injury. The medical records of patients aged ≤ 16 years diagnosed with open globe injury between January 2006 and December 2010 were retrospectively reviewed. Forty-nine pediatric patients were diagnosed with open globe injury during the study period. Forty-one of the 49 patients (83.7 %) were male. The mean age of the patients was 9.3 ± 4.6 years, with 49 % of the injuries occurring in patients between the ages of 11 and 16 years. Ocular penetration was the most common type of injury (63.3 %), occurring most frequently in the cornea (63.3 %). Wooden objects were the most common cause of injury. Following surgical intervention, 40.8 % of the patients obtained a final visual acuity (VA) of ≥ 6/60. Pars plana vitrectomy was performed in 51 % of cases, with only 36 % of these patients having a final VA of ≥ 6/60. The presence of retinal detachment was the only statistically significant factor (odds ratio 0.05, p < 0.001) that affected VA improvement of more than one line. Corneal penetration was frequently observed in pediatric patients with ocular trauma. Pediatric patients with a retinal detachment were significantly more likely to have a poor final visual outcome than open globe patients whose retina remained attached. Despite prompt surgical intervention, useful vision was preserved in less than half of the patients requiring pars plana vitrectomy.
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