Eye injuries in childhood: a retrospective investigation of 88 cases from 1988 to 2000

Surgical management of pediatric eye injuries

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.

Ocular Trauma in Pediatric Age Group at a Tertiary Eye Care Center in Central Maharashtra, India

PURPOSE

To study the demographic profile and visual outcome in pediatric ocular trauma.

STUDY DESIGN

Prospective and interventional study.

SETTING

Tertiary eye care center in central Maharashtra.

MATERIALS AND METHODS

The study included all children of age group 15 years and younger sustaining eye injuries and presented to the outpatient department or emergency services. The duration of the study was 1 year. A detailed medical history was obtained. Demographic profile was noted. A detailed ocular examination included visual acuity, slit-lamp biomicroscopy, and fundus examination. All patients were followed up to 6 months.

RESULTS

Out of 350 children examined, 66 (18.9%) had ocular trauma. The mean age at presentation was 8.33 ± 4.03 years. Children aged 6-10 years (39.3%) were most commonly affected followed by children from 11 to 15 years (36.1%). There were no significant differences between rural (54.1%) and urban (45.9%) children. Most (63.9%) had open and 24.6% had closed globe injuries. Perforating injuries to the cornea (n=29, 47.5%) was the most common injury. Sports-related injuries were common (n= 18) followed by wooden stick- (n = 14) and firecracker-related (n = 11) injuries. In the open and closed globe injuries, 36 (92.3%) and 5 (33.3%) patients, respectively, required immediate surgical intervention.

CONCLUSION

Sports-related activities were a common cause of ocular trauma in the pediatric age group in the central region of Maharashtra. We propose setting of rapid action ocular trauma team to prevent blindness occurring due to trauma.

Epidemiological profile of pediatric ocular trauma in a tertiary hospital of northern India

PURPOSE

Ocular trauma is one of the most common causes of acquired blindness in children. It measures about 8%-14% of total childhood injuries. This study aims to determine the epidemiological profile of ocular trauma in the pediatric age group attending a tertiary hospital in northern India.

METHODS

A retrospective study was conducted in our hospital between June 2014 to July 2015 and all the children aged 0-16 years presenting with ocular trauma in eye outpatient department and emergency were enrolled in the study. Various epidemiological parameters like age, sex distribution, duration of presentation, mode of injury, type of injury and final visual outcome were analyzed.

RESULTS

Of total 357 patients, 271 (76%) were below the age of 12 years; 41.1% of children with ocular trauma belonged to age group 2-6 years. The male to female ratio was 2.9:1. Out of total patients, 242 (67.8%) presented with closed globe injury. Among the closed globe injury, the history of fall was present in about 35% of children, followed by trauma while playing with bat/ball (15.7%) and finger nail trauma (13.2%). Among open globe injury, trauma with needle, knife, glass and pen were common causes. Home was the most common place of injury (47.8%), followed by streets (17.9%) and playground (14.9%).

CONCLUSION

Children are vulnerable to ocular trauma and need more supervision. Sharp objects like needles, knives, household chemicals like acids should be out of reach of children.

Epidemiological Features of Pediatric Ocular Trauma in Egypt

Purpose. To review the epidemiology of serious pediatric ocular trauma presenting to Kasr El Aini Hospital, Cairo University. Methods. Children with serious ocular trauma during a six-month period were examined and their data was analyzed. Results. Eighty eyes of 75 patients were included in this study, with 64% males (P < 0.001) and average age of 5 years (5 months–15 years). There were 67 (83.75%) open globe injuries, 11 (13.75%) closed globe injuries, and 2 (2.5%) chemical injuries. Of the open globe injuries, 24 (30%) were ruptured globes and 43 (53.75%) were lacerations (31 penetrating injuries (38.75%), 6 IOFBs (7.5%), and 6 perforating injuries (7.5%)). Of the closed globe injuries, 3 had hyphema (3.75%), 5 had traumatic cataracts (6.25%), and 3 had vitreous hemorrhage with retinal detachment (3.75%). Forty-two patients (56%) presented within 24 hours, 28 patients (37.33%) presented between 24 hours and 1 week, and 5 patients (6.6%) presented after one week from the time of trauma. Seven eyes developed posttraumatic endophthalmitis (10% of open globe injuries). On leaving the hospital, 55 (68.75%) eyes had poor vision, 13 (16.25%) had moderate vision, and 12 (15%) had good vision. Conclusion. Children at a higher risk of trauma are males, >5 years, unsupervised, and involved in street activities. Immediate comprehensive primary management and secondary rehabilitation are mandatory in these cases.

Epidemiology of patients hospitalized for ocular trauma in the Chaoshan region of China, 2001-2010

BACKGROUND

The burden and pattern of ocular trauma in China are poorly known and not well studied. We aimed at studying the epidemiological characteristics of patients hospitalized for ocular trauma at major ophthalmology departments in the largest industrial base of plastic toys in China.

METHODS

A retrospective study of ocular trauma cases admitted to 3 tertiary hospitals in China from 1st January 2001 to 31st December 2010 was performed.

RESULTS

The study included a total of 3,644 injured eyes from 3,559 patients over the 10-year period: 2,008 (55.1%) open-globe injuries, 1,580 (43.4%) closed-globe injuries, 41 (1.1%) chemical injuries, 15 (0.4%) thermal injuries and 678 (18.6%) ocular adnexal injuries. The mean age of the patients was 29.0±16.8 years with a male-to-female ratio of 5.2∶1 (P = 0.007). The most frequent types of injury were work-related injuries (1,656, 46.5%) and home-related injuries (715, 20.1%). The majority of injuries in males (56.2%) and females (36.0%) occurred in the 15-44 age group and 0-14 age group, respectively. The final visual acuity correlated with the initial visual acuity (Spearman's correlation coefficient = 0.659; P<0.001). The Ocular Trauma Score also correlated with the final visual acuity (Spearman's correlation coefficient = 0.655; P<0.001).

CONCLUSIONS

This analysis provides an epidemiological study of patients who were hospitalized for ocular trauma. Preventive efforts are important for both work-related and home-related eye injuries.

Clinical pattern of pediatric ocular trauma in fast developing country

BACKGROUND

Ocular trauma is a significant problem in pediatric patients. Also, leads to visual loss throughout the world there are no data of pediatric ocular trauma in Arabian Gulf Countries in the current literature.

AIM

To study the epidemiology, mechanism, causes and outcome of serious ocular trauma requiring hospital admission, in children below 16years of age.

STUDY DESIGN

A retrospective cohort study.

SUBJECTS

All pediatric patients (up to 16years of age) presenting with ocular injuries to a tertiary care pediatric ophthalmology and Pediatric Accident Emergency Department 1 January 2005 to 30 December 2009.

METHODS

Each file was studied to find out the demographic data, mechanism and cause of injury. The definitions and classifications of ocular trauma in our study were modified from the Ocular Trauma Classification Group guidelines and Birmingham Eye Trauma Terminology Presenting and final visual acuity were recorded along with details of anterior and posterior segment evaluation.

RESULTS

Hundred and six files of the children admitted to ophthalmology ward with the diagnosis of ocular trauma between 2005 and 2009 were reviewed. Majority were boys (77.4%). The mean age at admission was 6.63years. A higher incidence of ocular trauma was noted in children above 5years than those below (58.5%). Most number of trauma occurred at home (42.5%, n=45) followed by street (35.8% n=34), school (12.3%, n=13), sporting area (5.7%, n=6). Also, eight patients (8.5%) involved in Road Traffic Accidents (RTA). Closed globe injury occurred more frequently than open globe injury (59.4% vs. 40.6%). Initial visual acuity was more than 6/60 in (55.6%) patients of closed globe while in open globe injury was (37.3%). Final visual acuity was more than 6/18 in (82.5%) patients of closed globe injury group and in (63%) patients of open globe injury group. Severe impairment of vision was found in (11.6%) and blindness (4.7%) only in open globe injury group.

CONCLUSION

Most eye injuries in children are preventable so this reflects the importance of health education, adult supervision and application of appropriate measures that is necessary for reducing the incidence and severity of trauma.

Eye injuries in children and adolescents: a report of 205 cases

OBJECTIVE

To investigate the causes, place, type and visual outcome of eye injuries necessitating hospitalization in children and adolescents.

METHODS

Consecutive patients with eye injuries aged <18 years admitted to a tertiary hospital over an 18-month period.

RESULTS

Two-hundred-five patients were hospitalized because of eye injuries over the study period. One-hundred-forty-six (71.2%) were males and 59 (28.9%) were females, for a ratio of 2.5:1. Preschool children made up 14.1% of the cases and 63.9% were in school, while 9.8% were apprentice artisans. Fewer than 23.4% (n=48) patients presented within 24 hours of injury. Injuries sustained at home occurred in 97 cases (47.3%) and at school in 44 (21.5%). Of the 54.6% of whose injuries were inflicted by others, 24.9% were inflicted by adults while meting out corporal punishment. Pointed objects (43.8%) and missiles (25.8%) were the common causative agents of injuries. Such agents were belts, canes, sticks, cutlasses and hoes. Penetrating eye injuries were the commonest type of injury (40.5%), followed by contusions (31.7%). Final visual outcome was < or = 6/60 in 88 (48.4%). Most eyes with poor visual outcome had penetrating injuries. Seventy-four (40.7%) had visual acuity > or = 6/18 and 8 eyes had evisceration.

CONCLUSION

Eye injuries in children and adolescents admitted to this tertiary hospital were severe. They occurred mostly at home and school and in circumstances that could be avoided. Health education and legislation could reduce the burden of injury-related blindness in the study area.

A five-year retrospective study of the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in a Mediterranean area

Background

To determine the epidemiological characteristics and visual outcome of ocular trauma in southern Italy.

Methods

All cases of ocular trauma admitted to Department of Ophthalmology of Palermo University, Italy, from January 2001–December 2005 were retrospectively reviewed for open- or closed-globe injury (OGI or CGI). Data extracted included age, sex, residence, initial and final visual acuity (VA), cause and treatment of injury, hospitalization. The injuries were classified by Ocular Trauma Classification System (OTCS) and Birmingham Eye Trauma Terminology (BETT). We also referred to the Ocular Trauma Score (OTS) in evaluating the final visual outcome.

Results

Of the 298 eyes, there were 146 OGI and 152 CGI. Fifty eyes (16.8%) had an intraocular foreign body (IOFB). The annual incidence of eye injuries was 4.9 per 100,000. Most injuries occurred in men (84.6%, p < 0.0005), with an average age of 33.0 vs. 49.9 for women (p = 0.005). Cause of injury differed significantly by gender (p = 0.001) and urban vs. rural location (p = 0.009). The most frequent causes in men were outdoor activities related injuries (30.9%), work-related (25.4%), and sport-related (17.5%), and in women were home-related (52.2%) and outdoor activities related injuries (30.4%). In urban areas, road accidents were more frequent; in rural areas, work-related injuries were more frequent with a greater rate of IOFBs than in urban areas (p = 0.002).

The incidence of OGI and CGI differed in work-related injuries (p < 0.0005), sport-related injuries (p < 0.0005), and assaults (p = 0.033). The final visual acuity was 20/40 (6/12) or better in 144 eyes (48.3%), 20/40–20/200 (6/12–6/60) in 90 eyes (30.2%), and <20/200 (6/60) or less in 46 eyes (15.5%). Eighteen eyes (6%) had a final acuity of no light perception. Of those eyes that presented with hand motion vision or better, 220 (86.6%) had a final vision of better than 20/200 (6/60). Initial visual acuity was found to be correlated with final visual acuity (Spearman's correlation coefficient = 0.658; p < 0.001). The likelihood of the final visual acuities in the OTS categories was correlated to that of the OTS study group in 12 of 14 cases (85.7%).

Conclusion

This analysis provides insight into the epidemiology of patients hospitalized for ocular trauma. The findings indicate that ocular trauma is a significant cause of visual loss in this population.

Pediatric eye injury-related hospitalizations in the United States

OBJECTIVE

An estimated 2.4 million eye injuries occur in the United States each year, with nearly 35% of injuries among persons aged 17 years or less. Although previous research has identified some of the characteristics of pediatric eye injuries, many studies focused only on a specific patient population or type of eye injury or relied on self-reported data. In addition, little information has been reported on the total charges associated with treating pediatric eye injuries. Using a large national database, our aim was to examine hospitalizations for the treatment of pediatric eye injuries in the United States, including the demographic, medical care, and financial characteristics associated with major categories of eye injury.

METHODS

Cross-sectional data were derived from the 2000 Kids' Inpatient Database of the Healthcare Cost and Utilization Project. Eye injury-related hospitalizations were identified by using International Classification of Disease, Ninth Revision, Clinical Modification codes. Discharges were selected if the eye injury was the principal or secondary diagnosis. Guidelines from the Centers for Disease Control and Prevention were used to group external-cause-of-injury codes into broader categories to allow meaningful comparison with previous studies. The reported charges for the treatment of eye injuries and the expected primary payer were determined. Cases were statistically weighted to produce national estimates of hospitalizations for pediatric eye injuries and to determine the characteristics of these injuries.

RESULTS

Data were collected by the Kids' Inpatient Database for 3834 actual eye injury-related hospitalizations. These records represent an estimated 7527 eye injury-related hospitalizations among children aged 20 years or less in the United States during 2000. Inpatient charges for the treatment of these injuries were more than $88 million. The rate of hospitalization for pediatric eye injuries in the United States in 2000 was 8.9 per 100,000 persons aged 20 years or less. Young adults aged 18 to 20 years accounted for the highest percentage of hospitalizations (23.7%). Males accounted for 69.7% of hospitalizations. A majority of hospitalizations were for open wounds of the ocular adnexa. Motor vehicle crash was the most common cause of injury, followed by being struck by or against an object and being cut or pierced.

CONCLUSIONS

These findings illustrate the considerable morbidity, financial burden, and proximal causes for pediatric eye injury-related hospitalizations. Our data support the need for eye injury prevention efforts that consider the age, gender, and developmental stage of children. Educating parents and children about the potential for eye injuries at home and during hazardous activities is an important public health goal. In addition, promoting the use of appropriate protective eyewear by children during activities with a high risk of ocular trauma will help prevent future eye injuries.