Major Article
Epidemiological characteristics and visual outcome after open globe injuries in children

https://doi.org/10.1016/j.jaapos.2011.06.012Get rights and content

Purpose

To determine demographic, etiologic, clinical characteristics, visual outcome, and the factors affecting visual prognosis in children with open globe injuries.

Methods

The medical records of 82 patients under the age of 16 years who presented with open globe injuries from January 1998 to January 2009 were retrospectively examined. Age, sex, involved eye, cause, place of injury, wound location, presenting visual acuity, clinical signs, and final visual acuity were noted. The injuries were classified by Ocular Trauma Classification Group Guidelines and Birmingham Eye Trauma Terminology.

Results

Most injuries occurred in boys (54/82). The mean age was 8.4 ± 3.7 years. Most patients (37.8%) were in the 3- to 6-year age group. All patients had a minimum of 6 months’ follow-up (mean, 23.9 ± 23.2 months; range, 6-114). Pointed metallic objects were found to be the main causative agents. Injuries occurred most frequently in streets (36.3%), homes (18.7%), leisure areas (15.4%), and schools (7.7%). Factors adversely affecting visual prognosis were poor presenting visual acuity, posterior wound location, low ocular trauma score, retinal detachment, afferent pupillary defect, vitreous prolapse, uveal tissue prolapse, and hyphema.

Conclusions

Open globe injuries in children occur most frequently in preschool boys. Prognosis is determined by presenting visual acuity, trauma score, and wound severity and location.

Section snippets

Patients and Methods

A retrospective review of consecutive patients 16 years old or younger who presented with open globe injuries between January 1998 and January 2009 was conducted. Enrolled patients had presented to the Ophthalmology Department of the Ankara Training and Research Hospital and the Suleyman Demirel University Training and Research Hospital, Ankara, Turkey. We included patients who underwent primary surgical repair and definitive surgical management in our clinic and those with complete medical

Results

A total of 82 [54 boys (66%)] children were included. The right eye was involved in 53 children (64.6%). The mean age was 8.4 ± 3.7 years (range, 3-16 years). Most cases (37.8%) occurred in the preschool age group (3-6 years), followed by school-age children (31.7%) and adolescents (30.5%). In order of frequency, the most common open globe injuries were penetration (67 patients, 81.7%), rupture (10 patients, 12.2%), intraocular foreign bodies (3 patients, 3.7%), and perforation (2 patients,

Discussion

Ophthalmic trauma is one of the most common causes of acquired unilateral blindness in children. The mean age of patients with eye injuries was 8.4 years. Although many studies have noted that school-aged children are more vulnerable than younger children,10, 11 in the present study there was an even distribution between the age groups. The preponderance of injuries in boys of nearly 2:1 in the present study is similar to that reported in other studies, with the male–female ratio varying from

Literature Search

PubMed was searched using the following terms: open globe injury, pediatric OR children, prognostic factors AND visual outcome.

References (30)

  • D.A. Alexander et al.

    Psychiatric sequelae and psychosocial adjustment following ocular trauma: A retrospective pilot study

    Br J Ophthalmol

    (2001)
  • J. Klopfer et al.

    Ocular trauma in the United States: Eye injuries resulting in hospitalization, 1984 through 1987

    Arch Ophthalmol

    (1992)
  • H.J. Salvin

    Systematic approach to pediatric ocular trauma

    Current Opin Ophthalmol

    (2007)
  • A.J. Cariello et al.

    Epidemiological findings of ocular trauma in childhood

    Arq Bras Oftalmol

    (2007)
  • F. Kuhn et al.

    The Ocular Trauma Score (OTS)

    Ophthalmol Clin North Am

    (2002)
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