Discussion | Between 2012 and 2015, the proportion of injuries associated with these devices increased 32-fold, and in our study, pod-related injuries were associated with more than onequarter of chemical ocular burns among children in this age group.The NEISS does not allow for longitudinal follow-up of patients, and information on long-term outcomes is unavailable. Similarly, the NEISS only includes data on patients presenting to emergency departments, and visits to community physicians and urgent care facilities are not included. While the NEISS is not universal in scope, it is a validated sample of injuries commonly used to generate national estimates. 5 Conclusions | These data suggest that the role of laundry detergent pods in eye injuries among preschool-aged children is growing. As with most injuries in this age group, these burns occurred almost exclusively in the home. In addition to proper storage and use of these devices, prevention strategies might include redesigning packaging to reduce the attractiveness of these products to young children and improving their strength and durability.

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Declaration of funding sources: IHU FOReSIGHT [ANR-18-IAHU-0001] supported by French state funds managed by the Agence Nationale de la Recherche within the Investissements d'Avenir program.Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

ImportanceMost ocular lesions have been described for children with congenital Zika syndrome. The frequency of finding ocular abnormalities is unknown among children exposed to Zika virus (ZIKV) during pregnancy. This study was conducted on newborns whose mothers were positive for ZIKV, confirmed with reverse-transcription polymerase chain reaction (RT-PCR) testing.ObjectiveTo report ocular fundus manifestations in newborns with congenital ZIKV exposure in French Guiana, Martinique, and Guadeloupe, French West Indies, to assess its prevalence. Risk factors, such as the presence of extraocular fetopathies and the gestational term at infection, were sought.Design, Setting, and ParticipantsThis was a cross-sectional multicentric study, conducted from August 1, 2016, to April 30, 2019, for which data were collected prospectively. The study inception was at the beginning of 2016 from the onset of the ZIKV epidemic in the French West Indies. Newborns whose mothers tested positive (by RT-PCR) for ZIKV during pregnancy were included.InterventionsFundus examination was performed using widefield retinal imaging after pupil dilation. Infection date, delivery mode, and newborn measurements were collected.Main Outcomes and MeasuresAnomalies of the vitreous, choroid, retina, and optic disc.ResultsA total of 330 children (mean [SD] age, 68 [IQR, 22-440] days; 170 girls [51.5%]) were included. Eleven children (3.3%) had perivascular retinal hemorrhages, and 3 (0.9%) had lesions compatible with congenital ZIKV infection: 1 child had torpedo maculopathy, 1 child had a chorioretinal scar with iris and lens coloboma, and 1 child had a chorioretinal scar. Retinal hemorrhages were found at childbirth during early screening. Lesions compatible with congenital ZIKV infection were not associated with the presence of extraocular fetopathy. Microcephaly was not associated with lesions compatible with congenital ZIKV infection (odds ratio [OR], 9.1; 95% CI, 0.8-105.3; P = .08), but severe microcephaly was associated with an OR of 81 (95% CI, 5.1-1297.8; P = .002).Conclusions and RelevanceResults of this cross-sectional study suggest that the ocular anomalies found may be associated with ZIKV in 0.9% of the exposed population. Ocular lesions were rare, affected mostly the choroid and retina, and seemed to be associated with choroiditis-related scarring that developed during fetal growth.

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