Aims: To assess the aetiological factors associated with the occurrence of perforating ocular injuries in children in an urban setting and to assess the visual outcomes of such injuries. Methods: All cases of perforating ocular injury presenting to a single paediatric hospital (age less than 16 years) over a 17 year period were identified by a medical record search. All new cases of perforating ocular injury identified were included. All information was obtained retrospectively from the medical records. Results: There were 72 cases identified. The commonest causes of perforating ocular injury were sharp tools (knives/scissors) poked by the child into his/her own eye (17%), or objects thrown at the child (17%). Injuries were most likely to have occurred at home (58%). The age range for injuries was 8 months to 14 years 8 months. Perforating ocular injury was most frequent in the 3-6 year group (32%) followed by the 6-9 year group (25%). Males were more frequently involved than females (48-24). There was no correlation between the laterality of the eye, the time of day of the occurrence, or the day of the week of the occurrence. The final acuity achieved was better or equal to 6/12 in 36% and less than 6/60 in 31%. Injuries occurred more frequently on weekends than on weekdays. There were six enucleations (8%). Follow up was for an average period of 25 months. Conclusions: Penetrating ocular injury occurs most frequently in the home setting and mostly as the result of the use of sharp tools or by thrown objects. Prevention of penetrating ocular injury requires greater education of children and their carers especially on the potential dangers within the home. P erforating ocular injuries are a frequent cause of unilateral visual loss. Children account for between 20% and 50% of all ocular injuries.1-3 It has been estimated that 90% of all ocular injury are preventable. 4 Strategies for prevention require a knowledge of the cause of injury and may hence enable more appropriate targeting of resources towards prevention of such injuries. The aetiology of paediatric ocular injuries is likely to differ from that of adults, and is hence worthy of further investigation.The principles of management of penetrating ocular injury are the same for children and adults. However, the management of the child is made more difficult by variable cooperation with both assessment and continuing therapy. The possibility of amblyopia in young children further complicates treatment.This study addresses the epidemiology of penetrating ocular injury in children presenting to a single institution in a metropolitan centre. It also reviews the outcomes of these injuries. METHODSAll cases of full thickness perforating ocular injury presenting initially to the Royal Alexandria Hospital for Children in Sydney, Australia, between 1 January 1983 and 31 December 1999 were identified by a medical record search for the ICD code 871. Royal Alexandria Hospital for Children is a paediatric hospital (age 0-16 years) and is a tertiary referral centre. Pati...

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