Ocular trauma in children is a common cause of ocularmorbiditydespite introduction of new methods of treatment and improvement of management, and is a leading cause of non-congenitalunilateralblindness in thisage group [1,2] . Children are atrisk of ocular trauma because of theirinability to avoidhazards [3]. Most of thesehazards are foundwhile children play, or are at home. Identifying the causes of ocular injuries may help in determining the effective methods in reducing the incidence of seriousocular traumas. The purpose of this study is to analyze the differentepidemiological, clinical and therapeutic aspects of this affection in order to establishbetter management. This isaretrospective study of 153 patients withcomplicatedocular trauma, admitted to the OphthalmologyDepartment of the RabatUniversityHospital over a period of 36months. The averageage of the children was5,8years (3-15 years) with male predominance (sex ratio=2,1). The dominant mechanismwasdomestic accidents, especiallyby projection of bluntobjects (59,5% of cases). Ophthalmologicalexaminationfound initial visualacuitylessthan 5/10 in84,3% of cases. The lesions of the anterior segment dominated by hyphema (60,1%),subconjunctivalhemorrhage(56,9%), corneal abrasion (48,4%), high ocular pressure (34,6%) and posttraumaticcataract (33,3%). Posterior segment injurywasassociatedin 27.4% of cases . If not managedsufficientlyearly and appropriate, theselesionsmay cause definitive partial loss of vision or blindness . The establishment of effective awareness and prevention programs is essential to reducetheirfrequency and severity.
Pediatric endogenous endophthalmitis is a rare disease that can cause serious ophthalmic damage. We report and discuss the diagnostic aspects and the clinical outcome of pediatric endogenous endophthalmitisdue to bacterial meningitis in a immunocompetent 3 year old infant with a three days history of, photophobia, purulent discharge, redness, corneal edema, hypopyon, poor red reflex and nausea.His parents brought him to our emergency department. He was diagnosed as having bilateral endogenous endophthalmitis associated with bacterial meningitis.Intravenous broad-spectrum antibiotic therapy was initiated with Cefotaxime 200 mg / kg per day in 4 slow IV injections and vancomycin15mg/kg per day in 4 IV injections. Intravitreal antibiotic (vancomycin and ceftazidime) injections were performed in both eyes. Two weeks post presentation, the best-corrected visual acuity in both eyes improved to 0.4, and inflammation of the anterior chamber and vitreous cavity was decreased. We recommend that when endogenous endophthalmitis is suspected along with meningitis, or if it is known to be present, Intravitreal and intravenous antibiotics should be promptly administered to preserve vision.
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