Cataract secondary to self-inflicted blunt trauma in children with autism spectrum disorder

Lee, Yeon Hee; Lenhart, Phoebe D.; Lambert, Scott R.

doi:10.1016/j.jaapos.2016.02.013

Cited by 6 publications

(5 citation statements)

References 7 publications

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“…Lee et al. 1 also report that retinal detachment is one of the most serious complications of continued SII after the diagnosis of cataract, which was noted bilaterally in two out of three patients in their case series. More recently, reports have suggested that the incidence of retinal detachment in cataracts caused by chronic SII is 24-fold higher than cataracts due to accidental injuries.…”

Section: Discussionmentioning

confidence: 83%

“…Customized management strategies are thus essential for improving the visual prognosis in this patient population. 1 , 2 , 20 Continued hospital admission or a temporary rehabilitation stay may be required due to poor adherence to postoperative care including postoperative administration of drops. In circumstances where hospital admission is not feasible, consideration of postoperative oral medications and ongoing community support services will ensure appropriate recovery and were successfully implemented in majority of our cases.…”

Section: Discussionmentioning

confidence: 99%

“…Following this period, continued use of a safety helmet with eye protection may be advisable given the severity and nature of the SII. 1 , 2 We have previously demonstrated that helmets with a protective eye shield are effective in removing the positive reinforcement of the sensory stimuli associated with this maladaptive behavior and ultimately lower the rate of complications. 21 It is important to note that adoption of protective gear and compliance with continued wear may be challenging in some cases with severe intellectual disability and maladaptive behavior.…”

Section: Discussionmentioning

confidence: 99%

“…Self-inflicted injuries (SIIs) involving repetitive head-banging and striking of the face and the eyes are uncommon in the general pediatric population, 1 , 2 but have a prevalence of up to 50% in children with intellectual disabilities. 3 Vision-threatening complications following traumatic injury may include the formation of cataracts, and retinal breaks leading to retinal detachment in 9%–16% of cases.…”

Section: Introductionmentioning

confidence: 99%

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Long-term outcomes of pediatric traumatic cataracts and retinal detachments due to self-inflicted injuries

Felfeli

Mireskandari

Ali

2020

European Journal of Ophthalmology

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Purpose To report the characteristics and longitudinal visual outcomes of traumatic cataracts and retinal detachments in children with self-inflicted injury. Methods A retrospective case series of pediatric patients at a tertiary care center who sustained ocular trauma due to self-inflicted injury between 2000 and 2014. Results A total of 11 children, all with an intellectual disability and a mean age of 10 ± 4.8 years (range, 2.8–16.2), were identified with traumatic cataract secondary to ocular self-inflicted injury over the study period. Five eyes had a concurrent unilateral retinal detachment. Over the course of follow-up, one additional eye developed a cataract and five eyes developed a retinal detachment. Patients underwent an average of 2.5 ± 2.3 procedures and 17.1 ± 10.7 eye examinations over 11.7 ± 4.2 years of follow-up; 36% required general anesthesia for examination. Visual acuity was improved or preserved in 77% of the eyes that underwent surgical interventions, but was worse in the remaining cases due to development of traumatic retinal detachment. The use of protective helmets, eye shields, and immobilizing orthoses were essential in management of active self-inflicted injury. Conclusion Traumatic cataracts and retinal detachments due to self-inflicted injury may cause severe visual loss. Visual prognosis although poor in children with severe intellectual disabilities may be optimized with risk awareness for early detection and customized interventions.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Long-term outcomes of pediatric traumatic cataracts and retinal detachments due to self-inflicted injuries

Felfeli

Mireskandari

Ali

2020

European Journal of Ophthalmology

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“…Ocular self-injury, while uncommon, is an important consideration when evaluating patients with DD, as trauma is a common cause of cataracts [15]. Reports of self-inflicted blunt head trauma as a mechanism for cataract development also correlate with a higher incidence of vitreous hemorrhage, RD, and self-enucleation at presentation in patients with DD [15] [16] [17]. Even without visible injury to the globe or eyelid, dense cataracts have been reported in patients with chronic headbanging behavior [17].…”

Section: Discussionmentioning

confidence: 99%

Management of Cataracts in Pediatric Patients with Developmental Delay at a Tertiary Care Pediatric Hospital

Panneerselvam¹,

Chilakapati²,

Moisiuc³

et al. 2021

OJOph

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Background: Childhood cataract causing visual impairment can compound developmental delay (DD) if left untreated. Current literature in children with DD is limited; thus, we evaluated cataract etiology, challenges, and treatment compliance in this group. Purpose: To report the presentation and challenges associated with cataract management in children with developmental delay (DD) at a tertiary care pediatric hospital. Methods: Retrospective review of 100 patients (173 eyes) presenting with cataracts and DD from February 2014 to December 2017. Results: 100 patients (173 eyes) were included. 27 patients had unilateral cataracts and 73 bilateral. The average age was 120.55 months (SD 63.77, range 5.87 -243.16); the average follow-up period was 57.7 months (SD 139.14, range 1.03 -1412.30). 61% of patients (55% eyes) underwent medical management for cataracts due to: cataract was not visually significant (66% eyes), parent deferred surgery (11% eyes), self-abusive behavior (14% eyes), and medical conditions that limited visual recovery (9% eyes). 32% of patients were unable to perform objective visual acuity by age 5. Patients with self-abusive behavior were more likely to present with or develop retinal detachment (RD) (35%) compared to those without self-abusive behavior (6%) (p = 0.0028). A statistically significant difference in the difficulty of examination (p < 0.0001) and poor compliance of glasses wear (p < 0.0001) was found in nonverbal patients. Surgical complications occurred in 39% of eyes. Those with intraocular lens placement after cataract extraction were more likely to develop visual axis opacification (27% eyes) than those who remained aphakic (9% eyes) (p = 0.0313). Conclusion: Cataract extraction in pediatric patients with DD can be associated with success, however, providers should prepare for limitations in managing these patients.

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IOL Placement in Developmentally Delayed Patients

Lee¹

2020

Pediatric Cataract Surgery and IOL Implantation

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Cataract secondary to self-inflicted blunt trauma in children with autism spectrum disorder

Cited by 6 publications

References 7 publications

Long-term outcomes of pediatric traumatic cataracts and retinal detachments due to self-inflicted injuries

Long-term outcomes of pediatric traumatic cataracts and retinal detachments due to self-inflicted injuries

Management of Cataracts in Pediatric Patients with Developmental Delay at a Tertiary Care Pediatric Hospital

IOL Placement in Developmentally Delayed Patients

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