Combined anterior and posterior segment injuries in children: a review

Meier, Petra

doi:10.1007/s00417-010-1414-x

Cited by 27 publications

(22 citation statements)

References 74 publications

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“…Therefore, 28.4% of the children should be defined as legally blind according to the legal definition of blindness in the United States (best corrected visual acuity of 20/200, US notation; 6/60, 6 m notation; or 1 logMar in the better eye) [30]. Good initial vision and a high OTS were statistically correlated with good final vision in our study and were well proven by other reports [22], [32]–[35] although these values are not clinically used in China. Visual prognoses in children remain worse than adults despite therapeutic advances because of the nature of the injuries and amblyopic problems.…”

Section: Discussionsupporting

confidence: 87%

“…Open globe wounds exhibit a poorer visual prognosis than closed globe wounds, because they are more likely to require surgeries and result in long-term visual impairments or blindness and concomitant developmental delays [32], [46], [47]. Higher frequency of this kind of clinical diagnoses could likely cause a serious prognosis in our pediatric patients, presenting final visual acuity with no light perception in 3.6% and light perception to 20/200 in 24.8% of patients.…”

Section: Discussionmentioning

confidence: 99%

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Epidemiology of Pediatric Ocular Trauma in the Chaoshan Region, China, 2001–2010

Zhang³

et al. 2013

PLoS ONE

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BackgroundOcular trauma is the leading cause of monocular visual disability and noncongenital unilateral blindness in children. This study describes the epidemiology and medical care associated with nonfatal pediatric (≤17 years of age) eye injury-related hospitalization in the largest industrial base for plastic toy production in China.MethodsA population-based retrospective study of patients hospitalized for ocular and orbital trauma in the ophthalmology departments of 3 major tertiary hospitals from 1st January 2001 to 31st December 2010 was performed.ResultsThe study included 1035 injured eyes from 1018 patients over a 10-year period: 560 (54.1%) eyes exhibited open globe injuries, 402 (38.8%) eyes suffered closed globe injuries, 10 (1.0%) eyes suffered chemical injuries and 8 (0.8%) eyes exhibited thermal injuries, representing an average annual hospitalization rate of 0.37 per 10,000 (95% confidence interval [CI], 0.36–0.38) due to pediatric eye injury in the Chaoshan region. The mean patient age was 9.2±4.4 years with a male-to-female ratio of 3.3∶1 (P = 0.007). Children aged 6 to 11 years accounted for the highest percentage (40.8%, 416/1018) of hospitalization, 56.7% (236/416) of whom were hospitalized for open globe wounds. Injury occurred most frequently at home (73.1%). Open globe wounds cost the single most expensive financial burden (60.8%) of total charges with $998±702 mean charges per hospitalization.ConclusionsOpen globe wounds occurred at home are earmarked for the priorities to prevention strategies. Higher public awareness of protecting primary schoolchildren from home-related eye injuries should be strengthened urgently by legislation or regulation since the traditional industrial mode seems to remain the pattern for the foreseeable future. Further research that provide detailed information on the specific inciting agents of pediatric eye injuries are recommended for facilitating the development and targeting of appropriate injury prevention initiatives.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Epidemiology of Pediatric Ocular Trauma in the Chaoshan Region, China, 2001–2010

Zhang³

et al. 2013

PLoS ONE

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“…The risk factors include contamination of injured materials, remained intraocular foreign bodies, damage to the lens, and delayed wound care. [17] In this series, the frequency of endophthalmitis was 19.3% (17/89), which is similar to the report of Lee et al . [8] We consider that fibrosis of ciliary body in endophthalmitis cases after PPV could be a reason for unfavorable outcome due to the resulted hypotony and phthisis.…”

Section: Discussionsupporting

confidence: 90%

Clinical features and outcomes of vitrectomy in pediatric ocular injuries-eye injury vitrectomy study

Feng

et al. 2014

Indian J Ophthalmol

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Context:Severe pediatric ocular injury remains a frequent and difficult problem. Vitrectomy is a major technique that has been used to manage severely damaged eyes. However, limited follow-up studies exist currently.Aims:To evaluate the clinical features and predictive factors of visual and anatomic outcomes in Eye Injury Vitrectomy Study (EIVS).Settings and Design:Retrospective, consecutive, interventional case series.Materials and Methods:Reviewing and analyzing records of children, aged 15 years or younger, who had undergone vitrectomy for eye injuries in EIVS database between January 1997 and December 2009.Statistical analysis used:Descriptive analyses and multiple Logistic regressions were employed for all variables using SPSS software (version 17.0, SPSS Inc.).Results:Eighty-seven children (89 eyes) with more than 6 months follow-up and complete records identified in EIVS were included in this study. Average follow-up was 12.7 months. The mean age was 9.4 ± 3.8 years. Seventy-seven eyes (86.5%) had open globe injuries, and 12 (13.5%) had closed globe injuries. Seventeen eyes (19.3%) presented with endophthalmitis. Seventy-five eyes (88.2%) presented with visual acuity of 4/200 or worse; however, 42 eyes (47.7%) achieved 4/200 or better vision with anatomical restoration after vitrectomy. Multiple analysis showed that choroidal damage, large scleral wound, and endophthalmitis were significantly associated with unfavorable outcome, the OR values were 16.7 (95% CI: 2.7-102.4, P = 0.002), 10.9 (95% CI: 1.7-71.6, P = 0.013), and 6.6 (95% CI: 1.0-42.4, P = 0.048), respectively.Conclusions:Vitrectomy intervention resulted in favorable visual and anatomic outcomes in almost half of the injured eyes. Choroidal damage, large scleral wound, and endophthalmitis were the prognostic indicators of unfavorable outcome.

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“…These conditions should be managed aggressively with definitive surgical treatment, especially when the central visual axis is involved, to prevent amblyopia. [ 94 ]…”

Section: Complicationsmentioning

confidence: 99%

Pediatric open globe injury: A review of the literature

Zarbin

Bhagat

2015

J Emerg Trauma Shock

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Open globe injury (OGI) is a severe form of eye trauma estimated at 2-3.8/100,000 in the United States. Most pediatric cases occur at home and are the result of sharp object penetration. The aim of this article is to review the epidemiology, diagnosis, management, and prognosis of this condition by conducting a systematic literature search with inclusion of all case series on pediatric OGI published between 1996 and 2015. Diagnosis of OGI is based on patient history and clinical examination supplemented with imaging, especially computed tomography when indicated. Few prospective studies exist for the management of OGI in pediatric patients, but adult recommendations are often followed with success. The main goals of surgical management are to repair the open globe and remove intraocular foreign bodies. Systemic antibiotics are recommended as medical prophylaxis against globe infection, or endophthalmitis. Other complications are similar to those seen in adults, with the added focus of amblyopia therapy in children. Severe vision decline is most likely due to traumatic cataracts. The ocular trauma score, a system devised to predict final visual acuity (VA) in adults, has proven to be of prognostic value in pediatric OGI as well. Factors indicating poor visual prognosis are young age, poor initial VA, posterior eye involvement, long wound length, globe rupture, lens involvement, vitreous hemorrhage, retinal detachment, and endophthalmitis. A thorough understanding of OGI and the key differences in epidemiology, diagnosis, management, and prognosis between adults and children is critical to timely prevention of posttraumatic vision loss early in life.

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Combined anterior and posterior segment injuries in children: a review

Cited by 27 publications

References 74 publications

Epidemiology of Pediatric Ocular Trauma in the Chaoshan Region, China, 2001–2010

Epidemiology of Pediatric Ocular Trauma in the Chaoshan Region, China, 2001–2010

Clinical features and outcomes of vitrectomy in pediatric ocular injuries-eye injury vitrectomy study

Pediatric open globe injury: A review of the literature

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