Epidemiology, aetiology and outcome of paediatric ocular trauma in Sydney

Abstract

Aim: Report epidemiology, aetiology and outcomes of eye injuries in children 0-16 years treated at quaternary referral and paediatric hospitals in Sydney, Australia. Methods: A retrospective review of cases January 2009 to December 2015 using hospital diagnostic and International Classification of Diseases, 10th Revision codes. Medical records confirmed open globe injury (OGI) or closed globe injury (CGI) diagnosis and demographic, injury mechanism, ocular and best-corrected visual acuities (BCVA) before and after treatment. Results: A total of 295 patients, 298 eyes were included (96 OGIs, 202 CGIs.) Injuries were commonest in males (72%) with OGI peaks in 3-5-, and CGI, 12-14-year-old males. A projectile was the commonest mechanism (106, 36%) then being struck (101, 34%). Commonest agents were sporting equipment (13%), toys (10%) and sticks (10%). Another child was involved in 32.9% OGI and 27.6% CGI. Initial BCVA was a good predictor of final BCVA. Poor prognostic factors included lens injury, vitreous haemorrhage and relative afferent pupillary defect. Final BCVA 6/12 or better was achieved in 69% cases, including 40% of OGIs and 85% of CGIs. Enucleation and evisceration rates were both 1% (n = 3). Conclusion: Paediatric ocular trauma most commonly occurred in males from projectiles or being struck, with injuries commonly occurring from sporting equipment, toys and sticks. Vision was poorer with open than closed globe injuries.

Pediatric Open-globe Injuries: Clinical Characteristics and Outcomes of Repair in a Tertiary Center in Istanbul, Turkey

“…Although the visual outcome demonstrated a statistically signi cant improvement after the treatment in our study, the mean VA of 0.83 ± 1.13 logMAR at the last visit displays a considerable loss compared to normal vision in terms of visual ability of the children. This nding is supported also by many other studies in the literature focusing on pediatric ocular trauma 5,11,23 . The undesirable visual outcome after pediatric ocular traumas despite of the advancements in microsurgery points out to the signi cance of further preventive measures reducing the probability and severity of ocular injuries in order to avoid substantial visual morbidity in children.…”

“…presented a similar relationship in their studies, as well 5,6 . According to the ndings of Liu et al, however, the presence of a vitreous hemorrhage was also found to be a poor prognostic factor; about which we did not record any signi cant relationship in the present study 5 .…”

“…presented a similar relationship in their studies, as well 5,6 . According to the ndings of Liu et al, however, the presence of a vitreous hemorrhage was also found to be a poor prognostic factor; about which we did not record any signi cant relationship in the present study 5 . Likewise, the presence of a retinal detachment did not display a statistically signi cant in uence on the postoperative visual prognosis in our study while Choovuthayakorn et al claimed that it predicted a signi cantly worse visual outcome according to their ndings 8 .…”

“…Eye injuries account for 8-14% of all injuries in pediatric patients 4 . Children are more vulnerable to ocular trauma due to their lesser ability to recognize environmental hazards and limited capability of motor skills 5,6 . Apart from the high percentage of ocular trauma in children, however, the main distinction from adult ocular trauma is the di culty in terms of assessment and management in pediatric cases 7 .…”

“…First of all, initial assessment in pediatric eye injuries is challenging and may require general anesthesia for a thorough examination. Moreover, the visual outcome is limited even further by the subsequent amblyopia among children under 7 years of age 5,7,8 . Pediatric ocular injuries cause destructive lifelong impact on their quality of life as well as their adult life beyond childhood.…”