Ocular Injuries by Elastic Cords in Children

Abstract

ABSTRACT. Background. Elastic cords hitting the eyeball as high-speed projectiles can severely damage ocular structures and can produce permanent visual function impairment.Objectives. To evaluate the frequency, mechanics, and severity of eye injuries caused by elastic cords in children to adopt the most appropriate preventive measures.Methods. A retrospective medical records review of hospital admissions secondary to ocular trauma between 1991 and 1997 in a pediatric ophthalmology unit at an urban tertiary care pediatric hospital was performed to select all children admitted for ocular injury caused by an elastic cord.Results. Eight children fulfilled the inclusion criteria; the prevalence ratio was 2% of all pediatric trauma admissions. In all cases the mechanics of trauma was a combination of blunt and high-speed projectile injury. The mechanism of trauma in younger patients was typically a cord that was misused during unsupervised playtime, whereas cord slipping from car roof racks was noted in older patients. One patient suffered a severe permanent visual impairment caused by retinal detachment. All other children regained full visual acuity at the time of discharge and maintained it through a mean follow-up of 22 months (range: 18 -29).Conclusion. Circumstances of injury in younger children are different from those found in older children, the latter being similar to those reported for adults. Prevention is the primary measure to be taken to reduce the prevalence of this injury and to lower the risk for ocular severe anatomic damage as much as possible. This can be achieved primarily by modifying the design of the hooks, intensifying educational campaigns, and keeping elastic cords out of children's reach. Pediatrics 2000;106(5). URL: http://www.pediatrics.org/cgi/content/ full/106/5/e65; ocular traumatology, pediatric age, elastic cord, prevention.

Standardized classification of mechanical ocular injuries, efficacy, and shortfalls

“…In relation to closed eye injuries, similar to the previous studies, our study also showed that closed eye injuries caused by blunt objects, had a better final visual outcome. This compared to open eye injuries cause by similar objects, with only 6.1-20.8% of closed eye injuries caused by blunt objects had a final vision of worse than 0.7 (28)(29)(30). A common example of closed eye injuries caused by blunt objects seen in airbag accidents which is usually limited to zone I.…”

“…Hyphema, traumatic iritis, iris sphincter rupture, angle recession, iridodialysis, iridodonesis, traumatic cataract, and phacodonesis are common findings in type A closed eye injuries that have extended to zone II. Temporary vision loss is reported in such injuries in 4.3-50% (28)(29)(30). It is important to remember that angle recession glaucoma is a common finding in type A closed eye injuries that have extended to zone II.…”

The UK Paediatric Ocular Trauma Study 2 (POTS2): demographics and mechanisms of injuries

“…Gardening and do-it-yourself (DIY) activities have previously been highlighted as common causes of ocular injury, although the risks are often overlooked by those engaging in such activities, 31 and the dangers associated with misuse of bungee cords are widely known. 32 , 33 Each of these has the potential to cause serious ocular injury, but are easily preventable, have previously been highlighted in the medical press, yet continue to be reported in this pediatric population.…”

Επιδημιολογική Μελέτη Των Τραυμάτων Του Οφθαλμικού Βολβού

“…• Μια αυξανόµενη αιτία σοβαρού οφθαλµικού τραύµατος, θλαστικού (90%) ή διατιτραίνοντος (10%), αποτελεί η χρήση των <<χταποδιών>>, δηλαδή ελαστικών σχοινιών µε µεταλλικούς ή πλαστικούς γάντζους σε σχήµα S στην άκρη τους(Cruysberg et al 1995, Cooney et al 1997, Chorich et al 1998, Da Pozzo et al 2000, Aldave et al 2001, Brouzas et al 2002, Viestenz et al 2002. Σε µελέτη των οφθαλµικών τραυµάτων από ''χταπόδι'' στην Αθήνα(Brouzas et al 2002), βρέθηκε ότι αποτελούν το 0.1% των οφθαλµικών τραυµάτων που προσέρχονται στο τµήµα επειγόντων περιστατικών, µε το 85.7% να αφορά σε άντρες και το 14.3% σε γυναίκες.…”