Paediatric traumatic cataracts in Southwest China: epidemiological profile

Abstract

Background Paediatric traumatic cataracts are an important but preventable cause of acquired blindness. Understanding the epidemiology of paediatric traumatic cataracts is a prerequisite for prevention. This study aimed to characterize the epidemiological profile of paediatric traumatic cataracts in southwest China. Methods The medical records of children (age range, 0–14 years old) who developed traumatic cataracts following open-globe injuries and were hospitalized at the Department of Ophthalmology at West China Hospital, between January 2011 and December 2020 were retrospectively analyzed. The demographic data, causes of injuries, posttraumatic complications, and visual acuity were recorded and analysed. Results A total of 716 eyes from 716 patients were analysed in this study, including 521 (72.8%) males and 195 females in a gender ratio of 2.67:1; 117 of the patients were of ethnic minorities. Paediatric traumatic cataracts occurred more frequently in winter (32.5%). Sharp metal objects (scissors/knives/needles/sheet metal/nails/darts) – induced ocular injuries accounted for the highest proportion, followed by botanical sticks (wooden sticks /bamboo sticks /bamboo skewers)-induced injuries, and then stationery items (pencils/pens/rulers/paper)-induced injuries. The majority (68.7%) of the patients were aged 2–8 years, and the peak range of age was 4 - 6 years. The injuries were a result of penetrating trauma in 64.9% of patients, and blunt force trauma in the remainder (35.1%). Additionally, 131 (18.3%) cases developed posttraumatic infectious endophthalmitis after injuries. Patients with eye injuries caused by needles (P < 0.001), wooden sticks (P = 0.016), and bamboo skewers (P = 0.002) were at a greater risk of developing infectious endophthalmitis. The most common identified foreign organism was Streptococcus, which accounted for 42% (21/50) of all culture-positive specimens and was sensitive to vancomycin. Among the children who were younger than 5 years, 44.4% (55/124) of those with traumatic cataracts presented a corrected distance visual acuity less than or equal to 0.1 after undergoing cataract surgery, but among the children who were older than 5 years, this proportion was significantly smaller, just 20.4% of children aged 6-10 years (P < 0.001) and 18.4% of children aged 11-14 years (P < 0.001). Conclusion The main causative agents of paediatric traumatic cataracts in southwest China were sharp metal objects, botanical sticks, and stationery items. Specific preventive measures are essential to reduce the incidence of paediatric traumatic cataract.

Childhood traumatic cataract in Nigeria; a multicentre study: 2017–2021

“…Previous studies from Nigeria also reported closed globe injuries to be more associated with childhood traumatic cataract. On the contrary, open globe injuries were reported to be more associated with paediatric traumatic cataract in studies from Egypt, 4 China, 5,15 India, 8 Turkey 16 and Malaysia. 17 This disparity may be a re ection of the variation in the common agents of injury which the children are exposed to in different geographical regions.…”

“…A preponderance of traumatic cataract among boys observed in this study is consistent with the literature that boys are more likely to have ocular injuries. [4][5][6][7][8][9][10][11][12][13][14][15][16] The unanimity in the literature may not be unconnected with the fact that boys are more likely to engage in daring activities and rough play which may predispose them to eye injury. Over 80% of the children with traumatic cataract were between the ages of 5 years and 14 years (mean of 9.1 years).…”