Pattern of paediatric corneal laceration injuries in the University of port Harcourt teaching hospital, Rivers state, Nigeria

Abstract

BackgroundCorneal lacerations mostly affect younger children, commonly males, who will constitute the majority of the workforce. Clinical outcomes are reviewed and compared so that measures to reduce their occurrence and improve outcome can be proffered.MethodsRecords of all children between the ages of 1-18 yrs, who presented with penetrating eye injuries at the eye clinic of the University of Port Harcourt teaching Hospital, Rivers state, Nigeria between January 2002 and December 2009 were included. Information retrieved -patient’s Bio data, presenting symptoms, presenting visual acuity (VA), source of injury, surgical intervention and outcome using VA. All data analysed with EPI Info version 6 with the aid of a statistician.ResultsFolders of thirty-six children (36 eyes) between the ages of 0–18 years diagnosed with corneal laceration over a period of 8 years out of 65 cases managed within that period available. Other folders reported as missing. Male female ratio 3:1, the mean age is 8.7 years (SD ± 3.67). Only one presented within 24 hours. Objects causing injury mainly missiles with stones/catapult injuries (n = 8, 22.2%). Presenting VAs in those that could be measured, ranged from 6/24 to 6/60 (n = 4, 11%) to no light perception (NLP) (n = 5, 13.9%). Associated injuries include lid laceration, cataract, vitreous haemorrhage and retinal detachment. Twenty one patients had primary corneal repair (58.3%) carried out within 7 days of presentation. Four had endophthalmitis. After 3 months follow up, VA of 6/60 and better was achieved in 11 of 18 eyes left in follow up (6/60-6/24 in 8 eyes (22.2%), 6/18 and better in 3 eyes (8.3%).ConclusionMost eye injuries in children are preventable. In this study, the prognosis was better in those whose injuries were confined to a peripheral part of the cornea, with no other associated injury, who presented within 5 days and who did not have any intraocular infection at the time of presentation. The importance of health education, adult supervision of play and application of appropriate measures that is necessary for reducing the incidence and severity of trauma is emphasized.

Corneal laceration caused by river crab

“…Missiles with stones, catapults, glass, knives, sport-related injuries, and fishing-related injuries are a few of the commonest causes of corneal lacerations that have been reported. 4 – 6 Corneal laceration caused by a river crab claw is an unusual case, and to the best of our knowledge it has not been reported in any literature thus far.…”

“… 2 It has been reported that 6.8%–14.7% of ocular traumatic injuries that present at emergency departments are corneal lacerations and perforations, 8 – 10 and these are the commonest finding in the pediatric age-group. 4 , 11 Omobolanle et al found that males have a higher incidence of corneal lacerations compared to females, with a ratio of approximately 3:1 and mean age of 8.7 years. 4 …”

“… 4 , 11 Omobolanle et al found that males have a higher incidence of corneal lacerations compared to females, with a ratio of approximately 3:1 and mean age of 8.7 years. 4 …”

“…However, the management and prognosis of corneal lacerations varies, and strongly depends on the nature of the object involved and the wound characteristics, site and extent of the wound, time of presentation and treatment started, and other associated ocular injuries, such as lens opacity, vitreous hemorrhage, retinal detachment, limbal–scleral laceration with uveal tissue prolapse, lid laceration, and optic nerve avulsion. 3 , 4 …”

“…Besides that, by educating parents and caregivers in the importance of supervising children while they play and immediate action when trauma takes place is important in optimizing visual outcomes. 4 …”