Pediatric Open Globe Injury in Central China

Abstract

PurposeTo describe the characteristics, managements, and outcomes of pediatric open globe injury (OGI) in central China.MethodsRetrospective chart review of pediatric diagnosis in patients with OGI between 2017 and 2020 at Henan Eye Hospital. Four hundred and one eyes of the patients younger than 17 years were included in this study. Open globe injury was classified according to the Birmingham Eye Trauma Terminology system (BETT). Age, sex, history, cause, month of trauma, treatment received, and outcomes were recorded. Visual acuity was documented according to standard visual acuity chart (decimals).ResultsFour hundred and one eyes of patients were included in the study. The mean age was 6.6 ± 3.4 years with the range from 8 months to 16 years. Open globe injuries (OGIs) occurred most frequently in the 2–8 year age and significant male predominance was noted (70.8%). The incidence of pediatric OGIs was lowest in summer months while it increased in the winter months. The most common type of pediatric OGI was penetration (89%). Scissors/knife accounted for 22%, followed by pen/pencil (15.2%), and wood/bamboo sticks (14.5%) of all the pediatric OGIs. Among the injuries, the most frequently involved is the zone I (76.1%). Initially, 70.8% of the eyes received primary debridement and wound closure without any additional intervention, while only one eye has no possibility of anatomical reconstruction when it received an evisceration. After the initial management, 198 eyes received subsequent operation, including 44 eyes that underwent cataract removal + intraocular lens (IOL) implantation, and 24 eyes underwent IOL implantation. Finally, over 6 months of follow-up, 129 eyes (32.2%) got visual acuity (VA) of 0.3–1.5 and, 63 eyes (15.7%) got VA of 0.01–0.25, while 11 eyes (2.7%) were eviscerated.ConclusionThis study showed that pediatric OGIs in central China are most seen in 2–8-year age group with significant male predominance. Scissors/knife, pen/pencil, and wood/bamboo sticks accounted for over half of all cases. Pediatric OGIs often result in significant vision loss. In some severe cases (2.7%), evisceration was ultimately performed. We should call on the public to pay more attention to their children and build a safer environment for them.

Characteristics and scoring method of computed tomography in open-globe injuries

“…OGIs remain the important cause of visual impairment and loss in all ages. Although some cases of OGIs result in significant recovery, severe OGIs can lead to complete loss of ocular architecture and visual potential, requiring evisceration or enucleation of the eye [ 2 – 4 ]. In our previous study, 53 eyes (8.5%) with severe OGIs were eviscerated at primary management, 137 eyes (21.9%) were eviscerated finally after once or more surgeries [ 3 ].…”

Biomechanics of open-globe injury: a review

“…OGI include penetrating ocular injuries, perforating ocular injuries, ocular rupture, and intraocular foreign bodies [ 3 ] and can cause severe damage to intraocular tissue and vision. In China, OGI was most commonly found in people aged 47.8 ± 14.1, with more male patients than female [ 4 , 5 ]. In the elderly, falls are the main cause of open-globe injuries [ 6 , 7 ].…”