The aetiology of perforating ocular injuries in children

Abstract

Aims: To assess the aetiological factors associated with the occurrence of perforating ocular injuries in children in an urban setting and to assess the visual outcomes of such injuries. Methods: All cases of perforating ocular injury presenting to a single paediatric hospital (age less than 16 years) over a 17 year period were identified by a medical record search. All new cases of perforating ocular injury identified were included. All information was obtained retrospectively from the medical records. Results: There were 72 cases identified. The commonest causes of perforating ocular injury were sharp tools (knives/scissors) poked by the child into his/her own eye (17%), or objects thrown at the child (17%). Injuries were most likely to have occurred at home (58%). The age range for injuries was 8 months to 14 years 8 months. Perforating ocular injury was most frequent in the 3-6 year group (32%) followed by the 6-9 year group (25%). Males were more frequently involved than females (48-24). There was no correlation between the laterality of the eye, the time of day of the occurrence, or the day of the week of the occurrence. The final acuity achieved was better or equal to 6/12 in 36% and less than 6/60 in 31%. Injuries occurred more frequently on weekends than on weekdays. There were six enucleations (8%). Follow up was for an average period of 25 months. Conclusions: Penetrating ocular injury occurs most frequently in the home setting and mostly as the result of the use of sharp tools or by thrown objects. Prevention of penetrating ocular injury requires greater education of children and their carers especially on the potential dangers within the home. P erforating ocular injuries are a frequent cause of unilateral visual loss. Children account for between 20% and 50% of all ocular injuries.1-3 It has been estimated that 90% of all ocular injury are preventable. 4 Strategies for prevention require a knowledge of the cause of injury and may hence enable more appropriate targeting of resources towards prevention of such injuries. The aetiology of paediatric ocular injuries is likely to differ from that of adults, and is hence worthy of further investigation.The principles of management of penetrating ocular injury are the same for children and adults. However, the management of the child is made more difficult by variable cooperation with both assessment and continuing therapy. The possibility of amblyopia in young children further complicates treatment.This study addresses the epidemiology of penetrating ocular injury in children presenting to a single institution in a metropolitan centre. It also reviews the outcomes of these injuries. METHODSAll cases of full thickness perforating ocular injury presenting initially to the Royal Alexandria Hospital for Children in Sydney, Australia, between 1 January 1983 and 31 December 1999 were identified by a medical record search for the ICD code 871. Royal Alexandria Hospital for Children is a paediatric hospital (age 0-16 years) and is a tertiary referral centre. Pati...

Penetrating eye injuries in South African children: aetiology and visual outcome

“…The incidence of injuries caused by motor vehicle accident is at 1% very low in comparison with that found by other studies. 9,11,20,21 This may be explained by little traffic in the predominantly rural areas we studied, and by the use of public transportation by most of the children.…”

“…However, the lack of supervision is not restricted to developing countries as has already been pointed out in recent studies from the western world. [8][9][10][11] Visual outcome and prognosis is expected to improve with prompt medical examination and therapy. However, socioeconomic, geographic, and cultural factors may keep patients from receiving timely and appropriate medical assistance.…”

“…Identifying underlying aetiological factors may allow us to take effective preventative measures to reduce the incidence of such injuries in children. Epidemiological data pertaining to childhood penetrating eye injuries in developed countries have been published, [8][9][10][11] but there are few studies of the situation in Africa. [12][13][14] In South Africa, no current data are available with which accurately to assess the importance of ocular trauma in children in terms of frequency, distribution, and impact on vision.…”

A new ocular trauma score in pediatric penetrating eye injuries

“…Various studies have reported that 20-50% of ocular injury admissions are children. [11][12][13] Using the eye injury registry databases of the United States and Hungary, Kuhn et al 9 developed the ocular trauma score (OTS) in 2002, a simplified categorical system for standardized assessment and visual prognosis in ocular injuries (Table 1).…”

Epidemiological study of ocular trauma in SNMC and HSK hospital Bagalkot

“…This difference was because playing behaviour of Indian children was different from Australian children. 11 …”