Traumatic Endophthalmitis in Children

Abstract

To study the clinical profile and visual outcome in children with traumatic endophthalmitis undergoing vitrectomy. METHODS: A retrospective analysis was performed from hospital records of Minto ophthalmic hospital, Bangalore between 1 st April 2014 to 31 st March 2015 on traumatic endophthalmitis in children less than 15 yrs. Complete ocular examination along with B scan was done and endophthalmitis was confirmed. Systemic evaluation and necessary blood investigations for general anaesthesia were done.23 Gauge Three port pars plana Vitrectomy was done as early as possible. RESULTS: A total of ten children with traumatic endophthalmitis who underwent vitrectomy for traumatic endopthalmitis between July 2014 to April 2015 were studied. Nine cases presented with corneal tear and one case presented with self-sealed scleral tear. Nine cases underwent primary tear repair with intravitreal antibiotics, followed by an early vitrectomy and one case underwent primary tear repair and vitrectomy as a single procedure. Vitreous biopsy was sent for grams stain, KOH mount and culture and sensitivity. Nine cases underwent lensectomy along with vitrectomy. One case underwent repeat vitrectomy after 4 day since the exudates filled the vitreous cavity. Two cases developed retinal detachment and underwent surgery for the same. At the end of two months 3 cases had vision of 6/24 or better, three cases had vision of 1/60 and 4 cases had total retinal detachment with subsequent phthisis bulbi. CONCLUSION: Nature of injury, delay in communication by the children, delay in observation by the parents, delay in arrival for treatment and virulence of the organism may result in poor visual prognosis in children with endophthalmitis.