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Open globe injuries in children
C Jandeck1, U Kellner, N Bornfeld
1University Eye Clinic, Klinikum Benjamin Franklin, Berlin, Germany.
Insights
Pediatric open globe injuries can be successfully treated, preserving vision in most cases. Even severe injuries offer good visual outcomes, with macula salvage achieved in all patients.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Trauma Surgery
Background:
- Eye injuries represent a significant cause of monocular blindness in children.
- Limited follow-up studies are available on pediatric open globe injuries.
Purpose of the Study:
- To evaluate the outcomes of open globe injuries in children.
- To assess visual acuity and macula status following treatment.
Main Methods:
- Retrospective review of 38 pediatric patients (≤16 years) with open globe injuries.
- Classification of injury type (rupture, penetrating, perforating) and severity (four grades).
Main Results:
- Penetrating injuries were most common (79%). Macula remained attached in all eyes.
- Final visual acuity ranged from light projection to 1.0; 47% achieved ≥0.5, 74% achieved ≥0.1.
- In severe injuries (posterior segment involvement), 44% achieved ≥0.5 visual acuity.
- Early vitrectomy in severe injuries (grade 2-4) resulted in ≥0.5 visual acuity in 58%.
Conclusions:
- Successful salvage of injured eyes with attached macula was achieved in all cases.
- Good visual acuity is attainable in approximately 50% of severely injured eyes.
Background:
Eye injuries are the leading cause of monocular blindness in children. At present, however, only limited follow-up studies exist.
Methods:
The files of 38 consecutive patients aged 16 years or younger who had been treated for open globe injuries were examined. The type of injury was classified and the severity of injury was categorized in four grades.
Results:
Our series included 5 eyes (13%) with a rupture, 30 (79%) with a penetrating and 3 (8%) with a perforating injury. Follow-up varied from 3 days to 7 years (mean 15.5 months). The macula was attached at the last follow-up in all eyes. The final visual acuity ranged between 1.0 and light projection. In 47% of cases (18 eyes), the visual acuity was > or =0.5; 74% (28 eyes) achieved at least 0. 1. Eighteen of 38 eyes (47%) had severe injury with posterior segment involvement. Visual acuity of at least 0.5 was achieved in 44% (8/18) of these. Eyes with grade 2-4 injury treated with early vitrectomy had a final visual acuity of > or =0.5 in 58% of cases (7/13). Twenty-one (55%) of 38 children were < or =8 years of age and eight of them (38%) had a final visual acuity of > or =0.5.
Conclusion:
Salvage of the eye with an attached macula was possible in all eyes. Even in severely injured eyes good visual acuity can be established in about 50% of cases.