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Ocular injuries by elastic cords in children
S Da Pozzo1, S Pensiero, P Perissutti
1Ophthalmology Unit, Children's Hospital, Trieste, Italy. dapozzo@onenet.it
Insights
Elastic cords can cause severe eye injuries in children, acting as high-speed projectiles. Prevention through design changes and education is crucial to protect children from permanent vision impairment.
Area of Science:
- Ophthalmology
- Pediatric Trauma
- Public Health
Background:
- Elastic cords pose a significant risk of severe ocular damage and permanent vision impairment when striking the eye at high speeds.
- Understanding the specific mechanisms and circumstances of these injuries is vital for effective prevention strategies.
Purpose of the Study:
- To determine the incidence, biomechanics, and severity of eye injuries resulting from elastic cords in pediatric patients.
- To inform the development of targeted preventive measures for elastic cord-related eye trauma.
Main Methods:
- A retrospective review of hospital admissions for ocular trauma in a pediatric ophthalmology unit between 1991 and 1997.
- Inclusion criteria focused on children with eye injuries specifically caused by elastic cords.
Main Results:
- Eight children met the criteria, representing 2% of pediatric trauma admissions.
- Injuries involved a combination of blunt force and high-speed projectile trauma.
- Younger children experienced injuries from misuse during play, while older children had injuries from car roof rack incidents; one child sustained permanent vision loss from retinal detachment.
Conclusions:
- Injury mechanisms differ between younger and older children, with older children's injuries mirroring adult patterns.
- Primary prevention is essential to minimize the prevalence and severity of elastic cord eye injuries.
- Recommendations include modifying hook designs, enhancing educational campaigns, and restricting children's access to elastic cords.
Background:
Elastic cords hitting the eyeball as high-speed projectiles can severely damage ocular structures and can produce permanent visual function impairment.
Objectives:
To evaluate the frequency, mechanics, and severity of eye injuries caused by elastic cords in children to adopt the most appropriate preventive measures.
Methods:
A retrospective medical records review of hospital admissions secondary to ocular trauma between 1991 and 1997 in a pediatric ophthalmology unit at an urban tertiary care pediatric hospital was performed to select all children admitted for ocular injury caused by an elastic cord.
Results:
Eight children fulfilled the inclusion criteria; the prevalence ratio was 2% of all pediatric trauma admissions. In all cases the mechanics of trauma was a combination of blunt and high-speed projectile injury. The mechanism of trauma in younger patients was typically a cord that was misused during unsupervised playtime, whereas cord slipping from car roof racks was noted in older patients. One patient suffered a severe permanent visual impairment caused by retinal detachment. All other children regained full visual acuity at the time of discharge and maintained it through a mean follow-up of 22 months (range: 18-29).
Conclusion:
Circumstances of injury in younger children are different from those found in older children, the latter being similar to those reported for adults. Prevention is the primary measure to be taken to reduce the prevalence of this injury and to lower the risk for ocular severe anatomic damage as much as possible. This can be achieved primarily by modifying the design of the hooks, intensifying educational campaigns, and keeping elastic cords out of children's reach.