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Ophthalmic injuries in children involved in all-terrain vehicle crashes
Brenda C Edmonson1, Matthew W Wilson, James C Fleming
1Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee 38163, USA.
Insights
Children involved in all-terrain vehicle (ATV) crashes frequently sustain ophthalmic trauma, including severe injuries like orbital fractures and optic neuropathies. Helmet use and operator age are critical factors in injury severity.
Area of Science:
- Ophthalmology
- Trauma Surgery
- Pediatric Emergency Medicine
Background:
- All-terrain vehicles (ATVs) are a common source of recreational injury in children.
- Ophthalmic trauma is a significant concern in pediatric trauma cases.
- Understanding the spectrum of injuries is crucial for effective management and prevention.
Observation:
- A retrospective review of 20 children admitted to a level 1 trauma center for ATV crashes between 1997 and 2002.
- Nine patients (45%) sustained ophthalmic injuries.
- Common injuries included eyelid lacerations, orbital fractures, and traumatic optic neuropathies.
Findings:
- Ophthalmic injuries in pediatric ATV crashes range from minor lacerations to severe sight-threatening conditions.
- Two cases of traumatic optic neuropathy resulted in profound vision loss (count fingers and no light perception).
- All patients sustained head trauma, and none wore helmets, suggesting a link between protective gear and injury severity.
Implications:
- Ophthalmic trauma is a frequent and potentially severe complication of pediatric ATV use.
- The findings underscore the importance of age-appropriate operation and mandatory helmet use in preventing serious eye injuries.
- Further research and public health initiatives are needed to mitigate risks associated with pediatric ATV involvement.
Purpose:
To describe the spectrum of ophthalmic injuries in children involved in all-terrain vehicle (ATV) crashes.
Methods:
We retrospectively reviewed the medical records of a level 1 children's trauma center to identify cases with ICD-9 codes pertaining to crashes involving ATVs and cross-referenced for ophthalmic trauma. From these cases, we documented the nature of the crash, patient's age, ophthalmic injuries received, and length of hospitalization.
Results:
Twenty children, 5 to 16 years of age (mean, 11.1 years), involved in ATV crashes were admitted between June 1997 and April 2002. One was riding with an adult and 3 with other children; 16 were operating the vehicles alone at the time of their crashes. None was wearing a helmet, and all had head trauma. Nine patients had ophthalmic injuries, including lacerations of the eyelid (n = 5), orbital fractures (n = 9), and traumatic optic neuropathies (n = 2). The latter two had final visual acuities of count fingers and no light perception. The average length of hospitalization was 6.6 days.
Conclusions:
Ophthalmic trauma is a frequent complication of ATV crashes involving children. Injuries may range from minor lacerations to complex orbital fractures; visual loss may be severe. We believe that the age of the vehicles' operators and their failure to wear protective helmets contribute to the severity of injuries.
