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Penetrating eye injuries in South African children: aetiology and visual outcome
1Department of Ophthalmology, Medical University of Southern Africa, PO Box 66, Medunsa 0204, South Africa. mgrieshaber@uhbs.ch
Insights
Penetrating eye injuries in South African children often occur during play at home, frequently caused by sharp objects. Most children achieve some vision recovery, but larger wounds and posterior segment involvement indicate a poorer visual outcome.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Trauma Surgery
Background:
- Penetrating eye injuries represent a significant cause of visual impairment in children.
- Understanding the specific epidemiology and risk factors in different populations is crucial for prevention strategies.
Purpose of the Study:
- To investigate the causes, prognosis, and visual outcomes of penetrating eye injuries in children under 16 in South Africa.
- To identify factors associated with poor visual outcomes in pediatric ocular trauma.
Main Methods:
- Prospective evaluation of 100 consecutive pediatric patients (≤16 years) undergoing surgery for penetrating eye injuries.
- Data collection included injury mechanism, location, time to presentation, and surgical findings.
- Visual acuity was assessed using Snellen equivalents post-operatively.
Main Results:
- Most injuries (66%) occurred during play, predominantly at home (55%) and often without caregiver supervision (85%).
- Sharp objects like sticks, wire, and glass were common causes (48%).
- While 71% regained visual acuity of 20/200 or better, factors like large wound size (>11mm), corneoscleral involvement, and posterior segment/lens injury predicted poorer outcomes.
Conclusions:
- Penetrating eye injuries in South African children are frequently linked to domestic play environments.
- Prevention efforts should focus on parental education, supervision, home safety, and safe toys.
- Early presentation does not appear to be a significant prognostic factor, but wound characteristics are critical.
Purpose:
To assess the aetiology, prognosis, and visual outcome of penetrating eye injuries in South African children.
Methods:
In all, 100 consecutive patients, aged 16 years and under, with penetrating ocular injuries undergoing surgery between January 2001 and November 2002 were prospectively evaluated.
Results:
Most children (66%) were injured during play. In all, 55% of penetrating eye injuries occurred at home, and all injuries to children under the age of 6 years occurred there. Most injuries occurred in the absence of a caregiver (85%). Sticks, wire, and glass caused half of all injuries (48%). The most common mechanism of injury was impact with a sharp object (46%). Only 25% of injured presented to the hospital within 24 h of injury; the more severe the sustained injury and the younger the patient, the earlier was attendance at the clinic. Most patients (71%) regained best-corrected visual acuity (Snellen equivalent) of 20/200 or better, and 51% regained 20/40 or better. Patient age and delay of presentation were not of prognostic value. Indicators of poor visual outcome were identified as wound size greater than 11 mm in length, mixed corneoscleral type wounding, and involvement of the lens and posterior segment in the injury.
Conclusions:
Penetrating eye injuries in African children, reviewed here, generally occur when children are at play in a domestic setting. Effective prevention should stress parental awareness, careful supervision, greater home safety, safe toys, and avoidance of hazardous games.
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