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Rock, paper and scissors? Traumatic paediatric cataract in Victoria 1992-2006
Sandra E Staffieri1, Jonathan B Ruddle, David A Mackey
1Centre for Eye Research Australia, Department of Ophthalmology, University of Melbourne, 32 Gisborne Street, East Melbourne, Vic. 3002, Australia. sesta@unimelb.edu.au
Insights
Paediatric traumatic cataracts are common, with males more frequently affected. Injuries from sharp or blunt objects lead to varied visual outcomes after lens surgery.
Area of Science:
- Ophthalmology
- Paediatric Medicine
- Trauma Surgery
Background:
- Traumatic cataracts in children are a significant cause of visual impairment.
- Understanding the mechanisms and outcomes is crucial for effective management.
Purpose of the Study:
- To review visual acuity outcomes in paediatric traumatic cataracts.
- To examine the mechanisms leading to traumatic cataract formation in children.
Main Methods:
- Retrospective review of paediatric patients (<18 years) undergoing lens surgery for ocular trauma (1992-2006).
- Data included injury mechanism, wound type, age, refractive rehabilitation, complications, and visual acuity.
- Hospitals involved: Royal Children's Hospital and Royal Victorian Eye and Ear Hospital, Melbourne.
Main Results:
- 74 patients (75% male) identified over 15 years; mean age at injury 7.5 years.
- 88% of cataracts resulted from penetrating eye injuries.
- 34% achieved visual acuity of 6/12 or better; 19% had visual acuity <6/60; 16% lost to follow-up.
Conclusions:
- Trauma-induced cataract requiring lensectomy is not uncommon in paediatric populations.
- Males are more susceptible to these injuries.
- Variable visual outcomes are associated with diverse injury mechanisms.
Background:
To review visual acuity outcomes from paediatric traumatic cataract and examine the mechanisms by which they occur.
Methods:
A retrospective review of paediatric patients (aged less than 18 years) who underwent lens surgery following ocular trauma, between 1992 and 2006 at the Royal Children's Hospital and Royal Victorian Eye and Ear Hospital in Melbourne. Data collected included gender, mechanism of injury, wound type, age at injury, age at surgery, refractive rehabilitation, complications and visual acuity outcome.
Results:
A total of 74 patients (75% male) were identified over the 15-year period, representing an incidence of 4.9 cases per year. The mean age at injury was 7.5 years. Sixty-five cataracts (88%) followed a penetrating eye injury, whereas only nine patients (12%) developed cataract after known blunt trauma. Fourteen patients (19%) underwent lensectomy at the time of primary wound repair and 45 patients (61%) underwent primary intraocular lens (IOL) implantation. Visual acuity outcomes ranged from 6/5 to no perception of light. Twenty-five patients (34%) achieved 6/12 or better in the injured eye, 23 patients (31%) achieved between 6/15 and 6/60, and 14 patients (19%) had visual acuity of less than 6/60. Twelve patients (16%) were lost to follow-up.
Conclusion:
In a paediatric population, cataract formation as a result of trauma requiring lensectomy is not uncommon. Males are more likely to suffer from such injury. A variety of sharp and blunt objects are the primary mechanism by which the injury is sustained with variable visual outcomes.
