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Endophthalmitis in paediatric penetrating ocular injuries in Hyderabad
Sameen Afzal Junejo1, Munawar Ahmed, Mehtab Alam
1Department of Ophthalmology, Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad, Pakistan.
Insights
Delayed presentation of pediatric penetrating ocular injuries increases the risk of post-traumatic endophthalmitis. Prompt medical attention is crucial for better visual outcomes in children with open globe injuries.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Trauma Surgery
Background:
- Post-traumatic endophthalmitis is a severe intraocular infection following penetrating eye injuries.
- Children with open globe injuries are particularly vulnerable to developing endophthalmitis.
- Early diagnosis and management are critical for preserving vision.
Purpose of the Study:
- To investigate the incidence, risk factors, and visual prognosis of endophthalmitis in pediatric patients.
- To highlight the impact of delayed treatment on outcomes.
- To inform clinical practice regarding the management of pediatric eye trauma.
Main Methods:
- Retrospective analysis of pediatric patients (<15 years) with penetrating ocular injuries and endophthalmitis.
- Clinical examination including slit lamp biomicroscopy and fundoscopy.
- Urgent surgical intervention was performed following diagnostic workup.
Main Results:
- 43 patients were included, with a male predominance (67.4%).
- Nearly half (46.6%) presented more than 24 hours after injury.
- Endophthalmitis developed in 44.1% of cases, with poor visual outcomes (hand movements or light perception) in most affected eyes.
Conclusions:
- Delayed presentation to the hospital following open globe injury is a significant risk factor for developing endophthalmitis in children.
- Urgent surgical intervention and timely treatment are essential to improve visual outcomes.
- Pediatric eye trauma requires prompt specialized care to prevent severe complications like endophthalmitis.
Objective:
To determine the frequency, risk factors, and visual outcome of post traumatic endophthalmitis in children.
Methods:
The study was conducted on patients less than fifteen years age, presenting with penetrating ocular injuries and associated with endophthalmitis. Anterior segment slit lamp examination and if possible posterior segment slit lamp examination with 90 D fundoscopes was performed. After completing necessary investigations, urgent surgical intervention was carried out.
Results:
There were 43 registered patients with 29 (67.4%) males and 14 (32.6%) females. Twenty three (53.4%) children presented on the day of injury. Remaining 20 (46.6%) reported after first 24 hours. Twenty seven (62.7%) children presented with corneal wound, 11 (25.6%) had scleral entrance, and 5 (11.7%) patients had corneo scleral extension. Nineteen (44.1%) patients developed clinical evidence of endophthalmitis. Fifteen subjects with endophthalmitis completed six weeks follow up. Two (13.3%) subjects achieved final visual acuity (FVA) of 3/60. Four (26.7%) had only hand movements, 5 (33.4%) subjects were restricted to perception of light, and 2 (13.3%) patients developed phthisis bulbi.
Conclusion:
Delayed arrival of patients in eye hospital with open globe injury may result in endophthalmitis
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