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Aetiology and outcome of open and closed globe eye injuries in children
Subhashini Kadappu1, Sue Silveira, Frank Martin
1Children's Hospital at Westmead, Sydney, NSW 2145, Australia. subhashinibhat@yahoo.com
Insights
Childhood eye injuries, both open and closed globe, were studied to determine causes and outcomes. Many injuries were preventable, highlighting the need for increased safety measures to preserve vision in children.
Area of Science:
- Ophthalmology
- Pediatric Trauma
- Public Health
Background:
- Childhood eye injuries present a significant challenge in pediatric ophthalmology.
- Understanding the aetiology and outcomes of these injuries is crucial for prevention and management.
Purpose of the Study:
- To investigate the causes and visual outcomes of childhood open and closed globe eye injuries.
- To identify factors associated with poor visual prognosis in pediatric eye trauma.
Main Methods:
- A nine-year retrospective hospital-based study of 203 children with eye injuries.
- Injuries were classified as open or closed globe based on the Ocular Trauma Classification.
- Data on injury type, zone, initial visual acuity, wound length, and lens trauma were analyzed.
Main Results:
- Accidental poking was a common cause of injury, often occurring at home.
- Closed globe injuries had better visual outcomes than open globe injuries (P < 0.01).
- Poor outcomes were linked to globe rupture, zone 3 injuries, low initial visual acuity, long wounds, and lens trauma. 68% achieved 6/12 or better vision.
Conclusions:
- Improved visual outcomes were observed compared to prior studies.
- A significant number of childhood eye injuries resulted in unsalvageable vision.
- The majority of these injuries were preventable, emphasizing the need for enhanced safety interventions.
Background:
This paper reports on the aetiology and outcome of childhood open and closed globe eye injuries presenting to the Children's Hospital at Westmead, Sydney, Australia from January 2000 to December 2008.
Design:
Hospital-based retrospective study.
Participants:
Two hundred three cases of childhood eye injuries identified in a nine-year period, comprising 81 open globe and 122 closed globe injuries.
Methods:
Hospital records were examined for demographic data and injuries were classified into open globe and closed globe, based on the Ocular Trauma Classification.
Main Outcome Measures:
Parameters affecting the final visual outcome such as type of injury, zone of injury, initial visual acuity, wound length (only in open globe injuries) and lens injury were assessed.
Results:
Most of the eye injuries resulted from the child poking itself or being poked accidentally (26%), with the home being the most common place of injury. A favourable visual outcome was noted with closed globe injuries as compared with open globe injuries (P < 0.01). Parameters that indicated a poor visual outcome included globe ruptures, zone 3 injuries, poor initial visual acuity, wound length >10 mm and lens trauma. Final visual acuity of 6/12 or better was observed in 68% of injured eyes.
Conclusions:
This study demonstrated improved visual outcomes when compared with previous studies. However, many unsalvageable childhood eye injuries with little useful vision were evident, and most disconcerting is that the majority of childhood eye injuries in this study were preventable.
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