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Child Abuse and the Eye in an African Population
Michaeline A Isawumi1, Modupe Adebayo2
1Department of Surgery, College of Health Sciences, Osun State University, Osogbo, Nigeria.; Department of Ophthalmology, LAUTECH Teaching Hospital, Osogbo, Nigeria.
Insights
Child abuse in West Africa frequently causes severe eye injuries, including blindness, often from canes and sticks during beatings or child labor. Urgent legislation is needed to protect children from these devastating ocular traumas.
Area of Science:
- Ophthalmology
- Pediatrics
- Public Health
Background:
- Child abuse and its impact on ocular health are under-researched in West Africa.
- Understanding the causes and consequences of eye injuries in children is crucial for developing targeted interventions.
Purpose of the Study:
- To investigate the causes, circumstances, and ocular effects of child abuse in a pediatric population in West Africa.
- To determine the visual outcomes following ocular trauma related to child abuse.
Main Methods:
- A 3-year prospective study of children presenting with ocular features suggestive of abuse.
- Data collection included socio-demographics, presenting and post-treatment visual acuity, and comprehensive eye examinations.
- Analysis of injurious agents, perpetrators, and predisposing circumstances.
Main Results:
- Fifty-six children with 56 affected eyes were analyzed; males were more affected (1.8:1 ratio).
- Common ocular injuries included conjunctival hyperemia, corneal abrasion/ulcer, hyphema/uveitis, and globe perforation.
- Significant visual impairment and blindness (21.4% presenting, 25% post-treatment) were observed; common causes were canes and sticks during beatings and child labor.
Conclusions:
- Child abuse, particularly involving canes, sticks, child labor, and corporal punishment, leads to severe ocular injuries and vision loss in West African children.
- There is a critical need for legislation and protective laws to mitigate the psychosocial and economic impacts of child abuse on children and society.
Purpose:
There is a paucity of data on child abuse and the eye in West Africa. Therefore, a need exists to determine the causes and circumstances surrounding these occurrences and their effects on the eye and vision in a pediatric population.
Methods:
A 3-year study of consecutive cases of ocular features that presented to an eye clinic following a history suggestive of child abuse along with any associated eye injury was carried out. Socio-demographic characteristics were obtained, as were the presenting and posttreatment visual acuity, and a full clinical eye examination was also done.
Results:
Fifty-six children with 56 affected eyes were examined. The male to female ratio was 1.8 : 1; the mean age was 8.25 ± 3.5 years; and the subjects were predominately primary school children 30 (53.6%). The most common ocular disorders were conjunctiva hyperemia (46.4%), corneal abrasion/ulcer (25.4%), hyphema/uveitis (42.9%), retinal detachment (7.1%), sclera rupture (7.1%), and globe perforation (21.4%). The intraocular pressure was raised in 17.9% of participants. Presenting versus posttreatment visual acuities showed normal vision in four (7.1%) vs. eighteen (32.1%), visual impairment in 12 (21.4%) vs. six (10.7%), severe visual impairment in 20 (35.7%) vs. 12 (21.4%), and blindness in 12 (21.4%) vs. 14 (25%), p < 0.001. The most common injurious agents were canes (25.0%) and sticks (17.9%). The people who inflicted the injuries were parents/relatives (uncles) in 35.7% of cases and the children themselves (accidents) in 21.4% of cases. Circumstances predisposing participants to eye injuries were child labor in 39.3% and beatings in 25.0%. Complications were cataracts (25.0%), corneal opacity (39.3%), and retinal detachment (7.1%).
Conclusions:
Injuries commonly resulted from canes and sticks used during beatings, as well as from child labor, corporal punishment, accidents, and assaults. Legislation and laws need to be enacted to prevent negative psychosocial and economic impacts on the child, family and country as a whole.