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Ocular Injury Presenting to a Level-III Pediatric Trauma Center
Kari Schneider1, Hai Nguyen-Tran2, Bradley J Segura3
1From the Department of Pediatrics, Division of Emergency Medicine, University of Minnesota Masonic Children's Hospital.
Insights
Pediatric ocular injuries are common at trauma centers, with dog bites being a significant cause. Some children require operating room repair, and long-term vision issues like blindness can occur.
Area of Science:
- Ophthalmology
- Pediatric Trauma
- Emergency Medicine
Background:
- Pediatric ocular injuries present a significant challenge in emergency departments.
- Understanding injury patterns is crucial for effective management and prevention.
Purpose of the Study:
- To characterize pediatric ocular injuries treated at a level-III pediatric trauma center.
- To identify injury mechanisms, types, and outcomes.
Main Methods:
- Retrospective chart review of pediatric patients (0-18 years) with ocular injuries.
- Data collected included demographics, injury details, and treatment outcomes over a 5-year period.
Main Results:
- 356 injuries in 278 children were analyzed; males predominated.
- 15.46% of injuries required operating room repair; dog bites accounted for 7.19%.
- Long-term sequelae, including anophthalmia and blindness, affected 10.79% of patients.
Conclusions:
- Level-III trauma centers manage approximately one pediatric ocular injury weekly.
- Children treated at this center underwent operating room repair at a higher rate than reported for higher-level trauma centers.
- Dog bite-related injuries remain a notable cause of pediatric ocular trauma.
Abstract:
The purpose of this study is to describe pediatric ocular injuries presenting to a level-III pediatric trauma center and emergency department.
Methods:
We performed a retrospective study and identified children from January 1, 2011, to January 1, 2016. Charts were reviewed for any subject, age from newborn to younger than 18 years, based on International Classification of Diseases, ninth and tenth revision, codes for any ocular injury. Data abstraction included age, sex, means of arrival, eye involved, mechanism of injury, type of ocular injury, imaging studies obtained, procedures performed, location of definitive repair (in the operating room or emergency department), and subspecialty services involved.
Results:
In the 5-year period, we describe 356 injuries among 278 children. Males had a slightly higher rate of presentation than females (156 and 122, respectively). Forty-three children (15.46%) required repair in the operating room. Dog bites comprised of 7.19% children with outpatient follow-up, one patient (0.36%) eventually developed anophthalmia, and 30 children (10.79%) had long-term ophthalmological sequelae (ie, glaucoma and blindness).
Conclusions:
At our institution, a level-III trauma center, we evaluated and managed approximately 1 ocular injury case per week and children required surgical repair in the operating room at a higher rate than higher-level trauma centers. Injuries secondary to dog bites remain a clinically significant etiology.
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