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Incidence, clinical profile, and short-term outcomes of post-traumatic glaucoma in pediatric eyes

Charudutt Kalamkar1, Amrita Mukherjee1

  • 1Glaucoma Unit, Shri Ganesh Vinayak Eye Hospital, Raipur, Chhattisgarh, India.

Indian Journal of Ophthalmology
|March 23, 2019
PubMed

Insights

Pediatric ocular trauma can lead to elevated intraocular pressure (IOP), particularly after closed globe injury (CGI). Prompt medical and surgical interventions are crucial for managing post-traumatic IOP and preserving vision in children.

Area of Science:

  • Ophthalmology
  • Pediatric Traumatology
  • Glaucoma Research

Background:

  • Elevated intraocular pressure (IOP) is a significant complication following pediatric ocular trauma.
  • Understanding the incidence and risk factors associated with post-traumatic IOP is crucial for effective management.

Purpose of the Study:

  • To determine the incidence, injury mechanisms, treatments, and short-term outcomes of elevated intraocular pressure (IOP) in pediatric eyes following trauma.
  • To compare the occurrence and management of elevated IOP between open globe injury (OGI) and closed globe injury (CGI).

Main Methods:

  • A 5-year retrospective hospital-based study included children (≤16 years) with ocular trauma (OGI or CGI) and elevated IOP (>21 mmHg).
  • Data analyzed included demographics, injury type, IOP levels, best-corrected visual acuity (BCVA), and treatment outcomes (medical and surgical).
  • Minimum follow-up of 3 months was required for inclusion.

Main Results:

  • 15.6% of pediatric eyes with ocular trauma developed elevated IOP, with a significantly higher incidence following CGI (20.6%) compared to OGI (8.3%).
  • Hyphema and lens-related injuries were the most common causes of elevated IOP. Mean IOP decreased from 29.8 mmHg to 16.2 mmHg post-treatment.
  • Surgical management, including trabeculectomy, was required in 37% of cases, notably more in CGI eyes. Poor baseline vision and vitreoretinal involvement correlated with worse visual outcomes.

Conclusions:

  • Post-traumatic elevated IOP affects approximately 15% of pediatric ocular trauma cases, being more prevalent in CGI.
  • Glaucoma filtering surgery was necessary for nearly a quarter of CGI eyes to control IOP.
  • While medical management was employed in 63% of cases, 37% required surgical intervention. OGI with posterior segment involvement led to poorer visual acuity.
Abstract

Keywords:
Closed globe injuryincidenceopen globe injuryoutcomespediatricpost-traumatic glaucoma

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