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The UK Paediatric Ocular Trauma Study 3 (POTS3): clinical features and initial management of injuries
Robert J Barry1,2, Freda Sii1,3, Alice Bruynseels1
1Department of Ophthalmology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Insights
Pediatric ocular trauma remains a significant issue with no improvement in incidence or severity over 25 years. Eye care providers need enhanced emergency services for severe pediatric eye injuries.
Area of Science:
- Ophthalmology
- Pediatric Trauma
- Public Health
Background:
- Millions of children globally experience ocular trauma annually, necessitating specialized management due to unique healing patterns and outcomes in pediatric patients.
- Current management practices for pediatric ocular trauma show significant variation across centers, highlighting the need for standardized protocols.
- Understanding current trends in presentation and treatment is crucial for developing effective management strategies for pediatric ocular injuries.
Purpose of the Study:
- To investigate current trends in the presentation and treatment of pediatric ocular trauma.
- To provide data for the development of effective management protocols for pediatric ocular injuries.
- To assess the incidence and severity of pediatric ocular trauma in the UK.
Main Methods:
- A prospective, observational study was conducted over one year in the UK.
- Data were collected via reporting cards from the British Ophthalmic Surveillance Unit for children aged 16 or younger with acute ocular or orbital trauma requiring admission.
- A standardized questionnaire gathered information on clinical features and initial management.
Main Results:
- Eighty-six cases of pediatric ocular trauma were reported, with 76.7% involving the globe (60.1% open-globe).
- Anterior segment trauma occurred in 66.3% of cases, and posterior segment trauma in 26.7%.
- Severe trauma (visual acuity < 6/60) was observed in 29.1% of patients, with an incidence of 0.19 per 100,000 population.
Conclusions:
- The incidence and severity of pediatric ocular injuries have not improved in the last 25 years.
- Effective assessment and management of severe pediatric ocular trauma in emergency settings are critical.
- There is an ongoing need for specialized eye care services for children experiencing ocular trauma.
Purpose:
Worldwide, as many as 6 million children annually sustain ocular trauma, with up to a quarter of a million children requiring hospitalization. Management of pediatric ocular trauma differs from that in adults, both in terms of initial assessment and acute intervention, with significant variation in practice between different centers. Patterns of healing and long-term outcomes are also very different for children compared to adults. In order to develop effective protocols for management, it is first necessary to understand current trends in presentation and treatment.
Methods:
We conducted a prospective, observational study of pediatric ocular trauma presenting to UK-based ophthalmologists over a one-year period; reporting cards were distributed by the British Ophthalmic Surveillance Unit, and clinicians were asked to report cases of acute orbital and ocular trauma in children aged 16 years or less requiring inpatient or day-case admission. A validated, standardized questionnaire was sent to reporting ophthalmologists to collect data on clinical features and initial management of injury.
Results:
Eighty-six episodes of pediatric ocular trauma were reported. Trauma involving the globe was reported in 66/86 patients (76.7%), of which 40/66 (60.1%) were open-globe. Trauma to the anterior segment was reported in 57/86 (66.3%), and posterior segment in 23/86 patients (26.7%). Twenty-five of 86 (29.1%) patients sustained severe trauma defined as having best-corrected visual acuity worse than 6/60 Snellen (incidence 0.19 per 100,000 population).
Conclusions:
There has been no improvement in the incidence or severity of pediatric ocular injury rates over the past 25 years. Eye-care providers must be able to provide the necessary services for assessment and management of severe pediatric ocular trauma in the emergency setting.
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