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Epidemiology, aetiology and outcome of paediatric ocular trauma in Sydney
Ying Liu1,2, Annette K Hoskin1,3,4, Stephanie L Watson1,5,6
1Discipline of Ophthalmology, Sydney Medical School, The University of Sydney, Save Sight Institute, Sydney, New South Wales, Australia.
Insights
Paediatric eye injuries, often from projectiles or being struck by sporting equipment, toys, or sticks, are most common in boys. Vision outcomes were poorer for open globe injuries compared to closed globe injuries.
Area of Science:
- Ophthalmology
- Paediatric Medicine
- Trauma Surgery
Background:
- Eye injuries are a significant cause of vision impairment in children.
- Understanding the epidemiology and aetiology of paediatric ocular trauma is crucial for prevention and management.
Purpose of the Study:
- To report the epidemiology, aetiology, and outcomes of eye injuries in children aged 0-16 years.
- To analyze injury mechanisms, agents, and visual acuities following treatment.
Main Methods:
- Retrospective review of paediatric eye injury cases (January 2009 - December 2015).
- Utilized hospital diagnostic codes and International Classification of Diseases, 10th Revision (ICD-10).
- Confirmed diagnoses of open globe injury (OGI) or closed globe injury (CGI) and extracted demographic, injury, and visual acuity data.
Main Results:
- 295 patients (298 eyes) were analyzed, with males predominantly affected (72%).
- Common injury mechanisms included projectiles (36%) and being struck (34%), often involving sporting equipment, toys, or sticks.
- Final best-corrected visual acuity (BCVA) of 6/12 or better was achieved in 69% of cases; 40% for OGI and 85% for CGI.
Conclusions:
- Paediatric ocular trauma is most frequent in males, with projectiles and direct impact being leading causes.
- Sporting equipment, toys, and sticks are common agents; another child's involvement was noted in over 30% of cases.
- Vision outcomes are significantly poorer in open globe injuries compared to closed globe injuries.
Aim:
Report epidemiology, aetiology and outcomes of eye injuries in children 0-16 years treated at quaternary referral and paediatric hospitals in Sydney, Australia.
Methods:
A retrospective review of cases January 2009 to December 2015 using hospital diagnostic and International Classification of Diseases, 10th Revision codes. Medical records confirmed open globe injury (OGI) or closed globe injury (CGI) diagnosis and demographic, injury mechanism, ocular and best-corrected visual acuities (BCVA) before and after treatment.
Results:
A total of 295 patients, 298 eyes were included (96 OGIs, 202 CGIs.) Injuries were commonest in males (72%) with OGI peaks in 3-5-, and CGI, 12-14-year-old males. A projectile was the commonest mechanism (106, 36%) then being struck (101, 34%). Commonest agents were sporting equipment (13%), toys (10%) and sticks (10%). Another child was involved in 32.9% OGI and 27.6% CGI. Initial BCVA was a good predictor of final BCVA. Poor prognostic factors included lens injury, vitreous haemorrhage and relative afferent pupillary defect. Final BCVA 6/12 or better was achieved in 69% cases, including 40% of OGIs and 85% of CGIs. Enucleation and evisceration rates were both 1% (n = 3).
Conclusion:
Paediatric ocular trauma most commonly occurred in males from projectiles or being struck, with injuries commonly occurring from sporting equipment, toys and sticks. Vision was poorer with open than closed globe injuries.
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