Related Experiment Video
Updated: Nov 5, 2025
Anterior Segment Organ Culture Platform for Tracking Open Globe Injuries and Therapeutic Performance
Published on: August 25, 2021
Timing of Ocular Hypertension After Pediatric Closed-Globe Traumatic Hyphema: Implications for Surveillance
Theodore Bowe1, Anthony Serina2, Mikhayla Armstrong2
1From Harvard Medical School (T.B., D.Z., A.S.S.); Department of Ophthalmology, Boston Children's Hospital (T.B., A.S., M.A., J.W., D.Z., A.S.S.); Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital (S.J.S, D.Z.); Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, USA (T.B., A.S.S.).
Insights
Ocular hypertension (OHT) is common after pediatric eye injuries. Specific injury characteristics can predict when OHT occurs, aiding in early detection and management.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Trauma Surgery
Background:
- Pediatric closed-globe injury (CGI) and traumatic hyphema can lead to serious complications.
- Ocular hypertension (OHT), an elevation in intraocular pressure, is a significant concern following such injuries.
- Understanding the timing and predictors of OHT is crucial for effective management in pediatric patients.
Purpose of the Study:
- To evaluate the timing of ocular hypertension (OHT) development after pediatric closed-globe injury (CGI) and traumatic hyphema.
- To hypothesize that OHT occurrence varies based on specific injury characteristics.
- To identify risk factors associated with the timing of OHT.
Main Methods:
- Retrospective cohort study of pediatric patients (≤18 years) with CGI and traumatic hyphema (2002-2019).
- Intraocular pressure and injury demographics were abstracted from patient records.
- OHT was defined as intraocular pressure >21 mm Hg, and timing was categorized into presentation, acute (1-7 days), subacute (8-28 days), and late (>28 days).
Main Results:
- OHT occurred in 39% of eyes (119/305).
- OHT manifested at presentation (35), acutely (69), subacutely (35), and late (36).
- Pupil damage predicted acute OHT; presentation OHT predicted subacute OHT; iridodialysis and cataract predicted late OHT.
Conclusions:
- Ocular hypertension is a frequent complication following pediatric closed-globe injury and traumatic hyphema.
- Injury demographics serve as significant predictors for the development of OHT.
- These findings support the development of a risk-stratification tool for efficient OHT surveillance in pediatric eye trauma.
Purpose:
To evaluate the timing of ocular hypertension (OHT) after pediatric closed-globe injury (CGI) and traumatic hyphema. We hypothesize that OHT will occur at different times based on injury characteristics.
Design:
Retrospective, cohort study.
Methods:
Setting: Single-center, tertiary-care, pediatric hospital.
Participants:
Subjects included patients ≤18 years of age at the time of injury who suffered CGI and traumatic hyphema between 2002 and 2019. Observation Procedure(s): Intraocular pressure and injury demographics were abstracted for every visit after injury. OHT was defined as >21 mm Hg at presentation or after a reading of ≤21 mm Hg at a prior visit.
Main Outcome Measures:
The primary outcome measure was the timing of OHT categorized into 4 periods: presentation, acute (days 1-7), subacute (days 8-28), or late (day >28). Secondary outcome measures were identification of risks factors for OHT by multivariable logistic regression.
Results:
OHT occurred in 119 of the 305 (39%) subject eyes. OHT occurred in 35 patients at presentation, 69 times acutely, 35 times subacutely, and 36 times late. Pupil damage predicted acute-period OHT (P = .004). OHT at presentation predicted subacute period OHT (P = .004). Iridodialysis and cataract predicted late-period OHT (P = .007 and P < .001, respectively).
Conclusions:
OHT after CGI and traumatic hyphema in pediatric patients is common. Injury demographics predict this complication. Integration of these risk factors with current literature allows proposal of a risk-stratification tool to guide efficient surveillance for OHT.
Related Concept Videos
01:25Glaucoma: Overview
01:28Angle Closure Glaucoma: Treatment
01:27Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...