Visual Outcomes and Prognostic Factors for Pediatric Open Globe Injuries

Area of Science:

• Ophthalmology
• Pediatric Trauma
• Ocular Injury Assessment

Background:

• Open globe injuries (OGIs) are a significant cause of unilateral blindness in children.
• Established ocular trauma scoring systems (Ocular Trauma Score [OTS], Pediatric Penetrating Ocular Trauma Score [POTS], and Toddler/Infant Ocular Trauma Score [TOTS]) exist but require further validation in pediatric populations.

Purpose of the Study:

• To evaluate the effectiveness of three commonly used ocular trauma scores in predicting final visual acuity in pediatric patients with open globe injuries.
• To identify specific factors within these scores that correlate with visual outcomes in this demographic.

Main Methods:

• Retrospective review of medical records for pediatric patients with OGIs from 2011 to 2016.
• Application of OTS, POTS, and TOTS to patient data to assess predictive accuracy for final visual acuity (VA).
• Analysis of clinical presentation and examination findings, including relative afferent pupillary defect and zone of injury.

Main Results:

• Fifteen pediatric patients with OGIs were analyzed; 47% achieved a final VA of 20/40 or better.
• All three scoring systems (POTS, TOTS, and OTS) demonstrated significant correlation with final VA.
• Relative afferent pupillary defect and posterior zone of injury were associated with poorer visual outcomes.

Conclusions:

• The OTS, POTS, and TOTS are effective tools for predicting visual outcomes in pediatric patients with open globe injuries, even when used outside their original age parameters.
• Relative afferent pupillary defect and the zone of injury are critical indicators of poor visual prognosis in pediatric OGIs.