Paediatric traumatic cataracts in Southwest China: epidemiological profile
Pingping Wang1, Qingyu Fu1, Hongbo Yin1
1Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 61000, Sichuan, China.
Insights
Paediatric traumatic cataracts in China are often caused by sharp objects, botanical sticks, and stationery. Early prevention strategies are crucial to reduce acquired blindness in children.
Area of Science:
- Ophthalmology
- Epidemiology
- Pediatric Medicine
Background:
- Paediatric traumatic cataracts are a significant, preventable cause of acquired blindness in children.
- Understanding the epidemiology of these injuries is essential for effective prevention strategies.
- This study focuses on the epidemiological profile of paediatric traumatic cataracts in southwest China.
Purpose of the Study:
- To characterize the epidemiological profile of paediatric traumatic cataracts in southwest China.
- To identify common causes, risk factors, and outcomes associated with these injuries.
- To inform targeted prevention efforts.
Main Methods:
- Retrospective analysis of medical records of children (0-14 years) with traumatic cataracts from open-globe injuries.
- Data collected included demographics, injury causes, complications (e.g., infectious endophthalmitis), and visual acuity.
- Analysis spanned from January 2011 to December 2020 at West China Hospital.
Main Results:
- Sharp metal objects, botanical sticks, and stationery were the leading causes of injury.
- Traumatic cataracts were more prevalent in winter and in males (72.8%).
- Younger children (2-8 years) were most affected, with penetrating trauma being common (64.9%).
- Post-traumatic infectious endophthalmitis occurred in 18.3% of cases, with higher risk from needle, wooden stick, and bamboo skewer injuries.
- Streptococcus was the most common organism, sensitive to vancomycin.
- Visual outcomes were poorer in children under 5 years compared to older children post-surgery.
Conclusions:
- Sharp metal objects, botanical sticks, and stationery are primary causes of paediatric traumatic cataracts in southwest China.
- Targeted preventive measures are necessary to decrease the incidence of these injuries.
- Understanding seasonal and age-related patterns can aid in public health interventions.
Background:
Paediatric traumatic cataracts are an important but preventable cause of acquired blindness. Understanding the epidemiology of paediatric traumatic cataracts is a prerequisite for prevention. This study aimed to characterize the epidemiological profile of paediatric traumatic cataracts in southwest China.
Methods:
The medical records of children (age range, 0-14 years old) who developed traumatic cataracts following open-globe injuries and were hospitalized at the Department of Ophthalmology at West China Hospital, between January 2011 and December 2020 were retrospectively analyzed. The demographic data, causes of injuries, posttraumatic complications, and visual acuity were recorded and analysed.
Results:
A total of 716 eyes from 716 patients were analysed in this study, including 521 (72.8%) males and 195 females in a gender ratio of 2.67:1; 117 of the patients were of ethnic minorities. Paediatric traumatic cataracts occurred more frequently in winter (32.5%). Sharp metal objects (scissors/knives/needles/sheet metal/nails/darts) - induced ocular injuries accounted for the highest proportion, followed by botanical sticks (wooden sticks /bamboo sticks /bamboo skewers)-induced injuries, and then stationery items (pencils/pens/rulers/paper)-induced injuries. The majority (68.7%) of the patients were aged 2-8 years, and the peak range of age was 4 - 6 years. The injuries were a result of penetrating trauma in 64.9% of patients, and blunt force trauma in the remainder (35.1%). Additionally, 131 (18.3%) cases developed posttraumatic infectious endophthalmitis after injuries. Patients with eye injuries caused by needles (P < 0.001), wooden sticks (P = 0.016), and bamboo skewers (P = 0.002) were at a greater risk of developing infectious endophthalmitis. The most common identified foreign organism was Streptococcus, which accounted for 42% (21/50) of all culture-positive specimens and was sensitive to vancomycin. Among the children who were younger than 5 years, 44.4% (55/124) of those with traumatic cataracts presented a corrected distance visual acuity less than or equal to 0.1 after undergoing cataract surgery, but among the children who were older than 5 years, this proportion was significantly smaller, just 20.4% of children aged 6-10 years (P < 0.001) and 18.4% of children aged 11-14 years (P < 0.001).
Conclusion:
The main causative agents of paediatric traumatic cataracts in southwest China were sharp metal objects, botanical sticks, and stationery items. Specific preventive measures are essential to reduce the incidence of paediatric traumatic cataract.
