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Pediatric Open Globe Injuries Caused by Firecrackers in a Tertiary Eye Care Hospital in Iran
Alireza Peyman1, Alireza Dehghani1, Seyed-Ali-Akbar Mortazavi1
1From the Isfahan Eye Research Center, Department of Ophthalmology.
Insights
Pediatric open globe injuries from firecrackers are distinct, affecting older boys more frequently and often involving intraocular foreign bodies. These injuries differ significantly from other causes in terms of patient demographics and injury characteristics.
Area of Science:
- Ophthalmology
- Pediatric Trauma
- Public Health
Background:
- Open globe injuries in children are a significant cause of vision loss.
- Firecracker-related ocular trauma presents unique challenges in diagnosis and management.
- Understanding the specific characteristics of firecracker injuries is crucial for prevention and treatment.
Purpose of the Study:
- To identify and characterize open globe injuries caused by firecrackers in a pediatric population.
- To compare the features of firecracker-induced injuries with those from other mechanisms.
- To analyze demographic and clinical differences in pediatric ocular trauma.
Main Methods:
- Retrospective cross-sectional chart review of pediatric ocular trauma patients hospitalized between 2013-2017.
- Analysis of medical records, including injury mechanisms, clinical findings, and outcomes.
- Propensity score (PS) matching to control for confounding variables and compare patient groups.
Main Results:
- Of 396 pediatric open globe injuries, 22 (5.9%) were firecracker-related.
- Firecracker injuries occurred in older boys, with higher rates of hyphema, iris prolapse, and intraocular foreign bodies (IOFB).
- Patients with firecracker injuries had a higher prevalence of IOFB even after PS matching.
Conclusions:
- Pediatric open globe injuries from firecrackers exhibit distinct features compared to other injury types.
- Key differences include patient age, sex, urban residence, IOFB presence, and hospital stay duration.
- These findings underscore the need for targeted prevention strategies and specialized care for firecracker-related eye injuries in children.
Objective:
The aim of the study is to determine characteristic features of open globe injuries caused by firecrackers among pediatric population.
Methods:
In this retrospective cross-sectional chart review, medical records of children with ocular trauma who were hospitalized in Isfahan, Iran, during 2013-2017 were reviewed. We analyzed the collected data before and after propensity score (PS) matching.
Results:
Of 396 pediatric patients with open globe injury, 22 injuries (5.9%) were caused by firecrackers. Hyphema, iris prolapse, and lens rupture were noted in 15 (68.18%), 10 (45.45%), and 2 (9.09) eyes, respectively. None of patients had endophthalmitis. The mean age of patients in firecracker group was higher and significant (11.86 ± 4.05 in firecracker vs 7.80 ± 4.68 in nonfirecracker, P < 0.001). Furthermore, most boys were in firecracker group (95.5%, P = 0.005). Patients in firecracker group resided more in urban areas (86.4%, P = 0.054) and had more intraocular foreign body (IOFB) in the eyes (40.9%, P < 0.001). After PS matching, patients in firecracker group had higher IOFB ( P = 0.008). In logistic regression models, patients with corneal lacerations had lower odds for long-time admission (≥4 days) than patients with both corneal and scleral lacerations in crude model (odds ratio, 0.35; 95% confidence interval, 0.17-0.69) and adjusted model (odds ratio, 0.37; 95% CI, 0.18 to 0.74). After PS matching, there was no significant association between risk factors and outcomes.
Conclusions:
The present study showed several differences between the pediatric open globe injuries caused by firecrackers and other mechanisms of injuries, including the age, sex, living place, presence of IOFB, and length of hospital stay.
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