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Published on: August 25, 2021
Characteristics of pediatric open globe injuries in preschool-aged and school-aged children
Nihan Aksu-Ceylan1, Kemal Turgay Özbilen1, Arzu Karakiraz1
1Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Insights
Pediatric open globe injuries in children show that wound location and length significantly impact visual outcomes. Central corneal wounds in younger children pose challenges for visual recovery.
Area of Science:
- Ophthalmology
- Pediatric Trauma
- Ocular Injury
Background:
- Pediatric open globe injuries are a significant cause of vision loss in children.
- Understanding injury characteristics and outcomes is crucial for effective management.
Purpose of the Study:
- To evaluate the characteristics and visual outcomes of pediatric open globe injuries.
- To compare these factors between preschool-aged and school-aged children.
Main Methods:
- Retrospective review of 93 pediatric open globe injury cases.
- Patients divided into preschool (0-7 years) and school-aged (8-15 years) groups.
- Analysis of demographics, trauma characteristics, Ocular Trauma Score (OTS), and visual acuity (BCVA).
Main Results:
- Penetrating injuries from nonmetallic sharp objects were common in both age groups.
- Preschoolers had more central corneal wounds and longer mean wound lengths.
- Poor visual outcome correlated with lower OTS, worse initial BCVA, central/longer wounds, and specific ocular damage.
Conclusions:
- Corneal wound localization and length are key predictors of visual outcome in pediatric open globe injuries.
- Central corneal wounds in preschool-aged children present unique challenges for visual rehabilitation.
Objective:
To evaluate the characteristics and outcomes of pediatric open globe injuries in preschool- and school-aged children.
Method:
Medical records of 93 children were reviewed. Patients were categorized in 2 groups: preschool-aged group (0-7 years) and school-aged group (8-15 years). Demographic data, characteristics of trauma, Ocular Trauma Score (OTS), and initial and final best-corrected visual acuity (BCVA) were recorded and compared between groups.
Results:
The preschool-aged group consisted of 54 patients (mean age 4.6 ± 1.8 years), and the school-aged group consisted of 39 patients (mean age 11.5 ± 2.7 years). Most of the injuries were penetrating and caused by nonmetalic sharp objects in both groups. A corneal injury was detected in 45 patients (83.3%) in the preschool-aged group and 29 patients (74.4%) in school-aged group. Localization of the corneal wound was mostly central (46.7%) in the preschool-aged group and peripheral (48.3%) in school-aged group (p = 0.045). Mean corneal wound length was significantly longer in the preschool-aged group (p = 0.018). Most of the cases in the preschool-aged group were OTS group 2 (50%), whereas most of the cases in the school-aged group were OTS group 3 (38.5%). Poor visual outcome was significantly correlated with the following factors in both groups: lower OTS, worse initial BCVA, central corneal wound, longer corneal and total wound length, and presence of lens damage, retinal detachment, and hypotonia (p < 0.05 for all). Poor final BCVA also was significantly correlated with a longer scleral wound in the school-aged group and the presence of vitreous hemorrhage and uveal tissue prolapse in the posterior segment in the preschool-aged group (p < 0.05).
Conclusions:
Localization and length of the corneal wound is closely associated with visual outcome in children with open globe injuries. Especially in preschool-aged children, mostly central localization of a corneal wound can be a challenging factor for visual rehabilitation.
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