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A study on the clinical profile and visual outcome of pediatric ocular trauma in Eastern India
Sucheta Parija1, Koyal Chakraborty1, S R Ravikumar2
1Department of Ophthalmology, AIIMS, Bhubaneswar, Odisha, India.
Insights
Pediatric ocular trauma, particularly open globe injuries (OGIs), is common in Indian children and poses a high risk for blindness. Early detection and intervention are crucial for successful visual outcomes.
Area of Science:
- Ophthalmology
- Pediatric Trauma
- Public Health
Background:
- Ocular trauma is a significant cause of vision impairment and unilateral blindness in children.
- Understanding the clinical profile and outcomes of pediatric ocular injuries is crucial for effective management.
Purpose of the Study:
- To analyze the clinical characteristics of pediatric ocular injuries.
- To identify predictors of final visual outcomes in children with ocular trauma.
- To present findings from a tertiary care institute in Eastern India.
Main Methods:
- Retrospective observational study of 114 pediatric ocular injury cases (2016-2020).
- Data analysis included demography, injury nature, location, Ocular Trauma Score (OTS), visual acuity, and management.
- Classification based on Birmingham Eye Trauma Terminology and Ocular Trauma Classification System.
Main Results:
- Injuries most frequent in males aged 6-10 years from rural areas, often during outdoor activities.
- Sharp objects were the most common cause, followed by blunt objects.
- Open globe injuries (OGIs) were more prevalent than closed globe injuries (CGIs).
- Lower odds of blindness observed in CGIs compared to OGIs; late presentation (>6h) showed increased risk.
Conclusions:
- Pediatric ocular trauma often presents as an emergency, with OGIs posing a high risk for blindness.
- The Ocular Trauma Score (OTS) is valuable for predicting visual outcomes in pediatric OGIs.
- Strategic planning focusing on early detection, intervention, and awareness campaigns is essential for prevention and improved visual outcomes.
Purpose:
Ocular trauma in children is the leading cause of ocular morbidity and unilateral blindness. This study aims to analyze the clinical profile and predictors of final visual outcomes of ocular injuries in the pediatric age group presenting to a tertiary care institute in Eastern India.
Methods:
This is a retrospective, observational study conducted on 114 cases of pediatric ocular injuries over 4 years (between 2016 and 2020) at a tertiary care academic hospital in Eastern India. All the data were analyzed based on the demography, nature of the injury, location of the injury, ocular trauma score (OTS), the initial and final visual acuity, and management protocol. The ocular trauma classification was based on the Birmingham Eye Trauma Terminology and the Ocular Trauma Classification System.
Results:
Majority of the injuries (n = 51, 44.7%) occurred in children between 6 and 10 years and in males from the rural areas (60.75%). The mean age of children was 9 ± 3.47 years (range: 3-16 years). Most of the injuries occurred during outdoor activities (57.9%). Majority of ocular injuries were caused by sharp objects (34, 30%), followed by blunt objects (24, 21%). Open globe injuries (OGIs) were more common (85, 48.3%) as compared to closed globe injuries (CGIs) (71, 40.3%) and nonglobe injuries (20, 11.4%). Mean OTS was 2.8 in 11-16 years indicating a good final visual outcome. Final visual outcome on multivariate analysis showed that the odds of blindness in CGI were 82% less as compared to OGI (odds ratio [OR] 0.18 [confidence interval (CI) 0.03-0.88]; P < 0.03) and that in late presenting (>6 h) group was 47% more (OR 1.47 [0.13-16.47]; P < 0.75) compared to early reporting group.
Conclusion:
Children with ocular trauma commonly present as emergency cases, especially during the festivals in India. Our study reported OGIs to be more common with high risk for blindness. OTS is a useful tool for predicting the visual outcome of OGIs in children. Hence, strategic planning is needed with a focus on the early detection and intervention and also on creating the awareness activities for its prevention. The primary treatment is the key to a successful visual outcome.
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