Characterization, Epidemiology, and Outcomes of Periocular Dog Bites in Children

To characterize the presentation, management, epidemiology, and long-term outcomes of periocular dog bites in 150 pediatric patients at a tertiary referral center, Texas Children's Hospital in Houston, Texas.

The authors performed a retrospective chart review from 2011 to 2024 of patients with a diagnosis of "dog bite" or one of 120 eye-related International Classification of Disease (ICD)-10 codes, and an inpatient ophthalmology consult. They collected data on clinical presentation, work-up, management, and outcomes.

The authors identified 150 patients with periocular injury (mean age = 5.1, SD = 3.80, range = 0.75-16 years; 47.3% male, 52.7% female). Common injuries included eyelid lacerations (92.7%), canalicular lacerations (25.3%), brow lacerations (15.3%), and orbital fractures (12.0%). The mean age of patients with and without orbital fractures was 2.1 and 5.4 years ( p = 0.010). Infection was diagnosed in 15 patients (10.0%). Using multivariate logistic regression, age ≤2 was a predictor of infection (adjusted OR = 1.12, p = 0.017). Initial administration of intravenous antibiotics, repair in the emergency department versus operating room, and time to repair ≥12 hours were not statistically significant predictors of infection (adjusted odds ratio = 0.91, 0.99, 0.99; p = 0.10, 0.83, 0.92, respectively). Common surgeries included eyelid laceration repair (82.0%), canalicular repair (26.0%), and orbital fracture repair (2.0%).

The authors demonstrate an increase in dog bites over time, with a spike in 2020. Most bites resulted from a familiar animal; the American Staffordshire terrier (pitbull) was the most common known breed. Eyelid lacerations and injuries to canaliculi, brows, and orbits are most common. Complications and reoperations are rare. Physicians should counsel families on safe interactions with dogs.