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Incidence and clinical characteristics of pediatric traumatic hyphema from 2000 to 2009 in a population-based cohort
Grayson B Ashby1, Matthew R Claxton2, Brian G Mohney1
1Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota.
Insights
Pediatric traumatic hyphema incidence remains stable, with good visual recovery expected. However, long-term complications like angle abnormalities are common, and follow-up eye exams are crucial.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Epidemiology
Background:
- Traumatic hyphema is a significant cause of vision loss in children.
- Previous epidemiologic data on pediatric traumatic hyphema is limited and outdated.
Purpose of the Study:
- To update epidemiologic data on pediatric traumatic hyphema.
- To assess incidence, injury mechanisms, visual outcomes, and long-term sequelae.
Main Methods:
- Multicenter retrospective, population-based cohort study.
- Included patients <19 years diagnosed with closed-globe traumatic hyphema from 2000-2009.
- Analyzed incidence, injury mechanisms, visual acuity, intraocular pressure, and sequelae.
Main Results:
- Incidence of 19 per 100,000 patients; mean age 13 years.
- Sports and projectiles were common injury mechanisms.
- Good visual recovery (mean final logMAR 0.03), but 41% had long-term sequelae, often angle abnormalities.
Conclusions:
- Pediatric traumatic hyphema incidence is similar to historical data.
- Visual recovery is generally good, but long-term sequelae are common.
- Risk of ocular hypertension/glaucoma is low, but gonioscopy follow-up was insufficient in one-third of patients.
Purpose:
To provide updated epidemiologic data on pediatric traumatic hyphema.
Methods:
This multicenter retrospective, population-based cohort study included all patients <19 years of age diagnosed with a closed-globe traumatic hyphema from January 1, 2000, through December 31, 2009, in a single United States county.
Results:
During the 10-year study period, 70 patients (52 males [74%]) sustained a traumatic hyphema, yielding an incidence of 19 per 100,000 patients. Mean age at diagnosis was 13 years (range, 4.8-18.6). The most common injury mechanisms were sports (43%) and projectiles (23%). Mean logMAR visual acuity at presentation was 0.218 (range, 0.0 to light perception), and 14 patients (20%) had ocular hypertension during the first month post-injury. Microhyphema was present in 27 patients (44%), and 2 (3%) had a grade III hyphema or worse. Mean final logMAR visual acuity was 0.03 (range, -0.1 to 0.54). No patient had persistently elevated or asymmetric intraocular pressure. Long-term sequelae occurred in 29 patients (41%), most commonly angle abnormalities, but 27 (39%) did not undergo gonioscopy during the follow-up period.
Conclusions:
The population-based incidence of traumatic hyphema is similar to that reported five decades ago. Expected visual recovery is good, although long-term sequelae are relatively common. The risk of ocular hypertension or glaucoma following traumatic hyphema is low through young adulthood, but one-third of patients did not receive gonioscopy following injury.
