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Traumatically ruptured globes in children

J C Rudd1, E A Jaeger, S K Freitag

  • 1Department of Ophthalmology, Jefferson Medical College, Philadelphia, Pa.

Journal of Pediatric Ophthalmology and Strabismus
|September 1, 1994
PubMed
Summary
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Pediatric traumatic globe ruptures often occur during recreation and outside the home. Smaller corneal wounds and initial visual acuity predict better outcomes, with gun-related injuries showing particularly poor results.

Area of Science:

  • Ophthalmology
  • Pediatric Trauma
  • Emergency Medicine

Background:

  • Traumatic globe rupture in children is a significant cause of vision loss.
  • Understanding injury mechanisms and prognostic factors is crucial for effective management.

Purpose of the Study:

  • To identify the causes of traumatic globe ruptures in pediatric patients.
  • To evaluate the prognostic significance of clinical parameters on visual outcomes.
  • To analyze outcomes specifically for gun-related injuries.

Main Methods:

  • Retrospective chart review of 46 children (≤16 years) with full-thickness globe penetration.
  • Data collection on injury etiology, location, demographics, and clinical parameters.
  • Analysis of visual acuity and final visual outcomes.

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Main Results:

  • Most injuries (59%) occurred during recreation and outside the home; boys were predominantly affected (6:1 ratio).
  • Initial visual acuity was a less reliable prognostic indicator in children compared to adults.
  • Smaller corneal wounds correlated with better visual outcomes; gun-related injuries (22%) had poor visual prognosis, with ricochets being a factor in BB gun incidents.

Conclusions:

  • Recreational activities and non-home environments are common settings for pediatric globe ruptures.
  • Corneal wound size is a key prognostic factor for visual outcome in pediatric globe injuries.
  • Gun-related eye injuries in children necessitate urgent attention due to their severe visual consequences.