Abstract
ObjectivePediatric ocular trauma represents a major concern for ophthalmologists. Delays in presentation, incomplete exams, inaccurate visual acuity (VA) results, and amblyopia can limit accurately predicting final visual outcomes in pediatric eye trauma. We performed a retrospective clinical study to describe the demographics and causes of eye trauma. We also compared 2 ocular trauma scoring systems, one specifically designed for pediatric trauma, to classify injuries and determine which better predicted VA outcomes. A retrospective chart review of 3 years of pediatric globe trauma was performed. Analysis was focused on mechanisms of injury and VA outcomes. Complex factors that may worsen outcomes were recorded. Ocular trauma score (OTS) and pediatric ocular trauma score (POTS) were used to assign Groups 1–5 to each case. Group 1 was poorest prognosis, Group 5 best. Association between Group and final VA was examined. Accuracy of the two systems was compared.Results23 children met eligibility criteria (13 male). Initial VA averaged 20/200 (range no light perception (NLP)—20/20). Final VA was 20/150 (range no light perception (NLP)—20/20). Objects of injury were sharp metallic household objects (7), miscellaneous (4), toys (3), BB pellets (2), stick/wood (2), pencil/pen (1).
Highlights
Patients who had visual acuity (VA) outcomes for 6 months following initial trauma were included in trauma score analysis
Initial VA was able to be obtained in 16 children and averaged 20/200 (range no light perception (NLP)—20/20)
Average final VA was obtained in 20 children 6 months following injury and was 20/150
Summary
Estimates suggest that 20–50% of ocular injuries presenting to hospitals occur in children [1]. Children experiencing globe trauma can have a more complex clinical course than adults. Unclear mechanisms of injury, and cooperation with eye examination can make the initial assessment less accurate. Longterm recovery can be complicated by amblyopia. Ocular trauma scores have been developed to predict outcomes and assists in triage of globe injury. The significant weight placed on initial visual acuity may inaccurately bias scores in a pediatric population. Sii et al developed a pediatric ocular trauma score to try to offset this phenomenon [2]
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