A study on the clinical profile and visual outcome of pediatric ocular trauma in Eastern India.

Abstract

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. 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. 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. 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.