Aetiology and outcome of open and closed globe eye injuries in children

Abstract

This paper reports on the aetiology and outcome of childhood open and closed globe eye injuries presenting to the Children's Hospital at Westmead, Sydney, Australia from January 2000 to December 2008. Hospital-based retrospective study. Two hundred three cases of childhood eye injuries identified in a nine-year period, comprising 81 open globe and 122 closed globe injuries. Hospital records were examined for demographic data and injuries were classified into open globe and closed globe, based on the Ocular Trauma Classification. Parameters affecting the final visual outcome such as type of injury, zone of injury, initial visual acuity, wound length (only in open globe injuries) and lens injury were assessed. Most of the eye injuries resulted from the child poking itself or being poked accidentally (26%), with the home being the most common place of injury. A favourable visual outcome was noted with closed globe injuries as compared with open globe injuries (P < 0.01). Parameters that indicated a poor visual outcome included globe ruptures, zone 3 injuries, poor initial visual acuity, wound length >10 mm and lens trauma. Final visual acuity of 6/12 or better was observed in 68% of injured eyes. This study demonstrated improved visual outcomes when compared with previous studies. However, many unsalvageable childhood eye injuries with little useful vision were evident, and most disconcerting is that the majority of childhood eye injuries in this study were preventable.