Epidemiological characteristics and visual outcome after open globe injuries in children

Abstract

To determine demographic, etiologic, clinical characteristics, visual outcome, and the factors affecting visual prognosis in children with open globe injuries. The medical records of 82 patients under the age of 16 years who presented with open globe injuries from January 1998 to January 2009 were retrospectively examined. Age, sex, involved eye, cause, place of injury, wound location, presenting visual acuity, clinical signs, and final visual acuity were noted. The injuries were classified by Ocular Trauma Classification Group Guidelines and Birmingham Eye Trauma Terminology. Most injuries occurred in boys (54/82). The mean age was 8.4 ± 3.7 years. Most patients (37.8%) were in the 3- to 6-year age group. All patients had a minimum of 6 months' follow-up (mean, 23.9 ± 23.2 months; range, 6-114). Pointed metallic objects were found to be the main causative agents. Injuries occurred most frequently in streets (36.3%), homes (18.7%), leisure areas (15.4%), and schools (7.7%). Factors adversely affecting visual prognosis were poor presenting visual acuity, posterior wound location, low ocular trauma score, retinal detachment, afferent pupillary defect, vitreous prolapse, uveal tissue prolapse, and hyphema. Open globe injuries in children occur most frequently in preschool boys. Prognosis is determined by presenting visual acuity, trauma score, and wound severity and location.