Abstract
Objective: To describe the epidemiology, clinical characteristics, and clinical outcomes of pediatric traumatic open globe injuries and to determine the risk factors for poor visual outcome.Methods: The medical records of patients aged younger than 15 years of age who were diagnosed with open globe injuries from January 2005 to December 2015 were retrospectively reviewed. The patients’ demographic data were collected, including age, sex, injury date, place of injury, mechanism of injury, cause of injury, and the activity related to the injury. Clinical data were recorded, including initial visual acuity (VA), wound size, wound location, associated ocular findings at presentation, and complications. The prognostic factors for a poor visual outcome were assessed.Results: In total, 46 pediatric patients were included in this study. The mean age was 6.8 years old. Most patients were male (65.2%). The most common type of injury was penetrating injury (60.9%) and mostly occurred during playing (60.9%). Household appliances/furniture and scissors/knives were common causes of injuries (17.4%, 15.2%, respectively). Poor final VA worse than 6/60 was found in 17 patients (37%). Wound location and retinal detachment (RD) at the time of presentation were significant prognostic factors for a poor visual outcome according to the univariate analysis (p = 0.008, <0.001). Only wound location at zone II and III was found to be significantly correlated with poor final VA in the multivariate analysis (adjusted risk ratio (RR) = 2.87, 95% confidence interval (CI), 1.26-6.55, p = 0.012). Traumatic cataract was the most common associated injury (45.7%).Conclusions: One-third of pediatric patients with open globe injuries had a poor visual outcome. Wound location at zone II and III significantly correlated with a poor visual outcome in pediatric open globe injuries. The parents and caregivers should be made aware of the seriousness of open globe injuries in order to prevent children from possible injuries.
Highlights
In children, monocular visual impairment may disrupt binocular vision and affects visual development, which is very fragile, especially in infants and preschoolers
Our study aims to investigate the epidemiology, visual outcomes, and prognostic factors of open globe injuries among pediatric patients who were treated at a tertiary medical center in central Thailand
A total of 46 pediatric patients (46 eyes) diagnosed with open globe injuries between January 2005 and December 2015 were included in the study analysis
Summary
Monocular visual impairment may disrupt binocular vision and affects visual development, which is very fragile, especially in infants and preschoolers. It can delay a child’s development, mental growth, and learning. Ocular trauma is one of the most significant causes of monocular or even binocular visual loss in children [1], in those who suffer from severe open globe injuries. Our study aims to investigate the epidemiology, visual outcomes, and prognostic factors of open globe injuries among pediatric patients who were treated at a tertiary medical center in central Thailand
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