Abstract
The study assessed the pattern of ocular and adnexal injuries that required surgical intervention among children with the aim of strengthening preventive, curative and promotive eye care services. The ophthalmic surgical database of the facility was retrospectively reviewed to obtain information on children who had surgical intervention due to trauma from 1st January 2004-31st December 2017; these included demographic data; diagnosis, procedure and the type of anaesthesia administered. Epi Info software, version 3.4 was used for analysis. A total of 361 children (aged <18years) underwent a surgical procedure as a result of ocular trauma within the stated period. There were more males 255(70.6%) than females 106(29.4%) with a male:female ratio of 2.4:1. The mean age was 7.7±3.5years, 356(98.6%) participants had general anaesthesia administered, 267(73.9%) were aged ≤10 years. The main indications for surgical intervention were corneal laceration 143(39.6%), traumatic cataract 99(27.4%), corneo-scleral laceration 34(9.4%), lid ± canalicular laceration 21 (5.8%), intraocular foreign body 16(4.4%), ruptured globe 14(3.9%) and limbal rupture 11(3.1%). A higher proportion of males had corneal laceration 104(40.8%, p=0.40), intraocular foreign body 13(5.1%, p=0.25) and ruptured globe 12(4.7%, p=0.17) while a higher proportion of females had traumatic cataract 35(33%, p=0.14), lid laceration 4(3.8%, p=0.76) and scleral laceration 2(2.8%, p=0.33). The observed differences were however not statistically significant. Of 21 participants who had lid injuries 14(66.7%) were aged ≤5years. Of 14 participants who had ruptured globe, 8(57.1%) were aged 11-17years. We observed that a male child is twice more likely to have an ophthalmic surgery due to trauma.
Highlights
The study assessed the pattern of ocular and adnexal injuries that required surgical intervention among children with the aim of strengthening preventive, curative and promotive eye care services.The ophthalmic surgical database of the facility was retrospectively reviewed to obtain information on children who had surgical intervention due to trauma from 1st January 2004
Ocular injury that occurs when there is no full thickness wound of the cornea and sclera is termed “closed globe injury[4], while open globe injury refers to ocular injury which occurs when there is a full thickness wound of the cornea/sclera.[5]
The relative inability of younger children to detect and avoid hazards is contributory.8-9This study revealed that over two-thirds (70.6%) of participants were males. This is comparable to related studies in Nigeria which showed a range of 63%-72.2%.1016This preponderance of the male gender is in consonance with global findings that males are more prone to ocular injuries compared with females with proportions ranging from 60% to over 70% reported in literature.[17,18,19,20,21,22,23]
Summary
The study assessed the pattern of ocular and adnexal injuries that required surgical intervention among children with the aim of strengthening preventive, curative and promotive eye care services.The ophthalmic surgical database of the facility was retrospectively reviewed to obtain information on children who had surgical intervention due to trauma from 1st January 2004-. Injuries anterior to the pars plana (located approximately 5mm posterior to the limbus) will not cut the retina and carry a better prognosis.[6] Posterior injuries cut the retina and often result in a complicated retinal detachment. Long as the child is beyond the age when amblyopia can develop, the initial repair of a corneal or scleral laceration can be followed at a later date with the removal of the lens if the anterior capsule is intact. This „wait-and-see‟ strategy has no deleterious effects on the child other than the necessity for a second general anaesthetic
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