Ocular Trauma Classification Research Articles

Presentations and Incidence of Ocular Injuries Caused by Motorcycle Accidents in Iraq

Background Motorcycle accidents can be particularly hazardous, as riders are exposed to various risk factors, such as high speeds, lack of protective enclosures, and limited safety features. Aim of the study To describe the ocular injuries associated with motorcycled accidents presented to a tertiary center in Iraq. Patients and methods A multicenter cross-sectional (survey) study that involved 335 cases of motorcycle accidents that presented with unilateral or bilateral ocular trauma. The study was carried out at Ibn Al-Haitham Teaching Hospital, Al-Nauman Teaching Hospital, Al-Diwaniyah Teaching Hospital, and forensic centers located in Baghdad (Iraq capital) and Al-Qadisiyah from 1st of June 2019 to 1st of June 2023. Information regarding ocular injuries was recorded and classified according to the International Ocular Trauma Classification. Results The study involved 335 ophthalmological accidents; the mean age of the patients was 27.84± 9.6 years, most of them were males (96.7%), and there were only 11 females as passengers, 39 (11.6%) had injuries in both eyes. Lesions involving the periorbita, lids, and conjunctiva comprised most of the findings. There were 60.9% of patients with lid lacerations with or without sub-conjunctival bleeding, 22.1% with corneoscleral injury, and 17.9% with commotio retinae. It was the leading cause of decreased visual acuity, with 9% having lens capsule damage with or without iris prolapse and 8.1% having a ruptured capsule, 55.82% of patients had a mild injury, 27.16% had a moderate injury, and 17.01% had a severe injury. Conclusion Eye injury associated with motorcycle accidents mainly affect males in their youth age and has serious outcomes, sometimes ending with blindness.

Insights Into Ocular Resilience: Unraveling the Epidemiology, Prognostic Factors, and Visual Triumphs of Open Globe Injuries in the COVID-19 Era at a Leading Tertiary Care Centre of Western Rajasthan, India.

This study was conducted to describe the epidemiology, prognostic factors, and visual outcomes of open globe injuries (OGIs) at a tertiary care centre in Western Rajasthan, India. Data of OGI patients treated at the Department of Ophthalmology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, from March 2019 to December 2021 were reviewed retrospectively. Demographic details including age, gender, place of injury, wound characteristics (i.e., cause, mechanism, location, and size), visual acuity (VA), and associated ocular injuries were recorded. The Ocular Trauma Classification System (OTCS) and the Birmingham Eye Trauma Terminology (BETT) were used to categorize OGIs. All the data was entered into a Microsoft Excel sheet (Microsoft Corporation, Redmond, Washington, United States) and analyzed with IBM SPSS Statistics for Windows, Version 23.0 (Released 2015; IBM Corp., Armonk, New York, United States). A total of 40 patients with OGIs were included. OGI was discovered to be four times higher in males and 47.5%of the total cases were observed in patients aged 0-15 years, followed by patients aged 16-30 (27.5%). The rupture injury showed a higher incidence rate (32.5%) than the penetrating injury (62.5%). Of all OGIs,75% were grade 4 injuries, with zone 1 being the most often affected zone and wood stick injury being the most prevalent aetiology. A significant difference was noted (p<0.001) in comparing presenting VA with final VA with paired sample t-test. A negative Spearman correlation was noted between age and final VA (r = 0.53, p = 0.000),andthe grade of injury and final VA (r = 0.51, p = 0.001.) Conclusion: Young males were the most susceptible group to sustain OGIs due to their more physical activities. Health education and safety in the workplace and during sports are crucial to reduce the incidence of OGI.

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

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.

Characteristics and Visual Prognosis of Pediatric Open Globe Injury in Shanghai, China

Introduction: The aim of the study was to describe the characteristics of open globe injury (OGI) and the relationship between the complications and visual outcomes in children with this type of injury. Methods: This was a retrospective chart review of 1,664 children, under the age of 16 years, who were hospitalized for OGI between January 1, 2007, and December 31, 2015. Each patient’s age, sex, cause and agent of injury, complications, visual acuity, and classification of ocular trauma were collected for review and analysis. Results: The mean age was 5.6 ± 3.4 years. Right eyes were particularly vulnerable to injury (right eye:left eye ratio = 1.2:1). Traumatic cataract was the most common complication. The average initial and final best corrected visual acuity were logarithm of the minimum angle of resolution (logMAR) 2.04 ± 0.78 and logMAR 1.74 ± 0.88, respectively. Logistic regression analysis showed that hyphema (odds ratio [OR] = 1.850), iris prolapse (OR = 1.702), vitreous hemorrhage (OR = 9.703), retinal detachment (OR = 11.938), endophthalmia (OR = 5.377), intraocular foreign body (OR = 3.346), and initial visual acuity <0.05 (OR = 9.017) were risk factors for visual acuity <0.05 at hospital discharge. Conclusion: OGI was most frequent in preschool children and boys. Right eyes were more vulnerable than left eyes. Poor visual outcomes were associated with hyphema, iris prolapse, vitreous hemorrhage, retinal detachment, endophthalmia, intraocular foreign body, and an initial visual acuity <0.05.

A Simplified Classification of Ocular Trauma

A Simplified Classification of Ocular Trauma

Clinical Characteristics, Visual Outcomes, and Prognostic Factors of Open Globe Injuries.

Background and Objectives: Open globe injuries (OGI) remain an important cause of visual impairment and loss, impacting all ages. A better understanding of the factors influencing visual outcomes is important in an attempt to improve the results of the treatment of OGI patients. The author aimed to contribute to this knowledge with the analysis of clinical characteristics, prognostic factors, and visual outcomes of their cohort of OGI patients. Materials and Methods: A retrospective medical record review was performed for 160 patients (161 eyes) who sustained an open globe injury between January 2015 and December 2017 and presented to the Hospital of Lithuanian University of Health Sciences. Data analyzed included age, sex, type, cause, place of OGI, initial visual acuity (VA), final best-corrected visual acuity (BCVA), and tissue involvement. Open globe injuries were classified using the Birmingham Eye Trauma Terminology (BETT) and Ocular Trauma Classification System (OTCS). Univariate analysis was conducted to evaluate the prognostic factors. Results: The mean age of the patients was 41.9 years. The male-to-female ratio was found to be 8.4:1. The home was the leading place of eye injury (59.6%), followed by an outdoor environment (14.3%) and workplace (11.8%). Penetrating injury accounted for 43.5%, followed by intraocular foreign body injury (39.1%) and globe rupture (13%). Overall, 19.5% of patients regained a good final vision of ≥0.5, but for 48.1% of them, eye trauma resulted in severe visual impairment (BCVA ≤ 0.02). In the univariate analysis, a bad visual outcome of less than 0.02 was correlated with bad initial VA, iris dialysis, hypotony, vitreous hemorrhage, and vitreous prolapse at presentation. Phthisis bulbi was correlated with eyelid laceration, iris prolapse, iris dialysis, hyphema, vitreous prolapse, vitreous hemorrhage, and choroidal rupture at initial examination. Conclusions: Open globe injury remains an important preventable cause of ocular morbidity. This study provides data indicating that open globe injuries are a significant cause of visual impairment in our research group.

Open globe injuries: Epidemiology, visual and surgical predictive variables, prognostic models, and economic cost analysis

Open globe injuries (OGI) represent a visually and economically devastating cause of vision loss. We examined the epidemiology, predictive variables, prognostic models, and economic cost of surgically managed OGI. A retrospective tertiary centre study from 2008 to 2018 of 155 consecutive OGI in individuals aged 16 and older was performed. Medical records review, application of Ocular Trauma Score (OTS) and Classification and Regression Tree Analysis (CART) and cost analysis were undertaken. Key outcomes measured were visual acuity, number of operating theatre visits, prognostication using OTS and CART and estimated costs. Younger males at work with inadequate protective eyewear (89.1%) and falls in the elderly were overrepresented. Inferior visual outcomes were associated with a more severe OTS score, a larger injury zone, increasing age, the presence of retinal detachment, extraocular muscle involvement, intraocular foreign body, and globe rupture (R2 =0.723, p < 0.001). Multiple operating theatre visits were required in the presence of retinal detachment, lens or orbit involvement, work-related injury, globe rupture, and a history of previous intraocular surgery (R2 =0.0423, p < 0.001). Both OTS and CART prognosticated outcomes (p < 0.001). The OTS predicted for no vision (no light perception/enucleation/evisceration) and profound visual loss (worse than 6/120; specificity: both 100%, sensitivity: 88.2% and 88%) whereas the CART predicted for visual survival (light perception or better) and minimal-to-severe visual loss (6/120 or better; specificity: 88.5% and 81.7% , sensitivity: 97.7% and 100%). Estimated annual OGI cost for Australia was AUD48.1-60.5 million (USD37.3-47.0 million). The total cost of OGI is immense with young males and the elderly being disproportionately affected. Implementation of targeted government legislation and public health preventative measures may be cost-effective in ameliorating the significant burden.

Socioeconomic Status and Decreasing Incidence of Ocular Injuries in Bosnia and Herzegovina

ABSTRACT Purpose: To examine the epidemiologic and clinical characteristics of ocular injuries and their association with socioeconomic status (SES). Material and Methods: All cases of ocular injuries hospitalized in Department of Ophthalmology of University Clinical Center Tuzla, Bosnia and Herzegovina, from January 2009 to December 2012 and January 2017 and December 2019 were prospectively followed. The injuries were classified according to Ocular Trauma Classification System (OTCS) and Birmingham Eye Trauma Terminology (BETT). Results: This study included a total of 420 eyes from 396 patients. There were 162 (38.57%; 95%CI: 32.86–44.99) open globe injuries (OGI) and 258 (61.43%; 95%CI: 54.16–69.4) closed globe injuries (CGI). The decrease in incidence of ocular trauma requiring hospitalization was noted from 16.7 per 100 000 (95%CI: 13.11–20.97) in 2009 to 9.25 per 100 000 (95%CI: 6.64–12.55) in 2019 (p=0.006). Most injuries occurred in males 341 (81.19%; 95%CI: 72.8–90.28), active working patients 258 (61.43%, 95%CI:54.16–69.4), and patients with rural residence 285 (67.86%; 95%CI: 60.21–76.21). Almost all ocular injuries 418 (99.52%; 95%CI: 90.21–109.54) occurred in patients with middle and lower SES categories, and home was the most prevalent place of injury in 258 (61.43%, 95%CI: 54.16–69.4) patients. The total of 289 (70.49%; 95%CI: 62.59–79.1) patients had good final best corrected visual acuity (BCVA). Poor final BCVA was associated with lower ocular trauma score (OTS) (p=0.000), poor initial BCVA (p=0.000), penetrating injuries of cornea (p=0.004) and sclera (p=0.001), Zone III injuries (p=0.000), intraocular foreign body presence (p=0.000), cataract (p=0.002), retinal detachment (p=0.001), endophthalmitis (p=0.000) and vitreous hemorrhage (p=0.010). Conclusion: This study provides a detailed insight into epidemiology and socio-economic characteristics of patients hospitalized for ocular injuries.

Open-globe injuries in Palestine: epidemiology and factors associated with profound visual loss at St. John Eye Hospital, Jerusalem Riyad Banayot St. John Eye Hospital, Jerusalem, Palestine

Background: The purpose was to describe the epidemiology of open-globe injury (OGI) in Palestine and identify the prognostic factors associated with profound visual loss. Material and methods: The current study is a retrospective review of hospital files for 83 consecutive patients with OGI who presented to St. John Eye Hospital, Jerusalem, within 5 years, between 2009 and 2013. Demographic details included age, gender, wound characteristics, and visual acuity (VA). The Ocular Trauma Classification Group was used for wound location, classification, and scoring for each case. Results: We identified 83 OGI that presented to St. John eye hospital. The study group included 62 males and 21 females. The mean age was 16.66 years ± 3.216. The most frequent injuries were playground injuries (59%), followed by workplace injuries (26.5%). Penetrating injuries represented 45.8% of injuries, and rupture globes occurred in 39.8% of cases. The most frequent objects causing injury were metal (31.3%) and stone (20.5%). Kinetic impact projectiles were a statistically significant poor prognostic factor for the visual outcome. Variables that were statistically significant poor prognostic factors for visual outcome included: retinal detachment, macular scar, vitreous hemorrhage. Conclusion: This study showed that the act of demonstration, street injuries, kinetic impact projectiles, zone III injuries, globe disruption, retinal detachment, vitreous hemorrhage, and a poor VA at the first visit are poor prognostic factors for OGI. Recognition of these prognostic factors will help the ophthalmologist evaluate the injury and its prognosis.

Combat-related ocular trauma and visual outcomes during counter-terrorism urban warfare operations in Turkey.

The study was to report the clinical features and post-operative outcomes in military personnel admitted to the Ocular Trauma Center of Gülhane Training and Research Hospital after sustaining combat injuries in urban warfare. This is a retrospective, non-comparative, interventional case series analyzing Turkish military personnel transferred to our tertiary ocular trauma center from the warfare zone and combat support hospitals. Ocular injuries were subdivided into zones and ocular trauma classification. There were 103 combat ocular injuries in 74 military personnel. The average age was 27.31±4.64 years (range; 21-48 years), and all were men (100%). The average follow-up was 529.34±213.98 days (288-1464 days). There were 84 open-globe and 19 closed-globe injuries. Thirty-six (34.9%) had final vision of 20/40 or better. Pars plana vitrectomy was the most common surgery (79.6%). Five eyes underwent evisceration, and seven eyes developed phthisis bulbi. The globe survival rate was 88.3%. Zone III injuries (32.2%) were the most common cause of unfavorable visual outcomes, and most injuries were caused by improvised explosive devices (IEDs) (59.2%). These devices also had the worst impact on globe survival and visual improvement. These eyes had a higher likelihood ratio of requiring globe removal surgery or developing phthisis bulbi [odds ratio: 21.5 (95% CI: 1.23-373)]. Two eyes that underwent keratoprosthesis-assisted pars plana vitrectomy followed by penetrating keratoplasty (PKP) during the same session developed PKP failure while failure was not seen in any of the cases that underwent PKP in a later session. Ocular injuries related to IEDs had the most significant impact on both visual and anatomic prognoses, and globe survival was less likely in eyes with zone III trauma, in which intraocular foreign bodies penetrated the choroid. There is a higher pos-sibility of PKP failure if this procedure is performed during the same session as other ocular surgery.

Observation and Epidemiology of Ocular Trauma in Children: Hospital based Study

Background: This study was designed to identify the causes, demographic, clinical profile &amp; classify the patients according to the ocular trauma classification group. Method: 60 children of age fifteen year or less, with ocular injury, who had presented to emergency services/out-patient department of the Regional Institute of Ophthalmology (RIO), IGIMS medical college &amp; hospital, Patna (Bihar) were included. Demographic data, nature and cause of injury, duration between injury &amp; presentation to the hospital and diagnosis were recorded. Evaluation of visual acuity, anterior segment and fundus was done. Results: Majority of injuries occurred in children 7yrs and older (64.7%). There were 50 (83.33%) boys and 10 (16.66%) girls. 40 (66.67%) of cases presented within 24hrs of the injury while 20 (33.33%) of cases presented after more than 24 hr after trauma. Rural patients comprised 39 out of 60 (65 %) while urban were 21 out of 60 (35 %). Most of the patients n=36 (60%) belonged to average socioeconomic status fallowed by low socioeconomic status n=20 (33.33%) &amp; high socioeconomic status n=4 (6.67%). Most of the children n=35 (58.33%) were in their primary school. The highest proportion of injuries occurred outside (eg streets, roads, playgrounds, schools) n=40 (66.67 %) followed by home n=20 (33.33%). Conclusions: Eye trauma in children occur most frequently outdoors. Early diagnosis, management and prevention of complications of ocular injuries can be possible by educating parents and children.

Spectrum of Ocular Trauma Presenting to ophthalmic OPD

Introduction: Ocular trauma is one of the most common causes of vision loss. Etiologies of ocular injury differ from area to area and from country to country, difference according to demographic or socioeconomic classes have been reported. Measures to be taken for prevention of ocular trauma require knowledge of the cause and mechanism of injury, which may enable more accurate planning to prevent such injuries. The classification of ocular trauma with standardized terminology was developed by Kuhn and associates. The International Society of Ocular Trauma subsequently used this terminology to develop a classification system for mechanical injuries of the eye. This study was conducted to identify the etiology and nature of ocular trauma affecting our population. Aim: To identify the causes of ocular trauma and determine the types of various injuries presenting to the ophthalmic OPD Al-Thawra central hospital Al-Baida Libya. Subjects and Methods: 80 patients included in this study Presented to ophthalmic OPD Al-Thawra central hospital AlBaida Libya with history of Trauma during a period of three months. Following data were collected: patient’s age, gender, affected eye, etiology of trauma, place of trauma, visual acuity and Ocular Injury to time of presentation. Result: There were 80 eyes of 80 patients, of which 77.50% were males and 22.50% were females. The ages ranged from 1–50 years. The highest incidence of trauma was seen in the 21– 30-year age group (30.0%). Blunt trauma occurred in 42.5% of cases and foreign body trauma in 33.3% of cases. The highest incidence of eye injury occurred at workplace (50.0%) followed by the Home (22.5%), then Playground (20.0%). Assault-related eye injury was seen in 25% of cases and 75% of all injuries were accidental. Conclusion: Education programs regarding the safety measures to be taken to protect the eyes during work and other activities will be quite helpful to minimize the incidence of ocular trauma among the risk groups.

Frequency and Characteristics of Ocular Trauma in a Tertiary Care Hospital in Lodhran

Purpose: To find the frequency and characteristics of ocular trauma in a tertiary care hospital in Lodhran. Study design: Cross sectional study. Sampling Technique: Convenient non-probability sampling. Place and duration of study: This study was conducted at Shahida Islam Teaching Hospital affiliated with Shahida Islam Medical College, Lodhran from December 2016 to September 2018. Material and Methods: Detailed history and ocular examination were performed with regard to age, gender, classification of ocular trauma, aetiology of trauma, place where trauma occurred, note of ocular damage, nature of object, activity at the time of injury, presenting visual acuity and time lapse before presentation to hospital after trauma were recorded. Results: There were 393 patients included in this study. Mean age of patients was 28.97 ± 12.59 years. There were 198 (50.4%) closed globe and 195 (49.6%) open globe injuries. In 53 (13.5%) cases injury was caused by metal object. In 132 (33.6%) cases injury was classified as contusion. In 146 (37.2%) cases cornea was involved. There were 95 (24.2%) cases that occurred in home. In 156 (39.7%) cases presenting visual acuity was less than 6/60. There were 272 (69.2%) males and 121 (30.8%) females. There were 342 (87.0%) patients who presented within 1 day after trauma. In 122 (31.0%) cases there was prolapse of ocular contents. Conclusion: Ocular trauma occurred more commonly in males. It was blunt and occurred in home setting in most of the times. Most of the eye injuries aetiological agent was metal and wood. Key Words: Blindness. Contusion. Corneal injuries. Ocular trauma.

Visual outcomes and prognostic factors in open-globe injuries

BackgroundOcular trauma is an important cause of visual loss worldwide. Improvements in our knowledge of the pathophysiology and management of ocular trauma during the past 30 years, in conjunction with advances in the instrumentation and techniques of ocular surgery, have improved the efficacy of vitreoretinal surgery in injured eyes. The aim of the current study was to determine the visual outcomes and prognostic factors of open-globe injuries in the Japanese population.MethodsRetrospective study of 59 eyes of 59 patients presented with open globe injuries between September 2008 and March 2014 at Nagasaki University Hospital was conducted.Demographic factors including age, gender, and clinical data such as cause of injury, presenting visual acuity (VA), location of injury, type of injury, lens status, presence of intraocular foreign body, types of required surgeries, and final VA were recorded. According to the classification of Ocular Trauma Classification Group, wound location was classified into three zones. Chi-square test was used to compare presented data.ResultsOut of the 59 patients, 46 were placed in the Light Perception (LP) group, and 13 were placed in the No Light Perception (NLP) group. Work-related trauma was the most common cause (27 eyes) followed by falls (19eyes). Work-related trauma was common in males (P = 0.004), while falls was significantly common in females (P = 0.00001). Zone III injuries had statistically significantly poor prognostic factor compared to other zones (P = 0.04). All cases of NLP group (100%) presented with rupture globe. Poor VA at first visit (P = 0.00001), rupture globe (P = 0.026), history of penetrating keratoplasty (PK) (P = 0.017), retinal detachment (RD) (P = 0.0001), vitreous hemorrhage (VH) (P = 0.044), and dislocation of crystalline lens (P = 0.0003) were considered as poor prognostic factors.ConclusionPoor VA at first visit, rupture globe, zone III injuries, history of penetrating keratoplasty, RD, VH, and dislocation of crystalline lens were found to be poor prognostic factors. PPV had a good prognostic value in open globe injuries associated with posterior segment involvement.

A five-year retrospective study of the epidemiological characteristics and visual outcomes of pediatric ocular trauma

BackgroundPediatric trauma can lead to serious visual impairment as a result of the trauma itself or secondary to amblyopia. Precise data on epidemiological characteristics and visual outcomes of pediatric ocular injuries are valuable for the prevention of monocular blindness.MethodsA total of 268 cases of pediatric ocular trauma admitted to the Department of Ophthalmology of the Lithuanian University of Health Sciences Hospital from January 2008 to December 2013 were retrospectively reviewed. Data analysed included age, sex, cause, type and treatment of injury, initial and final visual acuity (VA) and tissues involvement. Eye injuries were classified by Birmingham Eye Trauma Terminology (BETT) and Ocular Trauma Classification System (OTCS).ResultsThe age of children ranged from 6 months to 17.5 years. Boys were more likely to suffer ocular injury than girls. Home was the leading place of eye injury (60.4%), followed by outdoors (31.7%), school (5.2%) and sporting area (2.2%). The highest percentage of eye injuries in children were caused by blunt (40.3%) and sharp objects (29.9%), followed by burns (9.3%), falls (6.7%), explosions (4.5%), fireworks (4.1%), gunshots (1.9%) and traffic accidents (0.7%). Closed globe injury (CGI) was the most common type of eye injury (53.4%). CGI were noted to be higher in children aged 13–18 years, while open globe injury (OGI) were higher in the pre-school age group. Injury of grade 4 and grade 5 were more common in OGI, while grade 1 and grade 2 predominated in cases of CGI. Hypotony, traumatic cataract, iris laceration, vitreous prolapse and uveitis were the most common presentations of OGI, while hyphema, secondary glaucoma and retinal edema were significantly related with CGI. Final diagnoses contributing to poor final visual outcome such as corneal scar corneal opacity, hypotony, aphakia, and retinal detachment were statistically significant related only with OGI. Overall, 65.63% of children regained good visual acuity (VA ≥ 0.5), but for 18.4% of them, the trauma resulted in severe visual impairment (VA ≤ 0.1).ConclusionOcular trauma in children still remains an important preventable cause of ocular morbidity. This study provides data indicating that ophthalmological injuries are a significant cause of visual impairment in children.

Visual outcome and ocular survival in pediatric ocular trauma

Purpose: Ocular injuries in children are a major under-recognized cause of ocular morbidity and can be prevented by identifying the etiology and implementing measures to prevent these injuries. This study intends to assess the visual outcome and ocular survival in paediatric ocular trauma.&#x0D; Design: A descriptive study set in a tertiary care teaching hospital in Southern India.&#x0D; Methods: A total of 56 children less than 18 years of age with ocular trauma during the period August 2010 to August 2012were studied. Injuries were classified as per modified Ocular Trauma Classification System (OTCS). Final visual outcome was assessed at the end of 1, 3, &amp; 6 months.&#x0D; Results: Of the 56 children assessed 87.5% were that of boys. About 12% were under-fives and almost 66% were in the age range of 5-14 years. And majority (47.45 %) had sustained trauma in the streets. Closed globe injury predominated (69.49%). At presentation, grade I injury noted in 28 eyes (47.45%), grade II in 1 (1.69%), grade III in 3 (5.08%) , grade IV in 8 (13.55%) , PL negative in 3 (5.08 %) and un-cooperative in 16 cases (27.11 %). At six months, good vision noted in 44 eyes (74.6%), moderate in 5 (8.47%), poor vision in 1 (1.69 %), PL negative in 4 (6.77%), un-cooperative 4 cases (6.77%). 4 eyes had phthisis (6.77%) and 1 eye (1.69%) was eviscerated.&#x0D; Conclusions: Ocular trauma in childhood was more common in the male child, mostly due to road traffic accidents. Ocular trauma being a significant cause of visual loss in childhood, awareness campaigns are necessary.

Epidemiology of Open Globe Injury in Children.

The purpose of this study was to evaluate the epidemiology and outcomes of pediatric open globe injury (OGI). The medical records of all patients diagnosed with OGI in the authors' clinic between 1996 and 2015 were screened retrospectively. A total of 893 eyes of 892 patients aged 16 years or younger were included in the study. Open globe injury was classified according to the ocular trauma classification (OTS). Age, sex, history, cause and month of trauma, treatment received, visual acuity at presentation, final visual acuity, and cause of vision loss were recorded. Children aged 16 years or younger comprised 67.7% of all OGI patients within the studied time period. The annual incidence of OGI in children was 5.16 per 100,000 overall, with 6.12 per 100,000 boys and 4.14 per 100,000 girls. Open globe injuries occurred most frequently in the 3 to 7 year age group and in the summer months. The most common scene of injury was playgrounds (50.2%). A strong, linear, negative correlation was found between OTS values and final visual acuity in logMAR (rp = -0.550, P = 0.0001). The authors' study revealed that a high proportion of all OGIs in the authors' region occurred in children under 17 years old. As with adults, OGI in children often results in significant vision loss. However, considering the varying degrees of visual recovery demonstrated by some of the authors' patients, particularly those with no light perception at admission, the authors believe an eye-sparing approach is warranted in pediatric OGI.

Validation of a modified Birmingham Eye Trauma Terminology classification for mechanical eye injuries

Introduction Criticisms have been levelled at the widely accepted Birmingham Eye Trauma Terminology (BETT) classification of mechanical ocular trauma, as it is not specific enough. Alternative modifications to the BETT have been proposed and this study aimed to assess these newer classifications. Methods A prospective cohort study of all patients presenting to the outpatient department between January 2005 and December 2014, who were examined and categorised based on the BETT. Cases which did not comply with the BETT system were placed in additional categories, and documented for each type of injury. Results A total of 4721 eyes suffered mechanical injuries and 1060 (22.4%) could not be classified with BETT, including 368 globe injuries (7%) associated with orbital/ocular adnexa injury; 692 eyes (14.6%) with ocular surface foreign body (OSFB) or ocular wall foreign body (IWFB). There were 77 eyes (1.6%) with contusion, 9 eyes (0.19%) with lamellar laceration-associated OSFB or OWFB, 29 eyes (0.6%) with globe rupture-associated OSFB, OWFB or intraocular foreign body (IOFB) and 60 eyes (1.4%) with laceration-associated OSFB or OWFB. Conclusion The BETT needs modification to be fully applicable to the wide range of ocular trauma seen across the world.

Clinical characteristics and prognosis of pediatric ocular trauma

Objective To analyze clinical characteristics and causes of pediatric ocular trauma. Methods A retrospective study. Data of 39 eyes of 35 children with ocular trauma was collected. The gender, involved eye, causes, site and extent of injury, initial visual acuity, surgical management, postoperative complications and treatment results were observed. Results Of all the pediatric patients, 26 cases were boys, and 9 cases were girls. The age was 5-18 years. Classification of ocular trauma: thermal burn injuries in 1 eye ( 2.6%), open globe injuries in 35 eyes (89.7%), and closed globe injuries in 3 eyes (7.7%). The most common cause of injuries was sharp toll (25.6%), followed by fireworks (20.5%), traffic accidents (15.4%), blunt objects (15.4%), stick (7.7%), crush (2.6%), dog bites (2.6%), fall on the ground (2.6%) and causes unknown (7.7%). The visual acuity improved in 28 eyes (71.8%), remained unchanged in 9 eyes (23.1%), and decreased in 2 eyes (5.1%) after treatment. The follow-up time was 6-48 months. Conclusion Pediatric ocular trauma is prone to boys, and gives priority to perforating injuries. Sharp object injury is the most common cause for open-globe injury. Key words: Ocular trauma, pediatric; Characteristics; Result, treatment

Epidemiology of Child’s Ocular Globe Injury: A Retrospective Study at the University Teaching Hospital-Campus of Lom&amp;#233; (Togo)

Aim: To study clinical and epidemiological characteristics of child’s ocular injuries. Patients and Method: Retrospective study on medical records of children suffering from traumatic injuries of the ocular globe presented to the Campus Teaching Hospital (CHU Campus) of Lome from 3 January 2015 to 30 June 2016 (18 months). Age, sex, nature of the traumatising agent, consultation delay and the width of the injury (zone I, II or III), the classification of ocular trauma, according to “Birmingham Eye Trauma Terminology (BETT) system”, connected lesions have been studied. Results: Twenty children about 46.51% children presented for ocular trauma have been suffering from a globe injury. The average age was 6.68 years with the extremes of 1 year and 12 years; the age bracket of 0 - 5 years was more represented (45%); predominance was more from the female with a sex-ratio = 0.67. Eighty percent of the children were from rural areas while twenty from urban areas. The delay of consultation was less than 24 hours in 40% of cases and 15% consulted between 24 h and 72 h after the trauma. Traumatisms were entirely unilateral and penetrating within a majority of 15 (75%) cases of which a “stick” is the traumatising agent of the most frequent (40%). The seat of the injury was the zone I (85.71%) and zone II (14.29%). Connected lesions were dominated by iris hernia 7 (35%) and traumatic cataract 6 (30%). Conclusion: children’s traumas were high predominantly and they came in majority from rural zones. Prevention through awareness remains the best treatment.