Open Globe Injuries In Children Research Articles

Ocular trauma score calculation for prognosis in open-globe injuries in children

PROBLEMSTELLUNG: Das Ziel dieser Studie liegt darin, den prognostischen Wert von Ocular-Trauma-Score (OTS) und die Folgen nach offenen Augenverletzungen bei Kindern an der Augenabteilung des Universitatskrankenhauses Maribor im Zeitraum von Januar 2000 bis zum Dezember 2009 zu bewerten. PATIENTEN UND METHODEN: Unsere Studie umfasste die Bewertung von Krankengeschichten und Operationsdaten aller Patienten, die junger als 18 Jahre waren und einem chirurgischen Eingriff bei einer offenen Augenverletzung unterzogen wurden. Bei der Erstprasentation wurden die OTS-Variablen wie in der OTS-Studie (Eingangsvisus, Rupturen, End-ophthalmitis, Penetrationsverletzung, Netzhautablosung und afferenter Pupillendefekt) zur Bestimmung des OTS Punktenwerts verwendet und in OTS Kategorien (1 bis 5) eingeteilt. Die Ergebnisse wurden mit den Resultaten der OTS Studie verglichen. Unsere Studie umfasste 28 Kinder (28 Augen) mit einer offenen Augenverletzung. Der Visus wurde in funf Gruppen eingeteilt: keine Lichtscheinwahrnehmung, Lichtscheinwahrnehmung/Handbewegung, 1/200–19/200, 20/200–20/50, ≥ 20/40. ERGEBNISSE: 14,3% (4 von 28) der Patienten waren weiblich und 85,7% (24 von 28) mannlich. Das Durchschnittsalter lag bei 8,9 Jahren (von 2 bis 17 Jahren). Im Durchschnitt erfolgte eine Nachuntersuchung nach 36,3 Monaten (3,0 Jahren), d.h. von 4 Monaten bis zu 120 Monaten. Kein Auge wurde enukleiert. Bei allen Augen blieb die Lichtscheinwahrnehmung vor dem chirurgischen Eingriff und bei der Folgeuntersuchung erhalten. In unserer Studie war der endgultige Visus in OTS Kategorien ahnlich wie bei der Gruppe aus der OTS-Studie, auser bei Lichtscheinwahrnehmung/Handbewegung in der Kategorie 1 (p < 0,001) und bei 1/200–19/200 in der Kategorie 2 (p < 0,001). Der endgultige Visus lag bei 20/20 in allen Fallen in der OTS Kategorie 5 und in keinem Fall der Kategorie. Die Prognose ist durch Art der Verletzung und den Umfang der initialen Schaden bedingt und besser fur jene Augen, die nur einen primaren Eingriff benotigen. SCHLUSSFOLGERUNGEN: Die Ermittlung von OTS ist daher bei einer primaren Untersuchung nicht nur bei Erwachsenen sondern auch bei Kindern zu empfehlen, um eine fruhe und zuverlassige Prognose zu erstellen. Die Methode ist einfach und gibt Anweisungen fur weitere Entscheidungen.

Comparison of the Clinical Presentation and Visual Outcome in Open Globe Injuries in Adults and Children over 30 Months

To compare the clinical presentation and final visual outcome of open globe injuries in children and adults in a referral hospital over a 30-month period. This is an institutional-based prospective study of open globe injuries cases presenting in the emergency department between July 2003 and December 2005. Patients were divided in 2 groups: group 1, children (2-15 years), and group 2, adults (>15 years). All the patients were admitted and emergency surgical interventions were undertaken. The clinical features at presentation and the final visual acuity are compared. Chi-square and Fisher exact tests were used for statistical analysis. Ninety and 84 patients were included in group 1 and group 2, respectively. The most common places of injuries were home or while playing outdoor games in group 1 (67%) and workplace in group 2 (53.5%). The presenting features were significantly more grave in group 2. These included poor presenting visual acuity (p=0.012), vitreous prolapse (p=0.002), presence of relative afferent pupillary defect (p=0.001), and incidence of endophthalmitis (p=0.004). Time interval between injury and surgical intervention (p=0.018) was better in group 2. Other features, such as presence of hyphema, uveal tissue prolapse, cataract, intraocular foreign body, and length or location of laceration were similar in both groups. The final visual outcome was similar in the groups (p = 0.21), with approximately half of the patients achieving vision of 20/60 or better in each group. The majority of injuries in children and adults occurred in their homes or workplaces, respectively. Although the clinical presentations of open globe injuries were significantly more grave in adults than in children, the final visual outcomes were similar.

Prognostic indicators of open globe injuries in children

Purpose To determine the prognostic indicators of visual outcome in children with open globe injuries. Basic procedures The charts of 62 patients, 16 years of age or younger, who had been treated for open globe injuries were reviewed. Main findings The types of injury included penetrating (30 eyes), rupture (20 eyes), intraocular foreign body (10 eyes), and perforation (2 eyes). Sharp objects, such as knives or scissors, were the most common causes of open globe injuries. A visual acuity (VA) of at least 20/40 was achieved in 80.8% (21/26) of eyes with a corneal injury only, in 45.5% (5/11) of eyes with additional lens damage, and in 17.4% (4/23) of eyes with extensive anterior and posterior injuries. Conclusions Unfavorable outcomes were related to the location of injury, the extent of injury, the initial presentation of hyphema, vitreous hemorrhage, retina detachment, cornea wound across the pupil, and the development of endophthalmitis.

Outcome and Prognosis of Pediatric Patients With Delayed Diagnosis of Open-Globe Injuries

Open-globe injuries in children can present in a delayed fashion, potentially increasing the risk of endophthalmitis and delaying surgical intervention. This article presents the outcome of pediatric patients with delayed diagnosis of open-globe injuries for 24 hours or more. The study was a retrospective observational case series of patients who presented with open-globe injuries diagnosed 24 hours or more after the injury between July 2002 and March 2007. Thirteen patients were included in the study. The average age at presentation was 5.8 +/- 2.8 years; average follow-up was 11.5 +/- 14.5 months. Mean time of presentation after injury was 9.2 +/- 16.0 days. The most common chief complaints were chronic red eye (7 of 13 patients), eye pain (5 of 13 patients), and decreased vision (4 of 13 patients). All patients had self-sealing corneal wounds; 8 of 13 patients had a visually significant traumatic cataract. One patient had sympathetic ophthalmia. Initial visual acuity was 20/200 or worse in 10 patients, and final visual acuity was 20/40 or better in 6 patients. No patient had endophthalmitis. Open-globe injuries, especially self-sealing corneal wounds, can present in a delayed fashion in children or may be missed if obvious findings, such as subconjunctival hemorrhage or prolapsed iris tissue, are not present. Pediatricians should be educated that they should maintain a high level of suspicion in the setting of chronic unilateral red eye, decreased visual acuity, or abnormal red reflex.

Visual predictive value of the ocular trauma score in children

Background/aims:To analyse the predictive value of ocular trauma score (OTS) in open-globe injuries in children.Methods:Thirty open-globe injuries in children 16 years or younger treated at our facilities were included. OTS...

Open globe injuries in children: factors predictive of a poor final visual acuity

Eye injuries are the leading cause of monocular blindness in children and are challenging to manage. However, limited follow-up studies currently exist. We describe the clinical characteristics and outcomes of open globe injuries presenting to a major UK centre and discuss factors affecting long-term prognosis. Identification of (1) demographic features, (2) causes, types and location of injuries, (3) initial clinical features and correlation with visual outcome, and (4) predictors of poor visual outcome. Retrospective study by reviewing and analysing records of 20 patients, aged 16 years and below, who had undergone repair of an open globe injuries at the Manchester Royal Eye Hospital, UK. Data recorded included demographic data, mechanisms and location of injury, visual acuity, clinical signs on presentation, surgical procedures, postoperative complications, and final visual acuity. The study group comprised of 85% male subjects, 15% female subjects. The average age was 9.8 years (range: 1-15). Average follow-up was 16.3 months (range: 3-48 months). Sharp objects (mainly glass or knife) accounted for the majority (65%) of injuries. Initial clinical signs associated with poor visual outcomes included poor initial visual acuity, cataract, RAPD, and no initial red reflex. Younger patients and blunt injuries (especially BB gun injuries) had worse visual outcomes. Factors suggesting unfavourable final visual acuity after open globe injuries in children are (1) young age at presentation, (2) poor initial visual acuity, (3) presence of a relative afferent papillary defect, (4) absence of red reflex, (5) cataract, and (6) types and number of surgeries performed.Awareness and education with regard to prevention of paediatric injuries need to be actively implemented.

Presentation and outcome of occult open globe injuries in children

Presentation and outcome of occult open globe injuries in children

Open globe injuries in children

Purpose: A retrospective review of open globe injuries in children was performed to identify the common types of injury and to correlate features of the injuries and surgical management with visual prognosis. Methods: The hospital records of 70 patients were reviewed to determine demographic data, the nature and location of the injuries, the anatomic and functional status of the injured eye before the initial repair, the details of all primary and subsequent surgical procedures, and the final visual outcome. Results: Fifty of the patients studied (71%) were male and 20 (29%) were female. The average age of the patients was 5 years. Sharp objects caused the majority of injuries (67%). Most of the injuries happened at home (72%). The cornea was involved in a majority of the injuries (92%). Thirty-two eyes (46%) required only primary repair; 15 eyes (21%) required primary repair with anterior vitrectomy and primary lensectomy; 17 eyes (24%) underwent secondary lensectomy or vitreoretinal surgeries, and 5 eyes (7%) were enucleated. Visual acuity of 20 40 or better was achieved by 45% of those patients who required only primary repair. Of those patients requiring a second procedure, 19% had a visual acuity of 20 40 or better. Initial clinical findings associated with an unfavorable visual outcome were retinal detachment, relative afferent pupillary defect, vitreous hemorrhage, and hyphema. Conclusion: The prognosis after an open globe injury in children is strongly influenced by the nature of the injury and the extent of the initial damage. Visual outcome is better in eyes that require only primary repair.