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Background:
Pediatric 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.
Methods:
A total of 268 cases of pediatric ocular trauma admitted t...
Citations
... Many studies have evaluated the effectiveness of these two scoring systems in pediatric populations. [5,[7][8][9][10] Building on previous research, Cohen et al. formulated a new Modified Pediatric Ocular Trauma Scoring (MPOTS) system by omitting parameters that do not affect prognosis in pediatric age groups. [6] They concluded that this new method is easier to use and more effective. ...
... Some studies suggest that OGI is more common in children younger than 7 years, while others indicate a higher prevalence in the age group of 7-12 years. [7][8][9][10] In the study by Cohen et al., age was excluded from MPOTS staging because it was not predictive, [6] aligning with our findings. While the literature shows that ocular trauma in the pediatric age group is more common in males, there are also studies suggesting no gender difference, especially in the pre- school age group. ...
... Previous studies vary, with some indicating a higher incidence of in-home injuries, while others report the opposite. [2,[7][8][9][10] Most injuries in our study were penetrating. Two patients had an IOFB, and four had globe rupture. ...
Background:
This study aims to assess pediatric patients with Open Globe Injury (OGI) using the Modified Pediatric Ocular Trauma Score (MPOTS) and to investigate the correlation between Neutrophil-to-Lymphocyte ratio (NLR) and Platelet-to-Lympho-cyte ratio (PLR) parameters with the prognosis determined by MPOTS.
Methods:
In this retrospective study, we included pediatric patients with OGI. Recorded data encompassed demographic details, injury type, duration from injury to surgery, complete ophthalmological examinations, initial and final visual acuities, anterior segment and fundus findings, and NLR and PLR values. Patients were categorized into three groups based on their MPOTS scores: Grade I (≤30 points), indicating high risk; Grade II (35-65 points), moderate risk; and Grade III (≥70 points), low risk. Differences between categories were statistically evaluated.
Results:
The study comprised 22 patients. In Category I, the duration from injury to surgery was longer (p=0.018). The most common injury type in this category was globe rupture, occurring in four (50%) patients, with a significant difference noted between the groups (p=0.041). Category I exhibited lower final visual acuity and higher NLR and PLR values compared to the other categories (p<0.050 for all values). Both NLR and PLR demonstrated significant negative correlations with MPOTS (respectively, r=-0.869, p<0.001; r=-0.809, p<0.001).
Conclusion:
The Modified Pediatric Ocular Trauma Score is an effective and practical method for assessing the prognosis of pediatric patients with Open Globe Injury (OGI). Furthermore, there is evidence indicating a negative correlation between MPOTS and the increase in NLR and PLR values that often follows OGI in this patient population.
... Although the cause in adults is usually occupational injuries, injuries in children often result from the penetration of sharp objects such as glass, scissors, and knives [9,10]. Existing literature includes studies investigating the epidemiology, etiology, and prognosis of ocular injuries in different age groups in childhood [11,12]. However, to the best of our knowledge, OE in children aged 0-2 years have not been reported earlier. ...
Ophthalmologic emergencies (OE) in the pediatric age group are classified as traumatic or nontraumatic, potentially causing partial or total visual loss. These emergencies, which are significant contributors to acquired visual impairment or loss, hold a prominent position in emergency department visits globally. This retrospective study aimed to analyze the demographic, etiological, and clinical characteristics of patients aged 0–2 years who were brought to the Emergency Department (ED) with ophthalmologic emergencies and requested ophthalmologic consultation. Age (month), sex, complaint etiology, affected eye (right or left), diagnosis, examination findings, treatment, and clinical progression were analyzed. Of the patients, 26 who met the inclusion criteria were included in this study. The median age was 20 (14.75–24) months; 5 (19.2%) children were aged less than 1 year and 21 (80.8%) were aged more than 1 year. Three of the patients (11.5%) were refugees. When the cases were grouped as infective and noninfective eye emergencies, the diagnosis of conjunctivitis was statistically significant between refugee and nonrefugee children (p=0.032). Traumatic injuries were more common in children aged 13–24 months, which was statistically significant (p=0.029). Only a small proportion of children brought to emergency departments with ocular complaints actually have a genuine emergency necessitating consultation. Early pediatric patients, in particular, should undergo a more meticulous systemic examination. It is crucial to explore the presence of severe emergencies that could lead to vision loss, one of our most vital senses, in every patient.
... Ten patients (52.6%) had visual acuity better than 0.5 after surgical repair. A previous study showed that 65.4% of patients achieved a visual acuity better than 0.5 after surgery [11]. The proportion of the children who achieved a visual acuity of 6/12 or better was reported in a wide range from 36% to 92%, in different studies evaluating the treatment outcomes of pediatric eye injuries [12][13][14]. ...
... The place where the injury occurred, differs according to the age of the children. It has been reported that childhood ocular traumas in the preschool age occur most frequently at home [8,11,13]. In our study, eye injuries most commonly occurred on the street (57.8%), which is an expected result considering the geographical location and sociocultural level of the region where this study was conducted. ...
... Most studies on pediatric eye injuries have shown that the incidence of closed globe trauma is higher than that of open globe injury [1,11]. However, in our study, the incidence of open globe injury was higher than that of closed globe injury. ...
... 24 In a 5-year epidemiological study in Lithuania, the most common type of ocular trauma was blunt trauma, similar to the present study. 25 In two cohort studies conducted in India, blunt trauma was also the most prevalent form of ocular trauma. 26,27 Although we did not assess the different reasons for blunt trauma in this study, some studies mentioned the different causes. ...
Purpose:
To determine the prevalence of different types of ocular trauma and their relationship with some factors in the elderly population.
Methods:
The present population-based cross-sectional study was conducted on the elderly population aged 60 years and above in Tehran, Iran, using multi-stage stratified random cluster sampling in 2019. After selecting the samples and their participation in the study, demographic information and history of ocular trauma were obtained through an interview. Psychological evaluation was performed using the Goldberg's 28-question General Health Questionnaire. All study participants underwent optometric and ophthalmological examinations.
Results:
Three thousand three hundred and ten people participated in the study (response rate: 87.3%). Of these, 1912 individuals (57.8%) were female and the mean age of individuals was 68.25 ± 6.55 (from 60 to 97) years. 7.46% (95% confidence interval [CI]: 6.51-8.41) of the study participants reported a history of ocular trauma. Blunt and chemical traumas were the most and the least common types of ocular trauma, respectively (5.72% and 0.16%). 3.93% of cases visited an ophthalmologist for ocular trauma, 1.67% reported a history of hospitalization, and 1.47% underwent surgery. The prevalence of visual impairment in individuals with a history of ocular trauma was 12.53%. Visual impairment was more prevalent in people with a history of ocular trauma than those without a history of ocular trauma (P < 0.05). History of ocular trauma was only significantly related to low education level (odds ratio = 0.63, 95% CI = 0.40-0.99). Participants with a history of ocular trauma had more anxiety and higher mean psychological distress score than those without a history of ocular trauma (P = 0.035).
Conclusions:
The development of preventive programs against the occurrence of ocular trauma can play an important role in reducing the psychological damage of affected patients while reducing visual disorders. These interventions should be especially considered in groups with a lower education level.
... Annually, more than quarter million children sustain eye injuries that require hospitalization (3). Pediatric population groups are at increased risk because of greater exposure to hazards, decreased ability to avoid or detect hazards, immature motor skills, limited common sense and a lower likelihood of functional recovery following eye injury (4). Ocular injuries are among the leading causes of deprivation amblyopia, bilateral low vision, non-congenital monocular blindness, and long-term acquired visual disability (4,5). ...
... Pediatric population groups are at increased risk because of greater exposure to hazards, decreased ability to avoid or detect hazards, immature motor skills, limited common sense and a lower likelihood of functional recovery following eye injury (4). Ocular injuries are among the leading causes of deprivation amblyopia, bilateral low vision, non-congenital monocular blindness, and long-term acquired visual disability (4,5). ...
Objective: In this study, it was aimed to evaluate the reasons for visits, demographic and clinical characteristics of patients, the methods of approach to these patients who visited the pediatric emergency service and were consulted to ophthalmology. Material and Methods: The files of patients consulted to the Ophthalmology Clinic from Pediatric Emergency Department were analyzed retrospectively. Age and gender distribution of patients, complaints at the time of visits, clinical characteristics, diagnoses, diagnostic examinations and treatment methods were recorded. Results: Of the 241 patients, 164 (68.0%) were male and 77 (32.0%) were female. The median age was 11.0 (3.0-15.0) years. According to age groups, the highest number of patients was in the 12-17 age group with 117 (48.5%) patients. The most common complaints were foreign body in eye with 30.3% (n=73), eye redness with 10.8% (n=26), sticky eye with 8.3% (n=20) and eyelid swelling with 8.3% (n=20). The most common diagnoses were foreign body (31.1%, n=75), conjunctivitis (26.1%, n=63) and corneal epithelial defect (10.0%, n=24). Considering the distribution of diagnoses by age groups, conjunctivitis was the most common in the 0-5 and 6-11 age groups, foreign body in the 12-17 age group. While medical treatment was given to 59.3% (n=143) of the patients, intervention under local anesthesia was performed for 29.5% (n=71) of the patients. Of the seven patients that were hospitalized, five of them were treated under general anesthesia and two of them received surgical operations. Conclusion: Pediatric emergency visits with eye complaints in children were most common between 12-17 years of age and the most common cause was foreign bodies in the eye. All hospitalized patients were 0-5 years old and the most common reason for hospitalization was foreign bodies. Clinicians' awareness should be increased on common pediatric eye emergencies accordingly.
... [1] Various studies have reported a wide variation in pediatric ocular injuries among developed and developing countries and also among the rural and urban populations of the same country. [3][4][5][6][7][8][9] The epidemiological pattern of ocular trauma in children varies based on the geographical region, age, and gender. According to several studies, children below 18 years account for 25.4% of ocular injuries. ...
... Children are at risk of ocular trauma because of their inability to avoid hazards, tendencies to experiment with new objects, and to imitate adult behavior, lacking awareness of the consequences. [7] The critical age of binocular vision development and high risk for amblyopia development is seen in the first 7 years of life. In this study, males (74.6%) were affected more than females which is similar to other studies. ...
... In this study, males (74.6%) were affected more than females which is similar to other studies. [7,8] The highest incidence of ocular injuries occurred among the age of 6-10 years (44.7%) which is similar to the studies from by Miratashi and Al-Bdour and Azab who reported maximum injuries occurred in 8-12 years (58.3%) and 6-10 years, respectively, but different from El-Sebaity et al. where 2-7 years children were affected. ...
PURPOSE: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSION: 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.
Keywords:
Blindness, closed globe injuries, firecracker, open globe injuries
... Previous studies have reported the characteristics and management of pediatric ocular trauma patients in various countries [2,[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20], but data from pediatric EDs in Japan are still scarce. The present study aimed to describe the characteristics and management of pediatric ocular trauma patients who visited a pediatric ED in Japan. ...
Introduction:
Pediatric ocular trauma is a common complaint in pediatric emergency departments (ED) and is a major cause of acquired monocular blindness. However, data on its epidemiology and management in the ED are lacking. The objective of this study was to describe the characteristics and management of pediatric ocular trauma patients who visited a Japanese pediatric emergency department (ED).
Methods:
The present, retrospective, observational study was conducted in a pediatric ED in Japan between March 2010 and March 2021. Children younger than 16 years who visited our pediatric ED and received the diagnosis of ocular trauma were included. ED visits for follow-up examinations for the same complaint were excluded. The patients' sex, age, arrival time, mechanism of injury, signs and symptoms, examinations, diagnosis, history of urgent ophthalmological consultation, outcomes, and ophthalmological complications were extracted from electronic medical records.
Results:
In total, 469 patients were included; of these, 318 (68%) were male, and the median age was 7.3 years. The incident leading to trauma occurred most frequently at home (26%) and most often involved being struck in the eye (34%). In 20% of the cases, the eye was struck by some body part. Tests performed in the ED included visual acuity testing (44%), fluorescein staining (27%), and computed tomography (19%). Thirty-seven (8%) patients underwent a procedure in the ED. Most patients had a closed globe injury (CGI), with only two (0.4%) having an open globe injury (OGI). Eighty-five (18%) patients required an urgent ophthalmological referral, and 12 (3%) required emergency surgery. Ophthalmological complications occurred in only seven patients (2%).
Conclusion:
Most cases of pediatric ocular trauma seen in the pediatric ED were CGI, with only a few cases leading to emergency surgery or ophthalmological complications. Pediatric ocular trauma can be safely managed by pediatric emergency physicians.
... Es importante destacar que al tratarse de una paciente con parálisis cerebral infantil, la mayoría de los datos clínicos previamente descritos, no fueron referidos por la paciente, lo cual hizo el abordaje integral más complejo e interesante. (7)(8)(9)(10)(11)(12) El hematoma retrobulbar requiere de un abordaje integral y urgente; retrasar el tiempo de intervención quirúrgica, compromete la integridad del globo ocular y conlleva a un desenlace desfavorable. En tiempos de la COVID-19, las restricciones sociales y sanitarias, retrasan la activación del sistema de emergencia en todo el mundo. ...
... This is similar to the study by El-Sebaity et al, [7] but some reports have found increasing OGI risk in the 7-12 years old age group. [8][9][10] Different studies showed different ratios of female OGL, but all agree that males' injury is statistically higher than females' injury, which is related to the propensity of the male gender to higher risk activities with less parental supervision as part of their natural growth. [4,[11][12][13][14][15] Besides, the differences between the sexes among the older age groups (12-18 years) increased significantly, and there was a negative correlation between age and incidence of OGI in females. ...
... Analysis of OGI in this report revealed that penetrating injuries were the most common type of ocular trauma (60.9%), which was consistent with data published by Puodžiuvienė et al. [8] The rate of globe ruptures was 7.3%, which was lower than the data reported by Court et al. [27] OGI with IOFB is more often experienced in adults. However, it is not rare in children. ...
Purpose:
To evaluate the epidemiological features of open globe injury (OGI) in a tertiary ophthalmic center in the south of Iran.
Methods:
The medical files of pediatric patients diagnosed with OGI between March 2014 and March 2019 were reviewed retrospectively. Demographic data, laterality, time of injury, cause of trauma, location and mechanisms, complications, and the involved tissues, visual acuity, type of operation, and antibiotic therapy were all analyzed. Data were processed using the SPSS.
Results:
In total, 110 eyes of 108 patients were included. Ages < 7 years comprised 49.1%, 7-12 years 26.4%, and 13-18 years 24.5% of cases. Of the 108 patients, 76 (70.3%) were males. No significant difference between right versus left eyes was seen. The incidence of OGI was lowest in winter and highest in spring, and it had more prevalence on the weekends. Sharp objects were the most common cause of OGI in ages < 7 years, while blunt objects, accidents and falls, and guns and fireworks were more prevalent in older children. Home was the most common place of injury overall. The most common type of injury was penetrating trauma. Upon arrival, most of the children had a visual acuity < 0.1 decimal. Primary wound closure was the most prevalent type of surgery done predominantly within 24 hr from admission time.
Conclusion:
Ages < 7 years and male gender were the most common age and sex of pediatric OGI, respectively, and sharp objects were the predominant etiology. Early management and primary repair are essential for prevention of complications such as endophthalmitis and amblyopia.
... Ocular trauma may cause irreversible visual impairment, and its incidence in younger patients is higher than that of other ocular diseases (2)(3)(4)(5). Therefore, socioeconomic costs tend to be substantially higher on the patients (6). ...
Background:
Ocular trauma can cause irreversible visual impairment, and its incidence is higher than that of other ocular diseases in young patients. Past studies on ocular trauma have been limited in terms of small sample sizes, specific age groups, or a short period of assessment. Moreover, no studies have yet investigated the effects of changes in lifestyle during the coronavirus disease 2019 (COVID-19) pandemic on these trends. Therefore, we aimed to determine the yearly trends in the incidence of various ocular traumas over a 10-year period (2011-2020), and to evaluate the effects of the COVID-19 pandemic on these trends.
Methods:
In this nationwide, population-based, cross-sectional study, we recorded the yearly number of patients diagnosed with hyphema and those who underwent open reduction surgery for orbital blowout fracture (BOF), primary closure of the cornea or sclera (PCCS), and intraocular foreign body (IOFB) removal.
Results:
While the annual incidence of closed-globe injuries and PCCS decreased significantly in age groups less than 60 years over the past 10 years, the incidence of surgery for BOF and IOFB increased significantly in age groups greater than or equal to 60 years during the same period. When the 2020 data were compared with data from 2011-2019, hyphema showed the largest decrease (47.24%) in incidence among all ocular traumas, reaching significance in those ages less than 20 years (64.41%, P=0.004); the incidence of surgery for BOF also showed the largest decrease, in patients age less than 20 years. In the population age greater than or equal to 60 years, higher incidences of surgery for BOF and IOFB were observed (13.08% and 25.53%, respectively).
Conclusions:
While the incidence of closed-globe injuries has decreased over the past 10 years in age groups less than 60 years, those age with more than 60 years have become more prone to serious ocular trauma. During the COVID-19 era, the incidence of closed-globe injuries fell markedly in patients younger than 20 years of the age, possibly due to social distancing which involved school closures and reduction in outdoor activities.
