Clinical and epidemiological characteristics of pediatric patients with post-traumatic open globe injury
Abstract
Purpose: The aim of this study was to determine the epidemiology and clinical features of pediatric traumatic open globe injuries in our region.
Materials and Methods: Medical records of patients under the age of 18 who were diagnosed with open globe injury between January 2012 and December 2022 were retrospectively reviewed. Demographic data of the patients such as age, gender, time of injury, area of injury, type of injury, and cause of injury were recorded. Initial and final visual acuity and ocular findings at admission were recorded. Factors associated with final visual acuity were evaluated.
Results: The mean age of the patients was 7.62 ±4.22 years. The majority of the patients were male (n=28, 66,7%). The right eye was the most injured (n=30, 71.4%). The initial visual acuity of approximately 72.5% (n=29) of the patients was worse than 20/200. And the final visual acuity of 50% of the patients (n=20) was below 20/200. The most common type of injury was penetrating trauma (n=18, 42.9%). The region with the highest trauma was Zone I (n=30, 71.4%). The most traumatic materials were metallic objects (n=13, 31%). The most common accompanying clinical finding was lens damage (n=18, 42.9%). Iris damage, lens damage, hyphema, vitreous hemorrhage, retinal detachment, endophthalmitis, type of injury, material causing the injury, and injury area were significantly associated with final vision.
Conclusion: In our region, open globe injuries were mostly observed in boys under 12 years in the pediatric age group. Penetrating and cutting metallic objects seem to be the most important cause of trauma. Parents and all caregivers should be informed of the seriousness of open globe injuries to prevent possible injuries.
References
- Mulvihill A, Bowell R, Lanigan B, O'Keefe M. Uniocular childhood blindness: a prospective study. J Pediatr Ophthalmol Strabismus. 1997;34:111-4.
- Saksiriwutto P, Charuchinda P, Atchaneeyasakul LO, Surachatkumtonekul T, Phamonvaechavan P. Epidemiology of pediatric open globe injuries in a university hospital in Thailand. Cureus. 2021;13:e19366.
- Lesniak SP, Bauza A, Son JH et al. Twelve-year review of pediatric traumatic open globe injuries in an urban U.S. population. J Pediatr Ophthalmol Strabismus. 2012;49:73–9.
- Madhusudhan AP, Evelyn-Tai LM, Zamri N, Adil H, Wan-Hazabbah WH. Open globe injury in hospital university sains Malaysia - a 10-year review. Int J Ophthalmol. 2014;7:486-90.
- Oğurel T, Oğurel R, Onaran Z, Örnek N, Yumuşak E, Ölmez Y. Epidemiology of childhood globe injuries. Turk J Clin Lab. 2019;10:242-6.
- Ava S, Erdem S, Karahan M, Dursun ME, Hazar L, Keklikci U. Epidemiology and demography of open globe injury in children. Dicle Med J. 2021;48:416-24.
- Yildiz M, Kıvanç SA, Akova-Budak B, Ozmen AT, Çevik SG. An important cause of blindness in children: open globe injuries. J Ophthalmol. 2016;2016:7173515.
- Dogramaci M, Erdur SK, Senturk F. Standardized classification of mechanical ocular injuries: efficacy and shortfalls. Beyoglu Eye J. 2021;6:236-42.
- Tabatabaei SA, Khameneh EA, Soleimani M, Baramaki A. Open globe injuries in children under 7 years referred to a tertiary center in iran from 2006 to 2016. Eye (Lond). 2021;35:1235-39.
- Read SP, Cavuoto KM. Traumatic open globe injury in young pediatric patients: characterization of a novel prognostic score. J AAPOS. 2016;20:141-44.
- Sintuwong S, Winitchai R. Visual outcome in open globe injuries in thailand: a prospective study. Asian Biomed. 2011;5:289-.294.
- Çetin EN, Saraç G, Kaşıkçı A, Avunduk AM, Yaylalı V, Yıldırım C. Epidemiologic and clinical features of open-globe injuries in childhood. Turk J Ophthalmol 2012;42:16-9.
- Thompson CG, Kumar N, Billson FA, Martin F. The aetiology of perforating ocular injuries in children. Br J Ophthalmol. 2002;86:920-2.
- Choovuthayakorn J, Patikulsila P, Patikulsila D, Watanachai N, Pimolrat W. Characteristics and outcomes of pediatric open globe injury. Int Ophthalmol. 2014;34:839-44.
- Abdelazeem K, Al-Hussaini AK, El-Sebaity DM, Kedwany SM. Epidemiology, etiologies, and complications of playtime open globe injuries in children. J Pediatr Ophthalmol Strabismus. 2021;58:385-9.
- Gunes A, Kalayc M, Genc O, Ozerturk Y. characteristics of open globe ınjuries in preschool children. Pediatr Emerg Care. 2015;31:701-3.
- Liu X, Liu Z, Liu Y, Zhao L, Xu S, Su G et al. Determination of visual prognosis in children with open globe injuries. Eye (Lond). 2014;28:852-6.
- Podbielski DW, Surkont M, Tehran iNN, et al. Pediatric eye injuries in a canadian emergency department. Can J Ophthalmol. 2009;44:519-22.
- Batur M, Seven E, Akaltun MN, Tekin S, Yasar T. Epidemiology of open globe injury in children. J Craniofac Surg. 2017;28:1976-81.
- Li X, Zarbin MA, Bhagat N. Pediatric open globe injury: a review of the literature. J Emerg Trauma Shock 2015;8:216-23.
- Staffieri SE, Ruddle JB, Mackey DA. Rock, paper or scissors? traumatic paediatric cataracts in victoria 1990-2006. Clin Exp Ophthalmol. 2010;38:237-41.
- Xue C, Yang LC, Kong YC. Application of pediatric ocular trauma score in pediatric open globe injuries. Int J Ophthalmol. 2020;13:1097-1101.
- Bunting H, Stephens D, Mireskandari K. Prediction of visual outcomes after open globe injury in children: a 17-year canadian experience. J AAPOS. 2013;17:43-8.
- Baxter RJ, Hodgkins PR, Calder I, Morrell AJ, Vardy S, Elkington AR. Visual outcome of childhood anterior perforating eye injuries: prognostic indicators. Eye (Lond). 1994;8:349-52.
- Kadappu S, Silveira S, Martin F. Aetiology and outcome of open and closed globe eye injuries in children. Clin Exp Ophthalmol. 2013;41:427-34.
- Tok O, Tok L, Ozkaya D, Eraslan E, Ornek F, Bardak Y. Epidemiological characteristics and visual outcome after open globe injuries in children. J AAPOS. 2011;15:556-61.
- Rudd JC, Jaeger EA, Freitag SK, Jeffers JB. Traumatically ruptured globes in children. J Pediatr Ophthalmol Strabismus. 1994;31:307-11.
- Meng Y, Yan H. Prognostic factors for open globe injuries and correlation of ocular trauma score in tianjin, china. J Ophthalmol. 2015;2015:345764.
- Chaudhary A, Singh R, Singh SP. Prognostic value of ocular trauma score and pediatric penetrating ocular trauma score in predicting the visual prognosis following ocular injury. Rom J Ophthalmol. 2022;66:146-52.
Abstract
Amaç: Bu çalışmada bölgemizdeki pediatrik açık glob yaralanmalarının epidemiyolojisi ve klinik özelliklerini sunmaya çalıştık.
Gereç ve Yöntem: Ocak 2012 ile Aralık 2022 tarihleri arasında açık glob yaralanması tanısı alan 18 yaş altı hastaların tıbbi kayıtları retrospektif olarak incelendi. Hastaların yaş, cinsiyet, yaralanma zamanı, yaralanma bölgesi, yaralanma tipi ve yaralanma nedeni gibi demografik verileri kaydedildi. İlk ve son görme keskinlikleri ve başvuru anındaki oküler bulgular kaydedildi. Yaralanmaya eşlik eden oküler bulguların nihai görme seviyesi ile ilişkisi değerlendirildi.
Bulgular: Hastaların yaş ortalaması 7,62 ±4,22 yıl idi. Hastaların çoğunluğu erkekti (n=28, %66,7). Sağ göz en çok yaralanan gözdü (n=30, %71,4). Hastaların yaklaşık %72,5'inin (n=29) başlangıç görme keskinliği 20/200'den daha kötüydü. Hastaların %50'sinin (n=20) nihai görme keskinliği ise 20/200'ün altındaydı. En sık görülen yaralanma tipi penetran travmaydı (n=18, %42,9). Travmanın en yoğun olduğu bölge Zon I (n=30, %71,4) idi. En fazla travmatizan obje metal nesnelerdi (n=13, %31), En sık eşlik eden klinik bulgu lens hasarıydı (n=18, %42,9). İris hasarı, lens hasarı, hifema, vitre hemorajisi, retina dekolmanı, endoftalmi, yaralanma tipi, yaralanmaya sebep olan materyal ve yaralanma yeri nihai görme ile anlamlı şekilde ilişkiliydi.
Sonuç: Bölgemizde pediatrik yaş grubunda açık glob yaralanmaları en çok 12 yaş altı erkek çocuklarda izlenmektedir. Delici ve kesici metal cisimler travmanın en önemli nedeni olarak görünmektedir. Ebeveynler ve tüm bakıcılar, olası yaralanmaları önlemek için açık glob yaralanmalarının ciddiyeti konusunda bilgilendirilmelidir.
References
- Mulvihill A, Bowell R, Lanigan B, O'Keefe M. Uniocular childhood blindness: a prospective study. J Pediatr Ophthalmol Strabismus. 1997;34:111-4.
- Saksiriwutto P, Charuchinda P, Atchaneeyasakul LO, Surachatkumtonekul T, Phamonvaechavan P. Epidemiology of pediatric open globe injuries in a university hospital in Thailand. Cureus. 2021;13:e19366.
- Lesniak SP, Bauza A, Son JH et al. Twelve-year review of pediatric traumatic open globe injuries in an urban U.S. population. J Pediatr Ophthalmol Strabismus. 2012;49:73–9.
- Madhusudhan AP, Evelyn-Tai LM, Zamri N, Adil H, Wan-Hazabbah WH. Open globe injury in hospital university sains Malaysia - a 10-year review. Int J Ophthalmol. 2014;7:486-90.
- Oğurel T, Oğurel R, Onaran Z, Örnek N, Yumuşak E, Ölmez Y. Epidemiology of childhood globe injuries. Turk J Clin Lab. 2019;10:242-6.
- Ava S, Erdem S, Karahan M, Dursun ME, Hazar L, Keklikci U. Epidemiology and demography of open globe injury in children. Dicle Med J. 2021;48:416-24.
- Yildiz M, Kıvanç SA, Akova-Budak B, Ozmen AT, Çevik SG. An important cause of blindness in children: open globe injuries. J Ophthalmol. 2016;2016:7173515.
- Dogramaci M, Erdur SK, Senturk F. Standardized classification of mechanical ocular injuries: efficacy and shortfalls. Beyoglu Eye J. 2021;6:236-42.
- Tabatabaei SA, Khameneh EA, Soleimani M, Baramaki A. Open globe injuries in children under 7 years referred to a tertiary center in iran from 2006 to 2016. Eye (Lond). 2021;35:1235-39.
- Read SP, Cavuoto KM. Traumatic open globe injury in young pediatric patients: characterization of a novel prognostic score. J AAPOS. 2016;20:141-44.
- Sintuwong S, Winitchai R. Visual outcome in open globe injuries in thailand: a prospective study. Asian Biomed. 2011;5:289-.294.
- Çetin EN, Saraç G, Kaşıkçı A, Avunduk AM, Yaylalı V, Yıldırım C. Epidemiologic and clinical features of open-globe injuries in childhood. Turk J Ophthalmol 2012;42:16-9.
- Thompson CG, Kumar N, Billson FA, Martin F. The aetiology of perforating ocular injuries in children. Br J Ophthalmol. 2002;86:920-2.
- Choovuthayakorn J, Patikulsila P, Patikulsila D, Watanachai N, Pimolrat W. Characteristics and outcomes of pediatric open globe injury. Int Ophthalmol. 2014;34:839-44.
- Abdelazeem K, Al-Hussaini AK, El-Sebaity DM, Kedwany SM. Epidemiology, etiologies, and complications of playtime open globe injuries in children. J Pediatr Ophthalmol Strabismus. 2021;58:385-9.
- Gunes A, Kalayc M, Genc O, Ozerturk Y. characteristics of open globe ınjuries in preschool children. Pediatr Emerg Care. 2015;31:701-3.
- Liu X, Liu Z, Liu Y, Zhao L, Xu S, Su G et al. Determination of visual prognosis in children with open globe injuries. Eye (Lond). 2014;28:852-6.
- Podbielski DW, Surkont M, Tehran iNN, et al. Pediatric eye injuries in a canadian emergency department. Can J Ophthalmol. 2009;44:519-22.
- Batur M, Seven E, Akaltun MN, Tekin S, Yasar T. Epidemiology of open globe injury in children. J Craniofac Surg. 2017;28:1976-81.
- Li X, Zarbin MA, Bhagat N. Pediatric open globe injury: a review of the literature. J Emerg Trauma Shock 2015;8:216-23.
- Staffieri SE, Ruddle JB, Mackey DA. Rock, paper or scissors? traumatic paediatric cataracts in victoria 1990-2006. Clin Exp Ophthalmol. 2010;38:237-41.
- Xue C, Yang LC, Kong YC. Application of pediatric ocular trauma score in pediatric open globe injuries. Int J Ophthalmol. 2020;13:1097-1101.
- Bunting H, Stephens D, Mireskandari K. Prediction of visual outcomes after open globe injury in children: a 17-year canadian experience. J AAPOS. 2013;17:43-8.
- Baxter RJ, Hodgkins PR, Calder I, Morrell AJ, Vardy S, Elkington AR. Visual outcome of childhood anterior perforating eye injuries: prognostic indicators. Eye (Lond). 1994;8:349-52.
- Kadappu S, Silveira S, Martin F. Aetiology and outcome of open and closed globe eye injuries in children. Clin Exp Ophthalmol. 2013;41:427-34.
- Tok O, Tok L, Ozkaya D, Eraslan E, Ornek F, Bardak Y. Epidemiological characteristics and visual outcome after open globe injuries in children. J AAPOS. 2011;15:556-61.
- Rudd JC, Jaeger EA, Freitag SK, Jeffers JB. Traumatically ruptured globes in children. J Pediatr Ophthalmol Strabismus. 1994;31:307-11.
- Meng Y, Yan H. Prognostic factors for open globe injuries and correlation of ocular trauma score in tianjin, china. J Ophthalmol. 2015;2015:345764.
- Chaudhary A, Singh R, Singh SP. Prognostic value of ocular trauma score and pediatric penetrating ocular trauma score in predicting the visual prognosis following ocular injury. Rom J Ophthalmol. 2022;66:146-52.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Research |
| Authors | |
| Early Pub Date | September 25, 2023 |
| Publication Date | September 30, 2023 |
| Acceptance Date | August 20, 2023 |
| Published in Issue | Year 2023 Volume: 48 Issue: 3 |
