Abstract
In children eye injuries are an important cause of ocular morbidity.
Purpose: The purpose of this study was to identify the risk factors, different modalities of management and suggest preventive measures in children below 16 years of age.
Materials and Methods: A total of 290 children below 16 years of age with history of ocular injury were included in our study. A detailed history and complete ocular examination including Slit lamp examination, indirect ophthalmoscopy as well as special investigations like B-scan, X-ray were done wherever required and appropriate timely medical and surgical intervention was done.
Results: We observed the incidence of ocular trauma in this age group was 8.7%, male female ratio 2.5:1. Most of the injury occurred during outdoor activity and pointed objects mainly stick were the common cause of injury. Among all cases 75.2% were close globe injury, 16.6% cases were open globe injury and in 8.2% only ocular adnexa was involved. Most cases (76%) required conservative management only. At 6 months follow up 91.8% had BCVA ≥ 6/60, 3.9% had <6/60, 4.3% had no perception of light.
Conclusion: In children ocular injuries are an important cause of unilateral & some time bilateral blindness. Such injuries could not be always preventable but by identifying the risk factors, most effective methods of management, parents’ awareness and by reducing exposure to dangerous objects can prevent the morbidity to some extent.
Keywords: Mechanical injury, Close globe injury, open globe injury, Ocular adnexa injury, Ocular injury.
References
- Aghadoost D. Ocular trauma: An Over view. Arch Trauma Res.2014 June;3(2): e21639.
- MacEwen CJ, Baines PS and Desai P. Eye injuries in children: the current picture. Br. J. Ophthalmol., Aug 1999; 83:933-36.
- Parmar IP, Nagpal RC, Sunandan S. Pattern of ocular injuries in Haryana. Indian J Ophthalmol,1985;33(3):141-44.
- Salvin JH. Systematic approach to paediatric ocular trauma. Curr Opin Ophthalmol. 2007;18:366–72.
- Zagelbaum BM, Tostanoski JR, Kerner DJ, Hersh PS. Urban eye trauma- A one year Prospective study.Ophthalmology 1993;100:851-56.
- Saini JS, Mukharjer AK, Dabral SM, Moraes O. A Profile of penetrating eye injuries. Indian J Ophthalmol 1985;33:95-97.
- Takvam JA, Midelfart A. Survey of eye injuries in Norwegian children. Acta Ophthalmol, 1993 ;71(4): 500-5.
- Jaison SG, Silas SE, Daniel R, Chopra SK. Areview of childhood admission with perforating ocular injuries in a hospital in north-west India. Indian J Ophthalmol. 1994;42 (4) :199-201
- Dasgupta S, Mukharjee R, Ladi DS, Gandhi VH. Paediatric ocular trauma –a clinical presentation. J Postgrad Med, 1990;36(1):20-22.
- Jovanovic M, Medarevic A, Knezevic M, Krstic V. Mechanical eye injuries in children aged 0-15 years treated at the clinic of eye diseases in Belgrade: frequency, causes and preventive measures. Srp Arh Celok Lek, 2013,141: 586-91.
- Saxena R, Sinha R, Purohit A, Dada T, Vajpayee RB, Azad RV. Pattern of paediatric ocular trauma in India.Ind J of Pediatr, 2002;69(10):863-67.
- Cariello AJ, Moraes NS, Mitne S, Oita CS, Fontes BM, Melo LA Jr. Epidemiological finding of ocular trauma in childhood. Arq bras Oftalmol.,2007;70(2):271-75.
- Chakraborti C, Giri D, Choudhury KP, Mondal M, Datta J. Paediatric ocular trauma in a tertiary eye care centre in Eastern India. Indian J Public Health,2014;58(4):278-80.
- Hosseini H, Masoumpour M, Keshavarz-Fazl F, Razeghinejad MR, Ramin Salouti, and Mohammad Hosein Nowroo-zzadeh. Clinical and Epidemiologic Characteristics of Severe Childhood Ocular Injuries in Southern Iran. Middle East Afr J Ophthalmol. 2011; 18(2): 136–140.
- Soylu M, Sizmaz S, Cayli S. Eye injury (ocular trauma) in southern Turkey: Epidemiology, ocular survival, and visual outcome. Int Ophthalmol. 2010;30:143–48.
- Thompson CG, Kumar N , Billson FA and Martin F. The aetiology of perforating ocular injuries in children. Br.J. Ophthalmol., 2002;86: 920-22.
- Khatry SK, Lewis AE, Schein OD, Thapa MD, Pradhan EK,Katz J. The epidemiology of ocular trauma in rural Nepal. Br. J. Ophthalmol, 2004;88:456-60.
- Mukherjee AK, Saini JS, Dabral SM. Aprofile of penetrating eye injuries. Indian J Ophthalmol.1984;32:269-71.
- Niiranen M, Raivio I. Eye injuries in children. Br J Ophthalmol 1981;65(6):436-38.
- Jovanovic M. Mechanical injuries of the eyeball: Frequency, structure, and possibility of the prevention. Srp Arh Celok Lek.2006;134:11-21.
- Narang S, Gupta V, Simalandhi P, Gupta A, Raj S, Dogra MR. Paediatric open globe injuries. Visual outcome and risk factors for endophthalmitis. Indian J Ophthalmol. 2004;52(1):29-34.
- Desai P, MacEwen CJ, Baines P,Minassian DC. Incidence of cases of ocular trauma admitted to hospital and incidence of blinding outcome. Br J 1996; 80(7):592-96.
- Ilsar M, Chirambo M, Belkin M. Ocular injuries in Malawi. Br.J. Ophthalmol.1982; 66:145-48.
- Pieramici DJ, Sternberg P Jr, Aaberg TM Sr, Bridges WZ Jr, Capone A Jr, Cardilio JA et al. The ocular Trauma classification group.A system for classifying mechanical injuries of the eye (globe). Am j. Ophthalmol. 1997;123:820-31
- Soylu M, Demircan N, Yalaz M, Işigüzel I. Etiology of pediatric perforating eye injuries in southern Turkey. Ophthalmic Epidemiol. 1998;5:7–12.
Corresponding Author
Dr Jasmita Satapathy
Assistant Professor, Dept of Ophthalmology, Institute of Medical Sciences & SUM Hospital
(Sikhya O Anusandhan University, Bhubaneswar)