Pediatric open globe injury: A review of the literature

Li, Xintong; Zarbin, Marco A.; Bhagat, Neelakshi

doi:10.4103/0974-2700.166663

Cited by 93 publications

(23 citation statements)

References 92 publications

(140 reference statements)

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“… 18 Presentation to health care providers is thus often delayed, and affected children are placed at increased risk of developing post-traumatic endophthalmitis. 19 It is evident that further publicity is required to highlight this danger, and there is a strong argument to promote the use of protective eyewear for children playing with darts.…”

Section: Discussionmentioning

confidence: 99%

The UK Paediatric Ocular Trauma Study 2 (POTS2): demographics and mechanisms of injuries

Sii¹,

Barry²,

Abbott³

et al. 2018

OPTH

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PurposePediatric ocular trauma is an important cause of visual morbidity worldwide, accounting for up to one-third of all ocular trauma admissions. It has long-term implications for those affected and significant economic consequences for healthcare providers. It has been estimated that 90% of all ocular trauma is preventable. Targeted strategies are required to reduce the incidence and the severity of pediatric ocular trauma; this requires an understanding of the epidemiology and characteristics of these injuries and the children involved.MethodsProspective, observational study of pediatric ocular trauma cases presenting to UK-based ophthalmologists over a 1-year period; reporting cards were distributed by the British Ophthalmological Surveillance Unit, and clinicians were asked to report incidents of acute orbital and ocular trauma in children aged ≤16 years requiring inpatient or day-case admission. A validated, standardized questionnaire was sent to reporting ophthalmologists to collect data on the demographics and circumstances of injury.ResultsMedian age at presentation was 7.7 years, with boys more than twice as likely to be affected than girls (M:F =2.1:1.0). Almost 50% of injuries occurred at home, with 25% occurring in school or nursery. A total of 67% of injuries occurred during play, and 31% involved a sharp implement.ConclusionPediatric ocular trauma remains an important public health problem. At least three-quarters of all injuries are preventable through measures, including education of children and responsible adults, restricting access to sharp implements, improving adult supervision, and appropriate use of eye protection.

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Section: Discussionmentioning

confidence: 99%

The UK Paediatric Ocular Trauma Study 2 (POTS2): demographics and mechanisms of injuries

Sii¹,

Barry²,

Abbott³

et al. 2018

OPTH

View full text Add to dashboard Cite

show abstract

“…However, other studies found that age has an important influence on visual acuity prognosis. 13 , 14 Additionally, a study by Agrawal et al 13 reported that the time lag between the injury onset and hospital admission was significantly associated with the final visual acuity of the patients. It appears that involvement of the posterior part of the globe is associated with poorer visual outcomes.…”

Section: Discussionmentioning

confidence: 99%

Open globe eye injury characteristics and prognostic factors in Jazan, Saudi Arabia

Makhrash

Gosadi

2016

SMJ

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ObjectivesTo evaluate characteristics and prognostic factors of open globe injuries (OGI) presented to King Fahad Specialist Hospital in the Jazan region, Saudi Arabia.MethodsThis study is a retrospective review of medical records of OGI patients who underwent operative repair of their injuries in King Fahad Central Hospital, Jazan, Saudi Arabia between January 2011 and December 2013. Demographic information, eye injury, preoperative, and postoperative visual acuity were collected. The initial and final visual acuity outcomes were compared to identify subjects who witnessed any improvement in their visual acuity. Logistic regression was used to assess characteristics associated with improvements in the visual acuity.ResultsNumber of included cases was 120. Most frequently reported causes of injury were blunt trauma (20%) and shattered glass (18.3%). Approximately half of the cases were reported to have iris injuries or hyphema. Most cases suffered penetration (37.5%) of the eye globe. Only zone I injury was significantly associated with better visual acuity outcomes (odds ratio [OR]: 2.447, p=0.036). Among the variables that were associated with poorer prognostic outcomes, only aphakia (OR: 0.180), retinal damage (OR: 0.062), vitreous hemorrhage (OR: 0.266), and zone III injuries (OR: 0.092) were statistically significant (p<0.05).ConclusionZone I injury appears to have a better prognostic effect on visual acuity where injuries related to Zone III were associated with worse prognostic outcomes.

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“…Penetrating eye trauma (open globe injury) occurs in 2 to 3.8/100,000 population in the United States. Posttraumatic endophthalmitis occurs in 0.9 to 18% of adults and 5 to 54% of children with such injuries (57,58). Risk factors include delay in treatment of the eye trauma, rural setting of the injury, presence of an intraocular foreign body, lens capsule disruption, and a lacerating injury rather than blunt trauma with globe rupture.…”

Section: Posttraumatic Endophthalmitismentioning

confidence: 99%

Bacterial and Fungal Endophthalmitis

2017

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Endophthalmitis is a severe eye infection that may result in permanent loss of useful vision in the affected eye. Most cases are exogenous and occur as a complication of cataract surgery, an intravitreal injection, or penetrating ocular trauma. Endogenous endophthalmitis results from hematogenous seeding of the eye by bacteria or fungi, but bacteremia or fungemia may be transient and patients may present without symptoms of systemic infection. Nearly all endophthalmitis patients present with decreased vision, and some also have eye pain. Eye examination usually reveals a hypopyon and intraocular inflammation. Diagnosis is clinical, supported by cultures of the vitreous and/or aqueous or by blood cultures in some endogenous cases. Molecular diagnostic techniques have been used in research laboratories for pathogen identification in endophthalmitis and offer the possibility of rapid diagnosis, including in culture-negative cases. Intravitreal injection of antibiotics is the most important component of treatment; some cases also benefit from surgical debridement of the vitreous by a vitrectomy. The visual outcome depends partly on the pathogen: coagulase-negative staphylococcal endophthalmitis has a better prognosis than does streptococcal endophthalmitis, for example. Endophthalmitis is a medical emergency, and prompt diagnosis and treatment are essential for saving vision.

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Pediatric open globe injury: A review of the literature

Cited by 93 publications

References 92 publications

The UK Paediatric Ocular Trauma Study 2 (POTS2): demographics and mechanisms of injuries

The UK Paediatric Ocular Trauma Study 2 (POTS2): demographics and mechanisms of injuries

Open globe eye injury characteristics and prognostic factors in Jazan, Saudi Arabia

Bacterial and Fungal Endophthalmitis

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