Sharp-Object-Induced Open-Globe Injuries in Iranian Children Admitted to a Major Tertiary Center: A Prospective Review of 125 Cases

Abstract

Ocular trauma in children can result in catastrophic visual and psychological outcomes both for the child and his/her family. According to the WHO, childhood blindness is one of the major causes of avoidable blindness and so target of the Vision 2020 program. To achieve this program’s goals, it is necessary to explore the epidemiological patterns of ocular trauma in different countries which in its turn could be a valuable means to guide us in developing preventive measures. Our study is a hospital-based prospective study which was conducted to reveal detailed information about children who were admitted to a large tertiary care hospital with the diagnosis of lacerating globe injury due to a sharp object. Patients and Methods: During a 6-month period (December 2006 to June 2007), 125 eyes of 125 children (age ≤16 years) with the diagnosis of open-globe injury were enrolled. Clinical data were documented. Demographic data and details of the event were explored and documented based on the study questionnaire (adopting the Birmingham Eye Trauma Terminology and the United States Eye Injury Registry model as basis) by interviewing the parents and the child. Results: The mean age was 8.5 years (SD = 4.36 years, range: 1–16). The boys:girls ratio was 2.5:1; this ratio was age dependent, showing a significant increase with age. The home was the most frequent place (61.7%) for the trauma to occur in. Most traumas (50%) occurred in the afternoon (12 midday to 6 p.m.). Almost half of the traumas were unintentional self-injuries and occurred when the child was alone. A knife and fireworks were the two most frequent causes of injury. Conclusion: As the home is the most common place of ocular trauma in this age group and as lack of proper supervision and accessibility of sharp objects such as knives are the background of the event in most cases, it is strongly recommended to educate parents about providing a safe environment at home for their children. Work-related eye injuries in this age group should also be reduced by regulations for prohibiting children’s work or at least providing the necessary education and safety goggles.

Demographics of the Open-Globe Injuries in Pediatric Age Group in Northwest Turkey

“…The recent studies from different regions all around the world revealed the mean age for ocular injury is between 7-11 years (6,7,(11)(12)(13). The mean age of openglobe injuries in pediatric group was found to be 8 (12,13). The mean age is also 8 in our study, in accord with the results of other studies.…”

“…Seventy-five percent of the injuries occurred under 11 years, in accord with the studies from Asia. The recent studies from different regions all around the world revealed the mean age for ocular injury is between 7-11 years (6,7,(11)(12)(13). The mean age of openglobe injuries in pediatric group was found to be 8 (12,13).…”

Clinical Characteristics and Surgical Problems of Ruptured Globe Injury

“…Explosive injury is mostly caused by fireworks during the Chinese New Year festival. According to the World Health Organization, childhood blindness is one of the major types of avoidable blindness 11 . Therefore, it is important to teach safety, especially to children 12 …”

Pediatric open globe injury: A review of the literature

“…The ratio of males to females presenting with OGIs ranges from 1.9:1 to 5.1:1,[ 10 13 14 15 16 17 18 19 22 23 25 30 31 36 ] though there is no significant difference across these studies in the incidence of right versus left eye affected. Pediatric OGI cases most frequently are caused by sharp objects such as knives[ 7 15 16 17 18 19 20 21 30 33 39 ] making penetrating injury the most common. [ 14 15 18 22 23 ] The majority of injuries occur at home.…”

“…[ 14 15 18 22 23 ] The majority of injuries occur at home. [ 7 16 17 24 29 30 38 40 ] In some developing countries, outdoor and street injuries are more common. [ 13 14 ] Other accidental causes of OGI in children have been documented,[ 41 42 43 44 45 46 47 48 49 ] as well as cases of abuse or assault.…”