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

Abstract

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.

Clinical pattern of pediatric ocular trauma in a tertiary referral center

“…Younger are more prone to an irresponsible behavior and lack of appreciation of potential hazards and areas of harm. This is in accordance with other published reports [9,11,12]. Being more active and more exposed to outdoor activities and sometimes even involved in childhood labor especially in developing countries and rural communities, it is not surprising that more than 70% of the injured children were males as already highlighted [2,4,9,13,14].…”

“…In an attempt to dilute this effect, the authors extended the recruitment period for one extra month and hence the 7-month study duration. The fact that pediatric ocular injuries represent almost one-third of all ocular injuries reflects how much children are a vulnerable population to ocular injuries, especially in such underprivileged communities in developing countries, which is in accordance with the findings reported by Al Wadeai et al [9], by Khan et al [10] and by Wagle et al [2] in developing countries, and is much higher than that reported by Sii et al [11] in developed countries. Within the study cohort, it is obvious that younger age groups are more vulnerable than older age groups.…”

Management of penetrating injury with retained intraocular lead foreign body from a writing instrument: surgical video with implications for paediatric public health and safety

“…A previous analysis of risk factors among 115 patients requiring surgery at Manchester Royal Eye Hospital for ocular perforation throughout 1998–2004 revealed that injury from sharp/projectile mechanisms had a 20% risk of resulting in severe visual loss or even removal of the eye 9. Of relevance, 4 cases of pencil injuries causing ocular perforation were observed in that case series (which is from our hospital) and 7 such cases in the BOSU study 8 9…”

“…The British Ophthalmological Surveillance Unit (BOSU) study found the majority of paediatric ocular trauma in the UK was sustained in environments where direct supervision of the affected children would have been expected (own home, other home, school or nursery), whereas few (14%) such injuries occurred in relatively unsupervised locations (public places or sports facilities). It follows that majority of such ocular injuries are potentially preventable through appropriate supervision by a responsible adult 8. A previous analysis of risk factors among 115 patients requiring surgery at Manchester Royal Eye Hospital for ocular perforation throughout 1998–2004 revealed that injury from sharp/projectile mechanisms had a 20% risk of resulting in severe visual loss or even removal of the eye 9.…”

Clinical Features and Surgical Outcomes of Pediatric Ocular Trauma in Southwest of China

“…But Puodžiuvienė et al [14] suggested that the most common type of ocular trauma was closed globe injury. Literatures showed that 90% of all ocular trauma was avoidable [23]. Figuring out the major cause of injury, it will help parents and doctors establish effective protection to reduce the incidence of ocular trauma in children.…”