From the Divisions of Trauma and Burn Surgery.
Ophthalmology, Children's National Medical Center, Washington, DC.
Pediatr Emerg Care. 2021 Nov 1;37(11):e713-e715. doi: 10.1097/PEC.0000000000002129.
Criteria that predict the need for ocular injury treatment in children who suffer periocular facial scald burns are not known. The purpose of this study was to evaluate the incidence and management of ocular injuries among children sustaining facial scald burns and to determine predictors of injuries requiring additional treatment.
Children treated at a burn center with periocular facial scald burns were analyzed. Patient and injury profiles were compared between those evaluated and not evaluated by an ophthalmologist. Factors associated with an ocular injury requiring treatment were determined, and treatment differences before and after ophthalmology consultation were evaluated.
Seventy-three children with facial scald burns were identified, none with a full-thickness injury. Thirteen children had ocular findings on examination including corneal abrasion, conjunctivitis, scleral burn, and chemosis of the conjunctiva. Twenty-three patients received erythromycin ointment, only 8 of whom had a documented ocular injury. Children seen by an ophthalmologist (n = 24) more often had a positive finding on examination (37.5% vs 8.2%, P = 0.007) and received treatment (66.7% vs 14.3%, P < 0.001). Only 4 patients had modification in their treatment plan after consultation, 3 of whom were started on treatment despite not having a positive finding on examination.
Ocular injury after periocular facial scald burns is an infrequent finding. Among children with partial-thickness periocular facial scald burns, initial evaluation and treatment without ophthalmology consultation are appropriate. Ophthalmic antibiotic ointment is an appropriate initial treatment in most symptomatic patients, with ophthalmologic consultation being limited to children without symptomatic improvement.
目前尚不清楚哪些标准可以预测眼部损伤是否需要治疗。本研究旨在评估儿童眼周面部烫伤烧伤的眼部损伤发生率和处理方法，并确定需要进一步治疗的损伤的预测因素。
分析在烧伤中心接受眼周面部烫伤烧伤治疗的儿童。评估和未评估眼科的患者和损伤特征进行比较。确定与需要治疗的眼部损伤相关的因素，并评估眼科咨询前后的治疗差异。
共发现 73 例眼周面部烫伤烧伤患儿，无全层损伤。13 例患儿眼部检查发现角膜擦伤、结膜炎、巩膜烧伤和结膜水肿。23 例患者使用红霉素眼膏，其中仅 8 例有记录的眼部损伤。接受眼科医生检查（n = 24）的患儿检查结果阳性的更常见（37.5%比 8.2%，P = 0.007），接受治疗的也更常见（66.7%比 14.3%，P < 0.001）。仅 4 例患儿在咨询后修改治疗方案，其中 3 例尽管检查结果无阳性发现仍开始治疗。
眼周面部烫伤烧伤后眼部损伤并不常见。对于有眼周部分厚度烫伤烧伤的儿童，初始评估和治疗无需眼科咨询。眼部抗生素眼膏是大多数有症状患者的合适初始治疗方法，眼科咨询仅限于无症状改善的患儿。
