Parija Sucheta, Chakraborty Koyal, Ravikumar S R, Dhall Sulagna
Department of Ophthalmology, AIIMS, Bhubaneswar, Odisha, India.
Department of Community Medicine and Family Medicine, AIIMS, Bhubaneswar, Odisha, India.
Saudi J Ophthalmol. 2023 Jun 26;37(2):111-119. doi: 10.4103/sjopt.sjopt_61_22. eCollection 2023 Apr-Jun.
Ocular trauma in children is the leading cause of ocular morbidity and unilateral blindness. This study aims to analyze the clinical profile and predictors of final visual outcomes of ocular injuries in the pediatric age group presenting to a tertiary care institute in Eastern India.
This is a retrospective, observational study conducted on 114 cases of pediatric ocular injuries over 4 years (between 2016 and 2020) at a tertiary care academic hospital in Eastern India. All the data were analyzed based on the demography, nature of the injury, location of the injury, ocular trauma score (OTS), the initial and final visual acuity, and management protocol. The ocular trauma classification was based on the Birmingham Eye Trauma Terminology and the Ocular Trauma Classification System.
Majority of the injuries ( = 51, 44.7%) occurred in children between 6 and 10 years and in males from the rural areas (60.75%). The mean age of children was 9 ± 3.47 years (range: 3-16 years). Most of the injuries occurred during outdoor activities (57.9%). Majority of ocular injuries were caused by sharp objects (34, 30%), followed by blunt objects (24, 21%). Open globe injuries (OGIs) were more common (85, 48.3%) as compared to closed globe injuries (CGIs) (71, 40.3%) and nonglobe injuries (20, 11.4%). Mean OTS was 2.8 in 11-16 years indicating a good final visual outcome. Final visual outcome on multivariate analysis showed that the odds of blindness in CGI were 82% less as compared to OGI (odds ratio [OR] 0.18 [confidence interval (CI) 0.03-0.88]; < 0.03) and that in late presenting (>6 h) group was 47% more (OR 1.47 [0.13-16.47]; < 0.75) compared to early reporting group.
Children with ocular trauma commonly present as emergency cases, especially during the festivals in India. Our study reported OGIs to be more common with high risk for blindness. OTS is a useful tool for predicting the visual outcome of OGIs in children. Hence, strategic planning is needed with a focus on the early detection and intervention and also on creating the awareness activities for its prevention. The primary treatment is the key to a successful visual outcome.
儿童眼外伤是导致眼部疾病和单眼失明的主要原因。本研究旨在分析印度东部一家三级医疗机构收治的儿童年龄组眼外伤的临床特征及最终视力预后的预测因素。
这是一项回顾性观察研究，对印度东部一家三级医疗学术医院4年（2016年至2020年）期间的114例儿童眼外伤病例进行了研究。所有数据均基于人口统计学、损伤性质、损伤部位、眼外伤评分（OTS）、初始和最终视力以及治疗方案进行分析。眼外伤分类基于伯明翰眼外伤术语和眼外伤分类系统。
大多数损伤（n = 51，44.7%）发生在6至10岁的儿童以及农村地区的男性（60.75%）。儿童的平均年龄为9±3.47岁（范围：3至16岁）。大多数损伤发生在户外活动期间（57.9%）。大多数眼外伤由尖锐物体引起（34例，30%），其次是钝性物体（24例，21%）。开放性眼球损伤（OGIs）比闭合性眼球损伤（CGIs）（71例，40.3%）和非眼球损伤（20例，11.4%）更常见（85例，48.3%）。11至16岁儿童的平均OTS为2.8，表明最终视力预后良好。多因素分析的最终视力预后显示，与OGI相比，CGI失明的几率低82%（比值比[OR]0.18[置信区间(CI)0.03 - 0.88]；P < 0.03），与早期报告组相比，延迟就诊（>6小时）组失明的几率高47%（OR 1.47[0.13 - 16.47]；P < 0.75）。
眼外伤儿童通常以急诊病例就诊，尤其是在印度的节日期间。我们的研究报告OGIs更常见，失明风险高。OTS是预测儿童OGIs视力预后的有用工具。因此，需要进行战略规划，重点是早期发现和干预，并开展预防意识活动。初级治疗是获得成功视力预后的关键。
