Patterns of paediatric ocular trauma in a tertiary care hospital in Southern Tamil Nadu, India

Abstract

Though it accounts for 8 to 14% of total injuries in children,[2] it can be prevented in 90% of the cases.[1],[2] The major anticipated problems in pediatric ocular trauma even with good healing response are amblyopia, dense fibrous reaction, cataract, and also the lower success rate of keratoplasty due to excessive fibrin formation.[2],[6] This study aims to determine the patterns of ocular trauma and analyze the mode of injury, its complications, and the visual prognosis after injury. Methods: This study was a prospective observational case study conducted in the Department of Ophthalmology, in a tertiary care center for 1 year from January 2020 to January 2021, which included all children below the age of 12 years with a history of ocular trauma. Data were collected on the demographic characteristics, mode of injury, place of injury, intervention done, the course in the hospital, its complications, and final visual outcome. The eye injuries were also classified using the international classification of ocular trauma, the Birmingham Eye Trauma Terminology System (BETTS), and Ocular Trauma Score have been given to each patient. The data were entered in an Excel sheet, and Snellen's visual acuity was converted to a Log MAR unit for statistical analysis. Mean and standard deviation were used to describe the continuous variables, whereas frequencies were used to describe the categorical and binary variables. Results: A total of 50 children presented to the Department of Ophthalmology with a history of ocular trauma during the study period. Out of 50 children, the mean age of presentation was 7.434. Children aged 9 to 12 years (48%) were most commonly affected followed by the age group 0 to 4 years and 5 to 8 were equally involved (26% each). Thirty-five (70%) of the children were male and 15 were female (30%). Forty-five (90%) children were from rural areas and 5 (10%) were from urban areas. The most common mode of injury was road traffic accidents and accidental falls which were about 24% (n = 12 each). Ocular trauma has been classified as closed or open injury based on BETTS, which showed only 6% (3 patients) had open globe injury and 84% (42 patients) had closed globe injury, 10% (5 patients) had an adnexal injury. 40 children were managed medically, and 10 children required surgical intervention. Discussion: Eye injuries are an important cause of ocular morbidity in children, being a leading cause of unilateral blindness in this age group. Timely referral and prompt management can help prevent blindness from ocular trauma. Follow-up plays a vital role in identifying the secondary complications earlier. It is a prerequisite to educate the children, parents and teachers concerning ocular health and hygiene to minimize eye injuries. Introduction: Pediatric ocular trauma is an important cause of eye morbidity. Epidemiology varies in different regions of the world.

Keywords

• betts
• ocular trauma score
• pediatric ocular trauma