Pediatric ocular trauma: insights from a tertiary care hospital in Northern India

Abstract

Background Childhood ocular trauma has major consequences since it can lead to lifelong blindness and visual impairment. Purpose The aim of this study was to assess the burden of pediatric ocular trauma and to identify its important determinants. Patients and methods This prospective study included all individuals (N=124) less than 18 years old who experienced eye injuries and sought treatment at the Outpatient or Emergency Services of the Department of Ophthalmology, Government Medical College, Jammu, India. The collected data included a detailed history of the injury, including systemic factors. The demographic and clinical information, such as age, sex, urban or rural residence, injury date and time, and previous treatments were also recorded. Results A total of 523 children (0–18 years old) with a mean age of 10.96±0.24 years were included in the study. Among these, 124 (23.71%) children with a mean age of 9.86±1.23 years had ocular injuries. The highest incidence of ocular trauma (68.54%) was observed in the 6–12-year-old age group. Boys accounted for the majority of cases (74.19%), and rural children were disproportionately affected (69.35%). Open globe injuries were more prevalent (62.9%) than closed globe injuries (25.0%). Perforating corneal injuries were the most common type of open globe injury (70.51%), while bat/ball injuries (38.70%) and falls (22.58%) were the leading causes of closed globe injuries. Zone I injuries were the most frequent location for both open and closed globe injuries. The Ocular Trauma Score was used to predict the injury severity, demonstrating an accuracy of 80%. The visual acuity data were available for 63 (57.79%) children at the initial presentation. Among these, 14 (22.22%) had no light perception, 23 (36.51%) had light perception, and 26 (41.27%) demonstrated a best-corrected visual acuity of 0.2±0.1 (0.1–0.3). At the final follow up at 6 months, five (7.94%) eyes experienced a vision of no light perception attributed to optic nerve avulsion, one (1.59%) eye retained light perception, two (3.17%) eyes demonstrated counting fingers acuity, and 55 (87.3%) eyes achieved a best-corrected visual acuity of 0.8±0.6 (range: 0.8 to ≥0.9). Conclusion The current study highlighted the substantial impact of pediatric ocular trauma, with a focus on open globe injuries and prevalent risk factors. The observed improvement in visual acuity underscores the significance of timely intervention, yet the 7.94% incidence of monocular blindness signals the ongoing need for targeted prevention strategies in this vulnerable population.

Keywords

• closed globe injury
• open globe injury
• pediatric ocular trauma