New model for the prediction of visual outcomes in young children with mechanical ocular conditions and comparison with other models

Purpose: Herein, we compared the efficacy among the Ocular Trauma Score (OTS), Toddlers Ocular Trauma Score (TOTS), and Pediatric Ocular Trauma Score (POTS) for prognosis prediction in Indian children who had mechanical ocular conditions causing traumatic cataract. Methods: This prospective, interventional study recruited consecutive children undergoing operation for traumatic cataracts caused by mechanical eye injuries at Drashti Netralaya. The following details were obtained from their medical files: the circumstance and time of injuries, penetrating injury type, initial and final visual acuity (VA), time of operation, and associated eye diseases. Specific variables were employed to determine the OTS, TOTS, and POTS. For all patients, the final and predicted VA determined using all scores were compared using Fischer’s exact test. Accuracy, specificity, and sensitivity were evaluated for all the scores by using the area under receiver operating characteristic curve. Results: We enrolled 124 eyes. Patients’ mean value for age was 4.6 ± 1.29 years; 44 (35.41%) and 74 (64.5%) were female and male patients, respectively. Visual outcomes significantly improved after operation, and the outcomes did not differ between closed? and open?globe injuries (P = 0.162). The actual and predicted VA did not exhibit a statistically significant difference among the three scores. TOTS and POTS were more suitable for evaluating low?risk injuries, whereas the OTS could more efficiently examine high?risk cases. Conclusion: TOTS and POTS were more accurate than the OTS in VA prediction after operation in toddlers with traumatic cataracts caused by mechanical globe injury. TOTS and POTS were more suitable for evaluating low?risk injuries, whereas the OTS could more efficiently examine high?risk cases. All the examined scores can be helpful in estimating VA following treatment

A prospective cohort study on the epidemiology of ocular trauma associated with closed-globe injuries in pediatric age group

Purpose: To study the epidemiology of mechanical ocular trauma and closed globe injury using the Birmingham Eye Trauma Terminology System in patients belonging to the pediatric age group. Methods: This work involved a prospective cohort study of all ocular trauma patients (pediatric age group) registered between 2002 and 2017 at the ocular trauma care center. The data were collected using the international ocular trauma society form through our online MIS data and exported to the Excel sheet. The statistical analyses including the univariate analysis and cross tabulation were carried out using SPSS 22 software. Results: Our cohort consisted of 12687 patients with mechanical ocular trauma. There were 7546 (59.4%) eyes with open globe ocular injuries and 5328 (41.9%) with closed globe injuries. Of all closed globe injury patients, 1010 (19.0%) belonged to the pediatric age group (0-18 years), including 690 males (68.3%) and 320 females (31.7%). The mean age of the patients was 10.2 ± 5.1 years. Of all closed globe injuries, 692 (68.5%) were closed globe contusion and 318 (31.5%) were lamellar laceration. Conclusion: Closed globe injury is an important in cause of vision loss in children (24% <1/60). The condition is more prevalent in males and >51.7% in children under 10 years of age. The treatment has significant impact on the visual outcome in patients belonging to the pediatric age group.

Epidemiological profile of pediatric ocular trauma in a tertiary hospital of northern India / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Ocular trauma is one of the most common causes of acquired blindness in children. It measures about 8%-14% of total childhood injuries. This study aims to determine the epidemiological profile of ocular trauma in the pediatric age group attending a tertiary hospital in northern India.</p><p><b>METHODS</b>A retrospective study was conducted in our hospital between June 2014 to July 2015 and all the children aged 0-16 years presenting with ocular trauma in eye outpatient department and emergency were enrolled in the study. Various epidemiological parameters like age, sex distribution, duration of presentation, mode of injury, type of injury and final visual outcome were analyzed.</p><p><b>RESULTS</b>Of total 357 patients, 271 (76%) were below the age of 12 years; 41.1% of children with ocular trauma belonged to age group 2-6 years. The male to female ratio was 2.9:1. Out of total patients, 242 (67.8%) presented with closed globe injury. Among the closed globe injury, the history of fall was present in about 35% of children, followed by trauma while playing with bat/ball (15.7%) and finger nail trauma (13.2%). Among open globe injury, trauma with needle, knife, glass and pen were common causes. Home was the most common place of injury (47.8%), followed by streets (17.9%) and playground (14.9%).</p><p><b>CONCLUSION</b>Children are vulnerable to ocular trauma and need more supervision. Sharp objects like needles, knives, household chemicals like acids should be out of reach of children.</p>

Clinical Picture of the Pediatric Ocular Trauma

A prospective observational study was conducted of all children with ocular trauma who visited Dongguk University Pohang Hospital from January 1999 to December 1999. Current clinical features were evaluated and demographic and etiologic factors were determined. There were 56 patients, representing 15.4%of all ocular trauma patients. Among them, 42 children(75.0%)were boys, and 14(25.0%)were girls. Accidents at home were the commonest cause of injury in 0~5 years of age group, sporting activity in 6~10 age group, and accidents at school and other places in 11~15 age group. The types of injury were categorized into five groups. Many patients sustained more than one type of injury;therefore the total number of injuries(94 cases)is greater than the number of patients. Extraocular(33.0%)and nonperforating anterior globe injuries(47. 9%)occurred most commonly, whereas perforating globe injury occurred in only one case. In comparison with previous reports, incidence of pediatric ocular trauma and especially incidence of perforating ocular injury decreased. Even though all pediatric ocular trauma is not preventable, supervision for preventable causes by parents and teachers is needed.

Clinical Evaluation of the Pediatric Ocular Trauma

A retrospective survey was conducted on all children with eye injuries who were admitted to Chonnam National University Hospital from January 1993 to December 1998 to determine demographic, etiologic, and risk factors and to identify trend and preventable causes. Of the 147 children, 116 children(78.9%)were boys and 31 children(21.1%)were girls. The types of injury were categorized into six groups. Several of the patients sustained more than one type of injury;therefore, the total number of injuries(186)is greater than the total number of patients(147). The non-perforating anterior injury was the most frequent type of injury encountered(83 eyes;44.6%). The majority of these patients was diagnosed as hyphema. Penetrating anterior globe injury occurred in 55 children(29.6%). Stick or branch was the most common cause of all injuries, occurring in 20 children(13.6%). Other causes of pediatric ocular trauma were sports-related, BB pellet, fist, traffic accidents, glasses, toy, boomerang etc.Of the 68 children diagnosed as hyphema, 14 children(20.6%)were resulted from sports-related injuries. Of the 52 children of anterior perforating eye injuries, 9 children(17.3%) were resulted from branches or sticks.Of the 147 children admitted for ocular trauma, 87 children(59.2%)required surgical treatment. Primary repair of corneal perforation was the most common operation(17 children;19.5%). The preventable causes of pediatric ocular injuries are sports, toy such as BB pellet and broken glasses, but the most important factors are the control of dangerous play and the adequate adult supervision.