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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.

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and aims: Ocular traumas are among the most important causes of visual acuity loss and acquired unilateral blindness in children, with permanent effects on their psychological and social development. The epidemiology of ocular traumas, especially those of children in different societies, is affected by the culture and level of education, lifestyle, and socioeconomic level. Considering that no accurate statistics on these injuries have been reported in Hamadan, Iran, this study aimed to investigate the epidemiology of various types of injuries in children following ocular traumas in Hamadan. Methods: This cross-sectional study included 293 patients under 18 years of age with ocular trauma who were visited in Farshchian Sina hospital in 2019. A detailed medical history was obtained including demographic information, type of injury, initial and final visual acuity, cause of injury, mother’s occupational status, and the delay between trauma and the examination, and the examiner-recorded definitive care. Finally, the data were analyzed using Excel software, and a significance level of 0.05 was used. Results: Out of 293 patients examined, 38.91% were female, and 61.09% were male. Children aged 1-5 years (30.72%) were the most commonly affected group, followed by those aged 6-10 years (29.35%). There were 19 cases of chemical injury, 33 cases of penetrating trauma, and 241 cases of blunt trauma. The mean initial vision in patients was 0.31±0.347 logMAR, and the mean final vision was 0.06±0.084 logMAR. In 94 patients, it was impossible to check visual acuity due to their lower age. Besides, 49.83% of injuries happened at home. Conclusion: In this research, the most common type of ocular trauma was blunt trauma in male patients, which occurred at home in the presence of the mother. Therefore, it is obvious that the most effective way to prevent these incidents is that parents should pay more attention to their children, implement well-established safety precautions while playing at home, and use standard play equipment.

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.

AIM: To evaluate the predictive value and applicability of Ocular Trauma Score (OTS) and Pediatric Ocular Trauma Score (POTS) for closed and open globe injuries in the pediatric group. METHODS: A retrospective study of closed and open globe injuries in children age of 0-18-year-old between 2012-2019 was conducted. Medical records were collected, and injuries were classified using Birmingham Eye Trauma Terminology System (BETTS). The predictive value and applicability of both OTS and POTS to final visual acuity (VA) were analyzed. RESULTS: Of 84 patients, 59 (70.2%) presented with closed globe injuries (CGI) and 25 (29.8%) with open globe injuries (OGI). The mean of initial VA was 0.832±0.904 logMAR. OTS and POTS was calculated. Initial VA (P

Purpose Children represent approximately one-third of patients with serious ocular injuries. Our study evaluates associations between race and socioeconomic status in presentation and outcomes of pediatric and adolescent traumatic open globe injuries. Methods We conducted a retrospective chart review of traumatic open globe injuries in pediatric and adolescent patients presenting to Johns Hopkins Hospital and University of Maryland Medical Center between 2006 and 2020. Variables assessed included age, gender, parent-identified race, median household income, mechanism of injury, initial and final visual acuity (VA), and length of follow-up. Results Eighty patients ranging from 4 months to 17.7 years (mean 9.3 years) presented with traumatic open globe injury. Identifications were 28 White (35%), 38 Black (48%), and 5 Hispanic (6%). Initial presenting and final VA, pediatric ocular trauma score (POTS), and length of follow-up did not differ significantly among race, gender, or income. Black patients had higher rates of blunt trauma (odds ratio (OR) 3.81; 95% confidence interval (CI) 0.95-15.24, p = 0.07), uveal prolapse (OR 3.58; 95% CI 1.03-12.43; p = 0.049), and enucleation (OR 10.55; 95% CI 1.26-88.31). Hispanic patients presented at a younger age of 2.8 years mean age vs. 9.9 years (p = 0.004) for others. Conclusion Visual outcomes following traumatic open globe injury were independent of race, gender, or income. However, blunt trauma, uveal prolapse, and enucleation rates were higher in Black patients, and ocular trauma occurred at a younger age in Hispanic patients. [ABSTRACT FROM AUTHOR]

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.

Ocular trauma is one of the most common causes of acquired blindness in children. The epidemiological parameters associated with ocular trauma vary in different populations, especially in children. The objective of this study was to assess the ocular trauma epidemiology in children less than 18 years of age. In this crosssectional study, 145 children (under 18 years) with ocular trauma who referred to the emergency department of Bu-Ali-Sina Hospital in Sari, Iran were enrolled from November 2017 to January 2019. Of the participants, 57.9% were men, 70.4% had blunt trauma, 97.2% had a unilateral eye injury, and 54.5% had a right eye injury. The most risk factor for trauma was stationery (51.0%). Almost half of the patients (52.9%) had corneal injuries. The most trauma locations were at home (67.4%). Most patients (95.0%) had normal relative afferent pupillary defects. Blunt (52.6% vs. 47.4%) and penetrating (72.5% vs. 27.5%) traumas was higher in boys than girls (p=0.03). Most frequent part of eye injuries in blunt and penetrating traumas was related to the cornea (P=0.04). It seems that parents should have more supervision on children at home and give adequate education in using of stationery to school-age children by considering the results of present study.

Purpose: To construct a new pediatric ocular trauma score for predicting visual outcome after open globe injuries (OGI) and to compare it to the ocular trauma score (OTS) and pediatric ocular trauma score (POTS). Methods: This is a retrospective chart review study. For each case, the following data were collected: demographics, mechanism of the injury, initial ophthalmologic findings, presented and last follow-up visual acuity (VA), ocular treatments, and final ocular findings. We then analyzed the risk factors for the poor visual outcome (VA ≤ 20/200), and a modified pediatric ocular trauma score (MPOTS) was constructed accordingly and compared to the OTS and POTS for predicting poor outcome. Finally, a different cohort of pediatric OGIs was used for score validation. Results: Forty-five cases were included, significant predicting factors for poor visual outcome were initial VA ≤ 20/200, zone 2–3 locations of injury, presence of retinal detachment, vitreous hemorrhage, hyphema, and iris prolapse at initial presentation. The calculated Spearman correlation coefficients between each system score and poor visual outcome were OTS 0.56, POTS 0.57, and MPOTS 0.64 (P < 0.001 for all). A total of 71 new cases were used as validation cohort, and calculated Spearman correlation coefficients between each system score and poor visual outcome were: OTS 0.50, POTS 0.51, and MPOTS 0.53 (P < 0.001 for all). Conclusions: We suggest a new scoring system for predicting poor final visual outcomes after OGI's in children, which is simpler and more clinically suitable for this study population. It was found to be a better predictor of visual outcome in this scenario compared with existing scoring systems. [ABSTRACT FROM AUTHOR]

Copyright of Current Retina Journal / Güncel Retina Dergisi is the property of Anadolu Kitabevi Basim Yayim Medikal Turizm Kirtasiye Tic. Ltd. Sti. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: The purpose of this study is to report the demographics and risk factors for undergoing primary enucleation in the setting of acute open globe injury (OGI) in the pediatric population in the USA. Methods: This retrospective, cross-sectional study of pediatric patients with OGIs in the USA between 2002 and 2014 was conducted utilizing data from the National Inpatient Sample Database. Descriptive statistics, chi-square testing, and univariate and multivariable analyses were performed. Results: In the USA, 8944 cases of pediatric OGI were identified between 2002 and 2014 in the NIS Database, of which 344 underwent primary enucleation. Blacks and Asian/Pacific Islanders made up higher proportions of enucleated cases compared to non-enucleated cases. Older age, male sex, being Black or Asian/Pacific Islander, OGI with an intraocular foreign body, rupture type OGI, and concurrent endophthalmitis were identified as risk factors for undergoing enucleation. There was no significant difference in insurance status among enucleated versus non-enucleated cases. Mean length of hospital stay (in days) was almost 3 times higher in enucleated OGIs. By hospital's geographic location, the Midwest hospitals had a greater proportion of enucleated versus non-enucleated cases compared to other regions. Conclusion: Significant demographic differences were identified in OGI patients that underwent primary enucleation versus repair with regard to age, sex, race, the geographic location of hospital admission, mean length of hospital stay, type of ocular injury, and other ocular complications. Most pediatric traumatic enucleations between 2002 and 2014 were reported in teenagers (16–20 age group), in males, and in Blacks. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Salma M Kedwany, Mohamed GA Saleh, Dalia Tohamy, Magdi M Mostafa Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, EgyptCorrespondence: Magdi M MostafaDepartment of Ophthalmology, Assiut University, Assiut, 71515, EgyptTel +201093122344Email magdimohammad2013@gmail.comPurpose: To demonstrate the demographic features, causative agents, and outcome of pediatric traumatic cataract surgery in eyes without posterior segment involvement at Assiut University Hospital, Upper Egypt.Patients and Methods: This is a retrospective study on children (aged < 18 years old) who underwent traumatic cataract surgery from January to June 2019. Children with posterior segment injury and those who did not complete 6 months of postoperative follow-up were excluded. The demographic features, mechanism and time of eye injury, clinical features, surgical approach, and outcome were recorded and analyzed.Results: The study included 34 eyes of 34 children, 23 (68%) of them were boys. The mean age at the time of cataract surgery was 10± 3.97 years. Twenty-one eyes sustained open globe injury (62%) with the most common cause of trauma was wooden sticks, while 13 eyes had closed globe injury (38%) with the most common cause of injury was thrown stones. The time interval between eye injury and cataract surgery ranged from 1 day to 9 years with a median of 2.05 months. Posterior chamber intraocular lenses were implanted in all eyes; in 33 eyes, the posterior chamber intraocular lenses were implanted primarily at the time of cataract extraction. Corrected distance visual acuity significantly improved from 2.63± 0.66 LogMAR preoperatively, to 0.41± 0.38 LogMAR postoperatively (p < 0.001).Conclusion: Pediatric traumatic cataract is commonly present in primary school age especially after open globe injury. Primary prevention through health awareness should target this age population. Useful vision can be regained with timely proper surgical intervention and posterior chamber intraocular lens implantation.Clinicaltrials.gov Id: NCT04630509.Keywords: pediatric cataract, pediatric ocular trauma, lens, posterior chamber intraocular lenses implantation

Ashok Hukumchand Madan, Rajesh Subhash Joshi, Preeti Dasharath Wadekar Department of Ophthalmology, Government Medical College, Nagpur, Maharashtra 440012, IndiaCorrespondence: Rajesh Subhash JoshiGovernment Medical College, 77, Panchtara Housing Society, Manish Nagar, Somalwada, Wardha Road, Nagpur 440012, IndiaTel +91 9890131588Email jrajesh5@rediffmail.comPurpose: To study the demographic profile and visual outcome in pediatric ocular trauma.Study Design: Prospective and interventional study.Setting: Tertiary eye care center in central Maharashtra.Materials and Methods: The study included all children of age group 15 years and younger sustaining eye injuries and presented to the outpatient department or emergency services. The duration of the study was 1 year. A detailed medical history was obtained. Demographic profile was noted. A detailed ocular examination included visual acuity, slit-lamp biomicroscopy, and fundus examination. All patients were followed up to 6 months.Results: Out of 350 children examined, 66 (18.9%) had ocular trauma. The mean age at presentation was 8.33 ± 4.03 years. Children aged 6– 10 years (39.3%) were most commonly affected followed by children from 11 to 15 years (36.1%). There were no significant differences between rural (54.1%) and urban (45.9%) children. Most (63.9%) had open and 24.6% had closed globe injuries. Perforating injuries to the cornea (n=29, 47.5%) was the most common injury. Sports-related injuries were common (n= 18) followed by wooden stick- (n = 14) and firecracker-related (n = 11) injuries. In the open and closed globe injuries, 36 (92.3%) and 5 (33.3%) patients, respectively, required immediate surgical intervention.Conclusion: Sports-related activities were a common cause of ocular trauma in the pediatric age group in the central region of Maharashtra. We propose setting of rapid action ocular trauma team to prevent blindness occurring due to trauma.Keywords: pediatric ocular trauma, ocular trauma study, ocular trauma, posterior segment trauma

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% 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.

Abstract Purpose Pediatric ocular trauma is a major source of morbidity and blindness and the number of epidemiological studies is incommensurate with its significance. We sought to determine differences in epidemiologic patterns of pediatric ocular injuries based on intention. Methods A retrospective review of the National Trauma Data Bank (2008–2014) was performed and patients

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. [ABSTRACT FROM AUTHOR]

Purpose: Pediatric ocular trauma is a major source of morbidity and blindness and the number of epidemiological studies is incommensurate with its significance. We sought to determine differences in epidemiologic patterns of pediatric ocular injuries based on intention.Methods: A retrospective review of the National Trauma Data Bank (2008-2014) was performed and patients < 21 years old, admitted with trauma and ocular injury, were identified using ICD-9CM codes. Demographic data, types of injury and external circumstances including intention were tabulated and analyzed with students' t and chi-squared tests and logistic regression. Statistical significance was set at p < 0.05.Results: Fifty-eight thousand seven hundred sixty-five pediatric patients were admitted for trauma and ocular injuries. The mean(SD) age was 11.9(6.9) years. Most patients were male (68.7%) and White (59.1%). Unintentional injuries (76.3%) were mostly associated with falls (OR = 13.4, p < 0.001), assault (16.3%) with firearms (OR = 9.15, p < 0.001) and self-inflicted trauma (0.7%) also with firearms (OR = 44.66, p < 0.001). There was increasing mean(SD) age from unintentional, 12.9(6.6) years and assault 12.3(8.1) years to self-inflicted trauma, 17(3.4) years. The 0-3 year age group had highest odds of open adnexa wounds (OR = 30.45, p < 0.001) from unintentional trauma, and traumatic brain injury (TBI) (OR = 5.77, p < 0.001) and mortality (OR = 8.52, p < 0.001) from assault. The oldest 19-21 year group, had highest odds visual pathway injuries (OR = 8.34, p < 0.001) and TBI (OR = 1.54, p = 0.048) from self-inflicted trauma and mortality (OR = 2.08, p < 0.001) from unintentional trauma.Conclusion: Sight-threatening injuries were mostly associated with unintentional trauma in the youngest group and self-inflicted trauma in the oldest group. Patterns emerged of associations between demographic groups, mechanisms, types of injury and associated TBI with intention of trauma. [ABSTRACT FROM AUTHOR]

Background: Traumatic visual pathway injuries are often associated with severe head trauma and can have profound deleterious effects in developing children and their rehabilitation. We sought to elucidate the epidemiology of pediatric visual pathway injuries in the United States.Materials and Methods: This study is a retrospective evaluation of pediatric patients (less than 21 years of age) with visual pathway injuries that were submitted to the National Trauma Data Bank between 2008 to 2014. Patients were identified using the International Classification of Diseases, Ninth Revision Clinical Modification codes. Statistical analysis was performed with SPSS software. Variables were correlated using Student t test, chi-squared test, and logistic regression analyses.Results: Of the 58,765 pediatric patients (1.7%) who were admitted with ocular injuries, 970 had visual pathway injuries. The majority of these patients were male (69.2%), and the mean age was 11.6 years (±7.2). Traumatic optic neuropathy was the most common (86.1%) visual pathway injury. It had the greatest odds of occurring with oculomotor nerve injury (odds ratio = 3.84; P < 0.001). Associated ocular injuries were open adnexal wounds (87.4%) and orbital fractures (23%). Common mechanisms were motor vehicle occupant (21.5%) and firearms (15.6%). Motor vehicle occupants were most likely white and firearms injury, black. In the zero to three years age group, most injuries were due to falls; injuries in the 19 to 21 years age group had the greatest association with firearms. Overall mortality was 17.6%.Conclusions: Visual pathway injuries may have devastatating sequelae and should be considered in pediatric ocular injuries. The clear majority were traumatic optic neuropathies. The common mechanisms, motor vehicle occupant and firearms, revealed age and race disparities. [ABSTRACT FROM AUTHOR]

Purpose: 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.Methods: 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.Results: 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%).Conclusion: 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. [ABSTRACT FROM AUTHOR]

Pediatric posttraumatic endophthalmitis presents with great complexities and challenges arising due to delayed presentation, difficulty in eliciting an accurate history, or trauma with unusual and highly contaminated objects. The possibility of initial misdiagnosis as panuveitis, metastatic endophthalmitis, and masquerade syndrome is also very high, which results not only in several unwarranted investigations being performed, but also a delay in the initiation of treatment. The standard treatment remains primary repair of the wound, intravitreal therapy with broad spectrum antibiotics, and parsplana vitrectomy. Despite appropriate intervention, visual outcome in children with posttraumatic endophthalmitis is dampened by additional factors like poor compliance with postoperative instructions and high risk of amblyopia. Hence, it is important to recognize that posttraumatic endophthalmitis in children differs from that in adults in several ways. We made a very tailored effort to review the published literature pertaining to posttraumatic endophthalmitis in children and herein present the results of our search. [ABSTRACT FROM AUTHOR]

Objectives: To determine the demographics, incidence, etiology, and severity of pediatric ocular trauma cases seen in a tertiary hospital and to establish the visual outcomes of these cases using the Ocular Trauma Score (OTS). Methods: Pediatric patients, aged 0-18, who came to the emergency clinic for ocular trauma between January to April 2012 were included in the study. They were examined on initial consult and computed for the OTS by converting the OTS variables into OTS categories. They were followed up after 1, 2, and 3 months. The distribution of percentage of final visual acuity was compared with the OTS. Results: There was a male predominance (76%) occurring mostly in the 2-6 year age group (37%). Injuries were predominantly accidental (91%), occurring at home (72%), and frequently caused by blunt trauma (55%), followed by penetrating injuries (21%). Majority (76.2%) had no impairment while 14% had severe visual disability after three months. Eighty-three percent corresponded to the OTS proposed final visual acuities and the remaining 17% fell into the category one below or above the proposed final visual acuity. Conclusion: Ocular trauma is a common cause of visual impairment in children and can be prevented. There should be preventive measures, better supervision, public education, and aggressive and prompt management to improve visual outcomes.

Objectives: To determine the demographics, incidence, etiology, and severity of pediatric ocular trauma cases seen in a tertiary hospital and to establish the visual outcomes of these cases using the Ocular Trauma Score (OTS). Methods: Pediatric patients, aged 0-18, who came to the emergency clinic for ocular trauma between January to April 2012 were included in the study. They were examined on initial consult and computed for the OTS by converting the OTS variables into OTS categories. They were followed up after 1, 2, and 3 months. The distribution of percentage of final visual acuity was compared with the OTS. Results: There was a male predominance (76%) occurring mostly in the 2-6 year age group (37%). Injuries were predominantly accidental (91%), occurring at home (72%), and frequently caused by blunt trauma (55%), followed by penetrating injuries (21%). Majority (76.2%) had no impairment while 14% had severe visual disability after three months. Eighty-three percent corresponded to the OTS proposed final visual acuities and the remaining 17% fell into the category one below or above the proposed final visual acuity. Conclusion: Ocular trauma is a common cause of visual impairment in children and can be prevented. There should be preventive measures, better supervision, public education, and aggressive and prompt management to improve visual outcomes. [ABSTRACT FROM AUTHOR]

Ocular trauma is a topic of unresolved controversies and there are continuous controversial and debatable management strategies for open-globe injuries (OGIs). International classification of ocular trauma proposed almost 15 years ago needs to be reviewed and to be more robust in predicting the outcome in the setting of OGIs. Anterior segment trauma involves controversies related to patching for corneal abrasion, corneal laceration repair, and medical management of hyphema. Timing of cataract surgery and intraocular lens implantation in the setting of trauma is still debated worldwide. There are unresolved issues regarding the management of OGIs involving the posterior segment. Timing of vitrectomy has been and will continue to be debated by proponents of early versus delayed intervention. The use of prophylactic cryotherapy and scleral buckle is still practiced differently throughout the world. The role of intravitreal antibiotics in posterior segment trauma in the absence of infection is still debated. Similarly, the use of vitrectomy versus vitreous tap in the setting of traumatic endophthalmitis is not fully resolved. In optic neuropathy, the role of intravenous methylprednisolone versus conservative management is always debated and still there are no evidence-based guidelines about the beneficial role of pulse steroid therapy. The role of optic canal decompression in the setting of acute traumatic optic neuropathy is also not conclusive. Orbital and adnexal trauma has been shown to adversely affect the outcome of OGI patients but both lids and orbital injury are not taken as preoperative variables in international ocular trauma classification. The timing of intervention in blow-out fracture is still debated. The pediatric age group, owing to the high risk of amblyopia and intraocular inflammation as well as strong vitreoretinal adhesions, has to be managed by different principles. Although the risk of sympathetic ophthalmia is very rare, it is always one of the key debated issues while managing traumatized eyes with no light perception vision. Prospective, controlled clinical studies are not possible in the OGI setting and this article reviews pertinent data regarding these management issues and controversies, and provides recommendations for treatment based on the available published data and the authors' personal experience. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the predictive value and applicability of Ocular Trauma Score (OTS) and Pediatric Ocular Trauma Score (POTS) for closed and open globe injuries in the pediatric group., Methods: A retrospective study of closed and open globe injuries in children age of 0-18-year-old between 2012-2019 was conducted. Medical records were collected, and injuries were classified using Birmingham Eye Trauma Terminology System (BETTS). The predictive value and applicability of both OTS and POTS to final visual acuity (VA) were analyzed., Results: Of 84 patients, 59 (70.2%) presented with closed globe injuries (CGI) and 25 (29.8%) with open globe injuries (OGI). The mean of initial VA was 0.832±0.904 logMAR. OTS and POTS was calculated. Initial VA ( P <0.001) and traumatic cataract ( P <0.001) were significantly associated with visual outcome, followed by organic/unclean wound ( P =0.001), delay of surgery ( P =0.001), iris prolapse ( P =0.003), and globe rupture ( P =0.008). A strong correlation between OTS and POTS and final VA ( r =-0.798, P <0.001; r =-0.612, P <0.001) was found. OTS was more applicable in all age group of pediatric and in contrast to POTS, it was designed for 0-15 years old. POTS requires eleven parameters and OTS six parameters. Even though initial VA was not available, we could still calculate into POTS equation., Conclusion: OTS and POTS are highly predictive prognostic tools for final VA in CGI and OGI's in children., (International Journal of Ophthalmology Press.)

Ocular trauma is one of the most common causes of acquired blindness in children. The epidemiological parameters associated with ocular trauma vary in different populations, especially in children. The objective of this study was to assess the ocular trauma epidemiology in children less than 18 years of age. In this cross-sectional study, 145 children (under 18 years) with ocular trauma who referred to the emergency department of Bu-Ali-Sina Hospital in Sari, Iran were enrolled from November 2017 to January 2019. Of the participants, 57.9% were men, 70.4% had blunt trauma, 97.2% had a unilateral eye injury, and 54.5% had a right eye injury. The most risk factor for trauma was stationery (51.0%). Almost half of the patients (52.9%) had corneal injuries. The most trauma locations were at home (67.4%). Most patients (95.0%) had normal relative afferent pupillary defects. Blunt (52.6% vs. 47.4%) and penetrating (72.5% vs. 27.5%) traumas was higher in boys than girls ( p =0.03). Most frequent part of eye injuries in blunt and penetrating traumas was related to the cornea ( P =0.04). It seems that parents should have more supervision on children at home and give adequate education in using of stationery to school-age children by considering the results of present study., Competing Interests: There are no conflicts of interest.