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Iris S Kassem, Erica Z Oltra, Senem Salar; Visual Outcomes in Pediatric Open Globe Trauma with Early Amblyopia Therapy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):804.
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© ARVO (1962-2015); The Authors (2016-present)
Pediatric eye trauma is a significant problem because of the risk of amblyopia in younger children. This is reflected in the pediatric ocular trauma score (POTS), where younger age is an independent risk factor for poor visual outcome. We sought to determine if the initial timing of therapy is related to visual outcomes.
A retrospective chart review of all patients under the age of 18 seen at the University of Illinois Eye and Ear Infirmary (IEEI) Ophthalmology Service between 2001 and 2013 with ocular trauma was performed. Their ocular trauma score was calculated using the pediatric ocular trauma score. Their clinical course as well as final visual acuity were recorded.
Sixty-six open globe trauma patients were seen between the ages of 7 weeks and 17 years old and followed for up to 12 years. Seventy-one percent of patients were below 8 years old and 73 percent were male. Of 47 children under the age of 8, Fourty-three percent had treatment with either spectacle correction, patching, or atropine. Nine of 20 children with amblyopia therapy, or 19% of all patients under 8 years old, had treatment within 3 months. Of the nine patients with amblyopia therapy within 3 months of the initial injury, 8 had vision 20/40 or better and one had vision 20/50-20/200. Only 2 of the 11 patients with later therapy (> 3 months) achieved a vision of at least 20/40. Three out of 27 children without amblyopia therapy achieved vision of 20/40 or better. When comparing final vision by POTS category severity, there was still a tendency for better visual outcomes in children with earlier therapy independent of the type of injury.
Less than 20% of patients under 8 years old seen at the IEEI with pediatric open globe trauma had initiation of amblyopia therapy within 3 months. In children at the age at risk for amblyopia, initiation of amblyopia therapy within 3 months of open globe trauma may improve visual outcomes.
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