Purpose:
To evaluate the epidemiology, characteristics, and outcomes of pediatric open globe injuries occurring at home.
Methods:
Retrospective chart review of pediatric open globe injuries which presented to University Hospital, Newark between 1997-2008.
Results:
Eighty-nine pediatric open globe injuries were identified of which 42 occurred at home. A comparison is made with 47 cases which occurred outside of home during the same period. The mean age, gender, mode of injury, presence of intraocular foreign body (IOFB), and visual acuities (VA) are presented in the table below.
Among the cases which occurred at home, the causes of injury included poking with sharp objects (38%), falls onto object (29%), being struck with projectiles (14%), falling objects (12%), and blunt hits (7%). The most common objects involved in these injuries included broken glass, pens, furniture, knives, screwdrivers, wooden sticks and toys. Self-injury occurred in 57% cases, and was perpetrated by a sibling in 19% cases. Zone 1 injuries represented 57% of cases, zone 2 29%, and zone 3 14%. Enucleation was performed in 1 case with no-light-perception VA. Fifty percent of patients required additional surgeries, most commonly pars-plana vitrectomies, cataract extractions, and pars-plana lensectomies. The final VA in cases which occurred at home were not statistically different from visual acuities predicted by OTS (p>0.05). When compared to injuries which occurred outside of home both the initial (p=0.11) and final (p=0.15) VA were not statistically different. Retinal detachment (RD) within 6 months of initial presentation was diagnosed in 21% of cases, compared to 40% among injuries which occurred outside of home. None of the traumatic eyes injured at home or outside developed endophthalmitis.
Conclusions:
Close to half of the pediatric open globe injuries in this study occurred at home. Self-injury was the most common cause (57% cases) followed by sibling involvement in a fifth of the cases. Visual prognosis for pediatric open-globe injuries which occur at home remains poor.
Keywords: trauma • clinical (human) or epidemiologic studies: outcomes/complications • clinical (human) or epidemiologic studies: prevalence/incidence