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Ethan K Sobol, David Poulsen, Afshin Parsikia, JOYCE MBEKEANI; Patterns in Pediatric Ocular Trauma. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5957.
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© ARVO (1962-2015); The Authors (2016-present)
Ocular trauma is a leading cause of visual impairment and blindness in childhood. Although many injuries result in poor outcomes, they can be prevented with improved education and safety precautions. Herein, we evaluate the epidemiology of pediatric ocular trauma in the US.
A retrospective survey of the National Trauma Data Bank (2008-2014) was conducted of patients <21yrs admitted with major trauma. Ocular trauma was identified using ICD-9 codes. Data were analyzed using student t-test, Chi-squared, and odds ratio (OR) calculations with SPSS software. Statistical significance was set at p<0.05.
58,765 (18.6%) of 316,485 patients admitted with ocular trauma were <21yrs. Mean age was 11.9yrs (SD=6.9); median 14.0 (IQR:5-18). Males (68.7%) outnumbered females (31.3%) and were older (mean=12.6) than females (mean=10.6); p<0.001. Race was reported as Black, 17.6%, White, 59.1% and “other,” 29.3%. Hispanic ethnicity accounted for 16.3%. The regions submitting most cases were South (39.3%) and Northeast (26.6%). Most injuries resulted from blunt force (71.3%) and were unintentional (76.3%). Mean injury severity score (ISS) was “moderate”, 11.8 (SD=10.9). Median hospital stay was 2 days (IQR:1-5) and mortality occurred in 2.9%. Common injuries were eye/adnexa contusions (30.6%), orbital fractures (29.9%), and open wounds of adnexa (29%). Open globe injuries occurred in 11.6% and traumatic brain injury (TBI) in 54.7%. Frequent mechanisms were motor vehicle occupant (MVTO), (28.1%), struck by against (SBA), (16.1%), and falls (9.1%). Frequent locations were street (42.1%) and home (29.3%). SBA was most common in public buildings (OR=5.9 CI=5.4-6.4) as were falls (OR=3.1 CI 2.8-3.5); p<0.001. MVTO (OR=2. CI=1.92-2.09) and injury on the street (OR=2.4 CI=2.3-2.5); p<0.001 were more likely in the 19-21yrs group. The 0-3yrs group had greater odds of being injured at home (OR=9.9 CI=9.5-10.4; p<0.001). Whites had higher odds of motorcycle mechanism (OR=1.4 CI=1.2-1.6); MVT-pedestrian was higher in Blacks (OR=1.7, CI=1.5 to 1.8); p<0.001. MVT-pedestrian was more likely in the West (OR=1.6 CI=1.5-1.8); falls were more likely in the Northeast (OR=1.4 CI 1.3-1.5); p<0.001.
Pediatric ocular trauma occurred more frequently in males and from MVT and SBA. Most patients had associated TBI. We identified regional and demographic patterns that may help with the development of measures and policies to help prevent unnecessary vision loss.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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