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Robert John Barry, Alice Bruynseels, Freda Sii, Joseph Abbott, Richard J Blanch, Caroline J MacEwen, Peter Shah; Paediatric Ocular Trauma: A prospective nation-wide survey of presenting features and management. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2302.
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Paediatric ocular trauma is an important cause of visual morbidity worldwide, accounting for up to one third of all ocular trauma admissions, with long term implications for those involved and significant economic consequences for health-care providers. It has been estimated that there are 6 million cases of paediatric ocular trauma worldwide each year, with 250,000 cases requiring hospital admission. Fortunately, 90% of ocular trauma is thought to be preventable. Targeted strategies are required to reduce the incidence and severity of paediatric ocular trauma; this requires an understanding of the epidemiology and characteristics of these injuries and the children involved.
We conducted a prospective, observational study of paediatric ocular trauma cases presenting to all UK-based ophthalmologists over a one-year period; reporting cards were distributed nationally by the British Ophthalmic Surveillance Unit (BOSU), and clinicians asked to report cases of acute orbital and ocular trauma in children aged 16 years or less requiring inpatient or day-case admission. A validated, standardised questionnaire was sent to reporting ophthalmologists to collect data on the demographics and circumstances of injury, presenting clinical features and initial management.
In total, 86 cases of paediatric ocular trauma were reported. Median age at presentation was 7.7 years, with boys more than twice as likely to be affected than girls (M:F=2.1:1.0). 82.6% (n=71) of patients presented within 24 hours of injury, and 52.3% (n=45) had a best-corrected visual acuity in the affected eye of <10/20 on presentation. Globe injuries were observed in 77.9% (n=67), lid trauma in 19.8% (n=17), and orbital injury in 5.8% (n=5). 61.2% (n=41) of globe injuries were perforating/penetrating. 80.2% (n=69) of patients required surgical intervention, with surgery performed within 24 hours of presentation in 78.3% (n=54) of cases. Globe involvement was observed more frequently in girls (F:M=1.3:1, Chi-square=5.092, p=0.024).
Paediatric ocular trauma remains an important public health problem. Whilst injury can involve a wide range of orbital and extra-ocular structures, globe involvement is the most frequent cause for admission in the paediatric age group, with a high proportion of open-globe injuries in this cohort. The majority of children admitted following ocular trauma require surgical intervention.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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