Abstract
Purpose :
Open globe injuries are a severe form of ocular trauma with a high rate of vision-threatening complications that require emergent diagnosis and treatment. While less common in the pediatric population, open globe injuries still represent a significant cause of visual impairment in children worldwide. This study aims to characterize the demographic and clinical characteristics, general outcomes, and ocular complications of pediatric patients with open globe injuries over a 10-year period at a large trauma center in New York.
Methods :
This study is a retrospective chart review of all pediatric patients (16 eyes) with open globe injuries treated at 3 Northwell Health institutions from January 2012 to April 2022. The data collected consists of demographics, initial and final visual acuity, injury characteristics, including mechanism of injury, wound location and size, and ophthalmic complications, including the development of amblyopia or strabismus.
Results :
The average age of the patients in the study was 7.1±5.4 years (69% males; 31% females). Laceration due to penetrating injury was the most common mechanism of injury, occurring in 94% of patients, and rupture from blunt trauma occurring in 6%. A final visual acuity greater than 20/200 was observed in 6 patients (38%). Development of amblyopia was seen in 31% of patients, and 6% developed strabismus. Ocular signs on presentation included iris prolapse in 9 patients (56%), traumatic cataracts in 1 patient (6%), vitreous hemorrhage in 2 patients (13%), and retinal tear in 1 patient (6%). Three patients developed post injury cataract after the initial presentation, bringing the total with cataract formation to 25% of patients. 6 patients (38%) required additional surgeries for management.
Conclusions :
Open globe injuries occurred more frequently in male children and were primarily due to accidental penetrating trauma. Most patients developed severe permanent vision loss due to their injuries or the development of amblyopia, with only 38% achieving vision better than 20/200. Further insight into prognostic factors in pediatric open-globe injuries may guide treatment.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.