PROFILE OF PEDIATRIC OCULAR TRAUMA AT A TERTIARY EYE CARE CENTRE IN NORTHERN INDIA
Authors: Rajendra P Maurya, Virendra P. Singh, Ishan Yadav, Mahendra K. Singh, C.P.Mishra, Prithvi R. Sen,
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Purpose: To evaluate the pattern, causes and treatment outcome of ocular trauma in pediatric age group.
Methods: This prospective interventional study was conducted among all patients, up to 16 years of age, with ocular trauma, who visited the Ophthalmology OPD and Emergency OPD of S S Hospital, Banaras Hindu University, Varanasi between October 2011 to April 2014. The Demographic data, causes, type, extent & severity of injuries and impact on vision were identified and analyzed.
Results: Out of 82 patients, 54 (65.85%) were boys and 28(34.15%) were girls. The age ranged from 2 -16 years. Mechanical injuries accounted for 78.05%, while rests were chemical (12.20%) and thermal / firework injury (9.76%). Most of the injuries occurred at home (n=28, 34.15%) while rest (66.85%) occurred away from home e.g. playground (n=20, 24.39%), street/Road (n=18, 21.95%) and school (n=16, 19.51%). Most common cause of injury was projectile objects like ball/ stone/ toy gun /gulli (24.39%), followed by sharp objects like knife/needle/wire (19.51%), fall (15.85%), RTA (14.63%) and firework /cracker (9.76%) while the least common cause was animal injury (4.88%). Commonest type of injury was globe injury (51.22%) followed by Lid & particular injury (43.90%) and orbital fracture (21.95%). 29.27% had open globe injury while 21.95% had closed globe injury. Left eye was affected in 46.34%, Right eye in 42.68 %, while in 10.98 % cases both the eyes were injured. The most common complication was hyphema (31.70%) followed by traumatic cataract (21.95%), iris prolapse/ iridodialysis (19.51%), vitreous hemorrhage/retinal detachment (14.63%), endophthalmitis (6.10%) and disorganized globe or phthisis (13.41%). 47.56 % injured children were treated surgically while rest 52.44 % were managed by medical treatment .Initial visual acuity was good (> /= 6/12) in 36.59% ,moderate vision( 6/18-6/60) in 26.83% and poor vision (<6/60) in 21.95% while assessment was not possible in 14.63%. Final visual acuity was 6/18 or better in 46.34 %, between <6/18 to 3/60 in 21.95% and <3/60 to no PL in 19.51%. Final visual acuity could not be evaluated in 12.20 % cases.
Conclusion: This study emphasizes the need for eye injury prevention in children particularly during playing and while moving on road / street.