Original Article

Twelve-Year Review of Pediatric Traumatic Open Globe Injuries in an Urban U.S. Population

Sebastian P. Lesniak, MD; Alain Bauza, BS; Jung H. Son, BS; Marco A. Zarbin, MD, PhD; Paul Langer, MD; Suquin Guo, MD; Rudolph S. Wagner, MD; Neelakshi Bhagat, MD

  • Journal of Pediatric Ophthalmology and Strabismus
  • March/April 2012 - Volume 49 · Issue 2: 73-79
  • DOI: 10.3928/01913913-20110712-02
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Abstract

Purpose:

To evaluate the epidemiology, anatomical characteristics, and clinical outcomes of pediatric traumatic open globe injuries and to compare the observed final visual acuity to the expected visual acuity as predicted by the Ocular Trauma Score (OTS).

Methods:

Retrospective chart review of 89 pediatric patients (89 eyes) with open globe injury presenting between 1997 and 2008.

Results:

Sixty-five patients (73%) were male, average age was 9.7 years, and mean follow-up was 22.6 months. The most common causes of trauma were: accidents (79%), violence (10%), and motor vehicle accidents (9%). Penetrating ocular injury was the most common trauma (54%), followed by blunt rupture (34%). Zone 1 injuries represented 49% of cases, and zones 2 and 3 represented 29% and 21%, respectively. No patient developed endophthalmitis. The average presenting and final visual acuities were logarithm of the minimum angle of resolution 1.927 and 1.401, respectively. Lens trauma was noted in 44 (49%) eyes. Twenty-eight patients (31%) had retinal detachment within 6 months of presentation. Total retinal attachment was achieved in 12 (63%) of 19 eyes undergoing repair. Enucleation was performed in 9 (10%) patients. Final visual acuities were not statistically different from visual acuities predicted by OTS (P > .05).

Conclusions:

The visual prognosis in pediatric open globe injury is poor. The zone of injury may correlate with poor final visual acuity, risk of retinal detachment, and subsequent need for an enucleation. The final predicted visual acuity correlated well with the observed final visual acuity in these patients.

AUTHORS

From the Institute of Ophthalmology & Visual Science, New Jersey Medical School, Newark, New Jersey.

Presented at the Association for Research in Vision and Ophthalmology annual meeting; May 2–6, 2010; Fort Lauderdale, Florida.

Supported in part by Research to Prevent Blindness, Inc., the New Jersey Lions Eye Research Foundation, and the Eye Institute of New Jersey.

The authors have no financial or proprietary interest in the materials presented herein.

Dr. Wagner did not participate in the editorial review of this manuscript.

Address correspondence to Neelakshi Bhagat, MD, The Institute of Ophthalmology and Visual Science, New Jersey Medical School, 90 Bergen Street, Suite 6100, Newark, NJ 07101. E-mail: bhagatne@umdnj.edu

doi: 10.3928/01913913-20110712-02

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