Visual Outcome of Pediatric Traumatic Cataract in Lumbini Eye Institute, Bhairahawa, Nepal

2020 ◽  
Vol 12 (1) ◽  
pp. 17-24
Author(s):  
Govind Gurung ◽  
Kabindra Bajracharya
Keyword(s):  
Visual Acuity ◽  
Pediatric Trauma ◽  
Visual Outcome ◽  
Corneal Opacity ◽  
Study Data ◽  
Open Globe Injury ◽  
Traumatic Cataract ◽  
Open Globe ◽  
Corneal Laceration ◽  
Better Than

Introduction: There are not many studies of pediatric trauma in Nepal. Therefore, this study was conducted to find out the visual outcome of pediatric traumatic cataract and causes of poor visual acuity. Materials and Methods: In this hospital based prospective study, all children visiting the pediatric department of Lumbini Eye Institute and Research Center with traumatic cataract and visual outcome after surgery from July 2018 to August 2019 were evaluated. A total of 136 children ranging from age (0 months to 15 years) with traumatic cataract were included in the study. Data on age of presentation, sex and diagnosis were collected from clinical charts and analyzed. Results: The study enrolled 136 cases with traumatic cataract. 72.1% male and 27.9% female patients were involved with the average age being 9.46 years (SD 2.95). Final visual acuity was better than 20/60 in 73 percent of the children. Visual acuity was poor in 27 percent of children. In children with poor visual acuity 44 percent of the patients had corneal opacity, 23 percent had retinal detachment and 18 percent had vitreous opacification secondary to trauma. Closed globe injury was seen in 72 percent of children and 28 percent had open globe injury. Conclusion: Male children were more prone to traumatic cataract than female children. Open globe injury with corneal laceration and opacity was the major cause of decreased visual acuity.

scholarly journals Profile of Open Globe Injury in Children at Lumbini Eye Institute

2015 ◽  
Vol 3 (1) ◽  
pp. 37-40
Author(s):  
Binita Bhattarai ◽  
Santosh Pokhrel ◽  
Bel Thapa ◽  
Prachand Gautam ◽  
Nanda Gurung
Keyword(s):  
Visual Acuity ◽  
Public Health Problem ◽  
Visual Outcome ◽  
Medical Sciences ◽  
Open Globe Injury ◽  
Open Globe ◽  
Male Preponderance ◽  
Time Of Presentation ◽  
Better Than

INTRODUCTION: Ocular trauma is preventable public health problem throughout the world that especially affects the young. During the last several decades the prognosis of open-globe injuries has significantly improved. The aim of this study was to describe the clinical profile of open globe injury in children and visual outcome after surgery.MATERIAL AND METHODS: It is a prospective hospital based study that included children aged 1-15 yrs presenting to Lumbini Eye Institute (LEI), Bhairahawa with open globe injury. Visual acuity and Anterior and Posterior Segment examination findings were recorded at the time of presentation, after surgery and in three subsequent follow up visits.RESULTS: Out of 26,538 pediatric patients, during the study period 0.26% (n=69) had open globe injury. The most common age group was 510 years comprising 43.5%, with a strong male preponderance of 74% and mean age of 8.06±3.6years. Playing was the most common mode of injury comprising 58%, where as stick was the most common agent causing trauma consisting 51%. Fifty two percent were visually impaired and 39% were blind at the time of presentation and only 9% children had visual acuity better than 6/18. Improved vision was found in 52%, same vision in 34% and deteriorated vision in 13% till third follow up visit. Anatomical integrity of the globe was maintained in 88.4% and only 11.6% had Phthisis bulbi.CONCLUSION: The incidence of open globe injury among children at Lumbini Eye Institute was 0.26%. Male children were more vulnerable. Stick was the most common traumatizing agent. There was a favorable outcome with improved vision in most children after surgery.Journal of Universal College of Medical Sciences Vol. 3, No. 1, 2015: 37-40

Pediatric open-globe injury in a university-based tertiary hospital

2018 ◽  
Vol 30 (2) ◽  
pp. 269-274 ◽  
Author(s):  
Faisal AlDahash ◽  
Ahmed Mousa ◽  
Priscilla W Gikandi ◽  
Ahmed M Abu El-Asrar
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Visual Outcome ◽  
Tertiary Hospital ◽  
Open Globe Injury ◽  
Female Ratio ◽  
Initial Visual Acuity ◽  
Open Globe ◽  
Type Of Injury

Background: To investigate epidemiology, etiology, and outcomes after repair of pediatric open-globe injury. Methods: We retrospectively reviewed medical records of patients ⩽18 years who underwent primary open-globe repair. Results: A total of 213 patients were identified. Male–female ratio was 1.44:1. Type of injury was penetration in 157 (74.4%) cases, rupture in 52 (24.4%) cases, and perforation in 2 (0.9%) cases. Knife injuries were the most common cause, affecting 38/196 (19.4%), followed by metallic object in 37/196 (18.9%) patients, glass in 26/196 (13.3%) patients, and pen or pencil in 24/196 (12.8%). Predictors of good visual outcome defined as (⩾20/40) were good initial visual acuity (⩾20/40; p < 0.0001), time from injury to arrival at the emergency room >24 h (p = 0.038), size of wound less than 10 mm (p < 0.0001), absence of iris prolapse (p < 0.0001), deep anterior chamber at presentation (p < 0.0001), absence of hyphema (p = 0.043), intact lens (p < 0.0001), and no retinal detachment during follow-up (p < 0.0001). A total of 27 (12.7%) cases were documented to have retinal detachment at any time during follow-up period. Predictors of retinal detachment were perforation and rupture (p < 0.0001), whereas penetration was not associated with development of retinal detachment, size of the wound ⩾10 mm (p < 0.0001), initial visual acuity ⩽20/200 (p < 0.0001), lens injury (p < 0.0001), and development of endophthalmitis (p < 0.027). Eight (3.7%) eyes had the clinical diagnosis of posttraumatic endophthalmitis. Conclusions: The most common type of injury was penetration and the most common tool was knife. Visual outcome was affected by the initial presentation. Retinal detachment was a significant predictor of a worse final visual outcome.

scholarly journals VISUAL OUTCOME OF TRAUMATIC CATARACT: ONE YEAR REVIEW

1969 ◽  
Vol 6 (2) ◽  
pp. 827-831
Author(s):  
ARSHAD IQBAL ◽  
SHER AKBAR KHAN ◽  
TARIQ MOHAMMAD SAEED ◽  
HAROON RASHID
Keyword(s):  
Visual Acuity ◽  
Case Series ◽  
Visual Outcome ◽  
Teaching Hospitals ◽  
Traumatic Cataract ◽  
Young Males ◽  
Co Morbidity ◽  
Open Globe ◽  
Corneal Scar ◽  
One Year

BACKGROUND: Traumatic cataract is a very common ocular emergency encountered byophthalmologists worldwide. There is a long list of co-morbidities associated with traumatic cataract.Visual outcome is unpredictable after surgical management of the traumatic cataract.OBJECTIVES: To study the presentation and surgical outcome of traumatic cataract following openand closed globe injury.MATERIAL & METHODS: It is a prospective interventional case series. The study was carried out atDepartment of Ophthalmology, Saidu Group of Teaching Hospitals, Swat from 1st July 2015 to 30th June2016 on the patients with traumatic cataract.RESULTS: In this study we evaluated 40 eyes of 40 patients who presented with traumatic cataract andwere admitted to our unit during the study period. There were 72.5% male and 27.5% female. Stick andwooden splinter was the most common traumatic agent responsible for traumatic cataract in 40%followed by stone in 22.5% cases. Preoperative visual acuity was perception of light (PL) to handmovements (HM) in 45%, counting fingers to 6/60 in 50% patients. 50% patients had postoperativevisual acuity of less than 6/60, while 50% had visual acuity of 6/60 and above. Extracapsular cataractextraction (ECCE) with intraocular lens (IOL) was performed in 55% cases, while ECCE without IOLwas done in 7.5% cases. The most common co-morbidity was corneal scar in 12.5%, 27.5% patients hadcombined co-morbidities while 25% had no co-morbidity.CONCLUSION: Majority of the patients with traumatic cataract were young males. Postoperativevisual acuity was better in those cases which were not associated with other co-morbidities. Surgicalintervention was required in all cases and conventional ECCE with IOL implantation was the mostcommonly adopted surgical procedure. Trauma with stick and wooden splinter was the most commoncause of traumatic cataract.KEY WORDS: Traumatic cataract, Closed globe injury (CGI), Open globe injury (OGI), visual acuity(VA).

Comparative study of visual outcome between open- and closed-globe injuries following surgical treatment of traumatic cataract in children

2018 ◽  
Vol 28 (4) ◽  
pp. 406-411 ◽  
Author(s):  
Mehul A Shah ◽  
Shreya M Shah ◽  
Siddharth R Gosai ◽  
Satyam S Gupta ◽  
Raubaq R Khanna ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Outcome ◽  
Study Cohort ◽  
Traumatic Cataract ◽  
Eye Trauma ◽  
Open Globe ◽  
Observational Cohort ◽  
Group 2 ◽  
Terminology System ◽  
Group 1

Objective: To compare final visual outcomes of surgically treated traumatic cataract between open-globe and closed-globe injuries in children, as classified by the Birmingham Eye Trauma Terminology system. Methods: This is an observational cohort study with permission from Hospital Ethical Committee. We enrolled children meeting specific inclusion criteria, examined their eyes to review any co-morbidities due to trauma, performed surgery for traumatic cataracts, and implanted lenses. The patients were re-examined postoperatively. We classified the cases of traumatic cataract as either open-globe (Group 1) or closed-globe (Group 2) according to the Birmingham Eye Trauma Terminology system and compared visual acuity. Result: Our study cohort of 1076 eyes with traumatic cataracts included 405 eyes in Group 1 and 671 in Group 2. Postoperatively, the visual acuity was >20/60 in 223 (55.3%) and 377 (56.3%) operated eyes in Groups 1 and 2, respectively ( p < 0.001, analysis of variance). With further follow-up, >20/60 vision was significantly higher in Group 2 as compared to Group 1 (odds ratio = 1.61; 95% confidence interval = 0.85–3.02). Overall, 600 eyes (55.7%) regained final visual acuity >20/60. Conclusion: Closed-globe injury has more favourable prognosis for the satisfactory (>20/60) visual recovery after effective management of traumatic cataracts in children.

TO ANALYZE THE EFFECT OF DAMAGE TO OTHER OCULAR TISSUES ON VISUAL OUTCOME AFTER TRAUMATIC CATARACT SURGERY.

2019 ◽  
Vol 3 (9) ◽  
Author(s):  
Dr. Mita V. Joshi ◽  
Dr. Sudhir Mahashabde
Keyword(s):  
Visual Outcome ◽  
Corneal Opacity ◽  
Research Centre ◽  
Traumatic Cataract ◽  
Visual Axis ◽  
College Hospital ◽  
Ocular Tissues ◽  
Department Of Ophthalmology ◽  
Ocular Injuries ◽  
Final Visual Outcome

All patient coming to Index Medical College Hospital & Research Centre, Indore operated in Department of Ophthalmology for traumatic cataract due to various injuries Result: Of the 37 patients, 19 patients (51%) showed corneal/ corneal sclera injury. 10 cases had injury to iris in the form of spincter tear, traumatic mydriasis, iris incarceration, floppy iris, posterior and anterior synechiae. Subluxation of lens was seen in 2 cases and Dislocation of lens was in 1 cases. 3 cases had corneal opacity. Old retinal detachment was seen in 1 (3%) case. Out of 30 cases who had associated ocular injuries, 3 cases had vision of HM, 07 cases had vision of CF-ctf – CF-3’, 01 cases had vision of 5/60, 07 cases had vision of 6/60-6/36, 03 cases had vision of 6/24-6/18, 09 cases had vision of 6/12-6/6. Out of 7 cases without associated in injury, 2 cases had vision of 6/24-6/18, 05 cases had vision of 6/12-6/6. Conclusion: Corneal scarring obstructing the visual axis as well as by inducing irregular astigmatism formed an important cause of poor visual outcome in significant number of cases. Irreversible posterior segment damage lead to impaired vision case. The final visual outcome showed good result however the final visual outcome depends upon the extent of associated ocular injuries. Effective Intervention and management are the key points in preventing monocular blindness due to traumatic cataract. Keywords: Ocular, Tissues, Traumatic, Cataract & Surgery.

Surgical management and outcomes of pediatric open globe injuries requiring vitrectomy

2021 ◽  
pp. 112067212110006
Author(s):  
Xin Liu ◽  
Lufei Wang ◽  
Fengjuan Yang ◽  
Jia’nan Xie ◽  
Jinsong Zhao ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Management ◽  
Pediatric Patients ◽  
Vitreous Hemorrhage ◽  
Visual Outcome ◽  
Poor Visual Outcome ◽  
Early Vitrectomy ◽  
Open Globe ◽  
Time From Injury ◽  
Ocular Sign

Purpose: To describe surgical management and establish visual outcomes of open globe injury (OGI) in pediatric patients requiring vitrectomy. Methods: Forty-eight eyes of 48 pediatric patients underwent vitrectomy for OGI with secondary vitreoretinal complications in the eye center of Jilin University were included. Characteristics of patients, details of ocular examination and operation, presenting and final visual acuity were recorded. Results: Presenting visual acuity less than 20/400 was found in 44 eyes (91.7%), which included no light perception (NLP) in four eyes. At last visit, there was no eyes with visual acuity of NLP, and 19 eyes (39.6%) had a vision recovery to 20/400 or better. Mechanisms of injury, intraocular contents prolapse, presence of hyphema, intraocular foreign body, vitreous hemorrhage, retinal detachment, and total time from injury to PPV > 2 weeks were significant predictors of visual prognosis. Logistic regression analysis showed that hyphema was a significant predictive factor for poor visual outcome. Conclusion: Visual acuity was improved in most of the patients with OGI in this study. Hyphema is an important presenting ocular sign in estimating the post-vitrectomy visual outcome for OGI in children. Proper timing of vitrectomy is suggested, and in this study patients may benefit more with early vitrectomy as less proliferative vitreoretinopathy (PVR) was found together with a better visual acuity.

scholarly journals Open Globe Injury related to Road Traffic Accident: a Retrospective Study

2019 ◽  
Author(s):  
Phit Upaphong ◽  
Pongsant Supreeyathitikul ◽  
Janejit Choovuthayakorn
Keyword(s):  
Road Traffic ◽  
Visual Outcome ◽  
Considerable Proportion ◽  
Similar Proportion ◽  
Safety Education ◽  
Open Globe Injury ◽  
Eye Injuries ◽  
Globe Rupture ◽  
Open Globe ◽  
High Prevalence

Abstract BackgroundTo evaluate epidemiology, clinical characteristics and outcomes of patients who sustained road traffic-related open globe injury (OGI)MethodsMedical records of all road traffic-related OGI patients who were admitted to the hospital from January 2006 to December 2016 were retrospectively reviewed. Data including age, gender, vehicle type, initial ocular presentation, and final visual outcome were extracted.ResultsAmong the overall causes of OGI, road traffic-related accidents comprised 92/978 (9%) of cases. Of these, ten (11%) patients acquired bilateral eye injuries and 72 (78%) were male. Nearly half of the injuries (51%) occurred in the 20-39 years old age group and the majority of cases (59%) involved automobile transportation. Globe rupture, 48 (47%) eyes, occurred in a similar proportion of penetration, 46 (45%) eyes. Following treatments, LogMAR visual acuity (VA) significantly improved from a median (interquartile range) of 2.3 (1.9 - 2.3) to 1.7 (0.3 - 3.0), at the final follow-up appointment. Presence of relative afferent pupillary defect and presence of retinal detachment were predictors for poor final visual outcomes.ConclusionsThis study provides information regarding road traffic-related OGI that had a high prevalence in young. The risky transportation mode were motorcycles in teenager and automobiles in young adult. A considerable proportion of impaired final VA might have a significant impact on the socio-economic system. Establishing effective safety education and encouraging regular adherence to road safety behaviors are challenging issues that need more action.

scholarly journals Visual Outcome of Ocular Trauma Presenting in a Tertiary Care Hospital in Sahiwal

2020 ◽  
Vol 36 (2) ◽  
Author(s):  
Ahmad Zeeshan Jamil ◽  
Muhammad Luqman Ali Bahoo
Keyword(s):  
Visual Acuity ◽  
Ocular Trauma ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Visual Outcome ◽  
P Value ◽  
Care Hospital ◽  
Open Globe ◽  
Patient Reported

Purpose: To find the visual outcome of ocular trauma presenting in a tertiary care hospital in Sahiwal. Study Design: Descriptive observational study. Place and Duration of Study: This study was conducted at District Headquarter Teaching Hospital affiliated with Sahiwal Medical College, Sahiwal from January 2016 to June 2019. Material and Methods:  Four hundred and thirty five patients were included in the study by convenient sampling technique. Patient’s age, gender, occupation, activity at the time of injury, nature of object causing trauma, duration of trauma, visual acuity at the time when patient reported to hospital, the time delay before coming to the hospital were recorded. Ocular injuries were classified according to Birmingham ocular trauma terminology. Detailed ocular examination was performed. Patients were managed and post-management visual acuity at three months was recorded. Results: Mean age of patients was 29.07 ± 12.53 years. There were 219 (50.3%) closed globe and 216 (49.7%) open globe injuries. In 59 (13.6%) cases, cause of injury was metal object. In 146 (33.6%) cases injury was classified as contusion. In 164 (37.7%) cases cornea was involved. Majority of the patients were male. Eighty-seven patients presented within 1 day after trauma. In 154 (35.4%) patients, visual acuity at the time of presentation was 6/12 or better while in 171 (39.3%) cases it was less than 6/60. Chi-square test was used to calculate the difference between pre and post-management visual acuity. This difference was statistically significant with p-value less than 0.05 Conclusion:  Ocular trauma cases, if properly and timely managed, have a statistically significant increase in visual acuity.

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