Оpen globe injury in children: epidemiology and predictors of an adverse outcome

Here we aimed to analyse the prevalence, clinical course, and current approaches to the prevention and treatment of open globe injury in children as well as its complications: hyphema, retinal detachment, traumatic uveitis, and endophthalmitis. Currently, children are responsible for the 10-15% of open globe injuries. In developed countries, open globe injury is the leading cause of monocular blindness in children. Open globe injury mainly affects boys (60−70% cases), yet severe injuries are rare, and closed globe injury is the most common type of eye injury. Most injuries are accidental and occur at home in daily life (50−60%), outdoors (20−35%), at school (1−5%), or while playing sports (1−3%). Open globe injury most often affects cornea and is associated with a high risk of early and late complications and poor outcomes. Wearing of protective glasses during sports and active recreation is recognised as an efficient tool for primary prevention of open globe injury in children. The main problems in prevention of complications of open globe injury are the lack of specialised care in low-income countries and the limited awareness of parents.

Yearly Trends In The Prevalence of Ocular Traumas And The Effects of Covid-19: A Nationwide Population-Based Study of Korean Data

We identify the yearly trends in the prevalence of various ocular traumas in the Republic of Korea, and the effects of Covid-19. We recorded the yearly numbers of patients diagnosed with hyphema and those who underwent open reduction surgery because of orbital blowout fracture (BOF), primary closure of the cornea or sclera (PCCS), or intraocular foreign body (IOFB) removal. The incidence of closed globe injuries has decreased significantly over the past 10 years, while that of open globe injuries has not. The patients aged ≥ 60 years showed a significant increase in BOF surgery. Regarding the trend in PCCS, while other age groups showed significant decreases, the population aged ≥ 60 years did not. In addition, the population aged ≥ 60 years showed a significant increase in the incidence of IOFB. When the 2020 data were compared with those of 2019, hyphema evidenced the largest decrease (27.02%), especially in those aged < 20 years (54.33%). In terms of both BOF and IOFB, those aged < 20 years showed the largest decreases (28.85% and 47.93% respectively). In the Covid-19 era, ocular trauma fell markedly in those aged < 20 years, perhaps because of school closures and reductions in outdoor activities.

Clinical Characteristics, Visual Outcomes, and Prognostic Factors of Open Globe Injuries

Background and Objectives: Open globe injuries (OGI) remain an important cause of visual impairment and loss, impacting all ages. A better understanding of the factors influencing visual outcomes is important in an attempt to improve the results of the treatment of OGI patients. The author aimed to contribute to this knowledge with the analysis of clinical characteristics, prognostic factors, and visual outcomes of their cohort of OGI patients. Materials and Methods: A retrospective medical record review was performed for 160 patients (161 eyes) who sustained an open globe injury between January 2015 and December 2017 and presented to the Hospital of Lithuanian University of Health Sciences. Data analyzed included age, sex, type, cause, place of OGI, initial visual acuity (VA), final best-corrected visual acuity (BCVA), and tissue involvement. Open globe injuries were classified using the Birmingham Eye Trauma Terminology (BETT) and Ocular Trauma Classification System (OTCS). Univariate analysis was conducted to evaluate the prognostic factors. Results: The mean age of the patients was 41.9 years. The male-to-female ratio was found to be 8.4:1. The home was the leading place of eye injury (59.6%), followed by an outdoor environment (14.3%) and workplace (11.8%). Penetrating injury accounted for 43.5%, followed by intraocular foreign body injury (39.1%) and globe rupture (13%). Overall, 19.5% of patients regained a good final vision of ≥0.5, but for 48.1% of them, eye trauma resulted in severe visual impairment (BCVA ≤ 0.02). In the univariate analysis, a bad visual outcome of less than 0.02 was correlated with bad initial VA, iris dialysis, hypotony, vitreous hemorrhage, and vitreous prolapse at presentation. Phthisis bulbi was correlated with eyelid laceration, iris prolapse, iris dialysis, hyphema, vitreous prolapse, vitreous hemorrhage, and choroidal rupture at initial examination. Conclusions: Open globe injury remains an important preventable cause of ocular morbidity. This study provides data indicating that open globe injuries are a significant cause of visual impairment in our research group.