Visual outcome and ocular survival in pediatric ocular trauma

Abstract

Purpose: Ocular injuries in children are a major under-recognized cause of ocular morbidity and can be prevented by identifying the etiology and implementing measures to prevent these injuries. This study intends to assess the visual outcome and ocular survival in pediatric ocular trauma. Design: A descriptive study set in a tertiary care teaching hospital in Southern India. Methods: A total of 56 children less than 18 years of age with ocular trauma during the period August 2010 to August 2012 were studied. Injuries were classified as per modified Ocular Trauma Classification System (OTCS). Final visual outcome was assessed at the end of one, three and six months. Results: Of the 56 children assessed, 87.5% were boys. About 12% were under-fives and almost 66% were in the age range of 5-14 years. Majority (47.5 %) had sustained trauma in the streets. Closed globe injury predominated (69.5%). At presentation, grade I injury was noted in 28 eyes (47.5%), grade II in one (1.7%), grade III in three (5.1%), grade IV in eight (13.5%) and PL negative in three (5.1%) eyes. Sixteen children were not cooperative for assessment of visual acuity (27.1%). At six months, good vision was noted in 44 (74.6%), moderate in five (8.5%), poor vision in one (1.7 %), PL negative in four (6.8%) eyes and four children were un-cooperative (6.8%). Four eyes had phthisis (6.8%) and one eye (1.7%) was eviscerated. Conclusions: Ocular trauma in childhood was more common in the male child, mostly due to road traffic accidents. Visual acuity at presentation is one of the major criteria for the final visual outcome.