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Open Globe Injuries in Children
Beetari B., Krevet T. S., Ruprecht K. W., Käsmann-Kellner B.,
Universitätskliniken des Saarlandes, Augenklinik und Poliklinik (Homburg/Saar)
Purpose: To report the aetiology and results in children with an open globe injury (0-14 years) and to evaluate treatment methods and visual outcome.
Methods: Retrospectively we collected the data from 41 children (≤ 14 years) who suffered from an open globe eye injury between January 1990 and December 1998. The data included personal patients data, details about the mechanism of injury, visual acuity, operations, postoperative treatments and risk factors.
Results: 68% of the children were male. Most of the injuries occured at home (43%) and between 12 and 5 oclock p.m. In 73% of the cases the injury was caused by the children themselves. 59% suffered from a penetrating injury, 12 % from a perforating injury and 29% had a globe rupture. 22% ( n= 9) underwent a primary lens operation and seven of them were secondarily operated upon with a PCL-implantation. The interval between the injury and the lens implantation ranged from 14 to 420 days. 15% of the children developped a retinal detachment. During the follow-up period a secondary enucleation had to be performed in two children, in one case due to sympathetic ophthalmia. In two children no visual acuity measurement was possible. 4 children achieved a visual acuity less than 0,3; 7 children a visual acuity from 0,3 to 0,5 and 26 children a visual acuity better than 0,5.
Conclusions: Boys suffered from injuries more often than girls due to their behaviour in leisure time. Contact lenses or implantation of intraocular lenses are recommended for an imediate treatment of aphakia to prevent amblyiopia. The final visual acuity achieved correlates to the severity of the injury. More information about the danger of eye injuries in children, a responsible supervision of the parents and the education of the children about dangerous toys (e.g. in kindergarten) could prevent the incidence of ocular injuries in children.