Etiology and Pattern of Ocular Trauma in Children and their Management Consequences

Purpose: to determine the common causes of ocular trauma in the pediatric age group and their visual outcome after surgical intervention. Methods: A retrospective study was conducted with the children underwent surgical intervention for ocular trauma between January 2021 to December 2023. Children reported at pediatric outpatient and emergency department with age range 0 to 16 years were enrolled. Various epidemiological parameters like age, sex distribution, duration of presentation, mode of injury, type of injury, and final visual outcome were analyzed. Results: Out of 200 patients, 90% were below the age of 12 years; 35.5 % of children with ocular trauma belonged to age group 0 to 4years. The male to female ratio was 2:1. In this study, 149(74.5%) cases presented with corneal injury. Among ocular injuries, the major traumatic agents were wooden objects 70 (35%) and sharp object 38 (19%). Home was the most common place of injury152 (76%), followed by playground 27(13.5%), school 20 (10%) and workplace 1(0.5%). 27 (13.5%) cases were closed globe injuries and the rest 173 (86.5%) were open globe injuries. Most of the cases needed single surgery 128 (64%) and the rest 72 (36%) underwent multiple surgeries. Among them 41.5% needed repair of corneal injury with excision of prolapsed iris and 34% cases treated with IOL implantation with PPC & AVT later on. 48.5% of the patients got better visual acuity ranging from 6/6 to 6/18. In 12% cases central, steady, maintained were present, 39.5% patients were visually impaired and 4.5% developed phthisis bulbi. Conclusion: Pediatric eye injuries occur most frequently in the home setting and mostly as the result of the use of wooden sticks and sharp objects like glass pieces, knife, and scissors, pen/pencil, and toy pistols. Corneal scars, astigmatism and amblyopia remain the most common causes of decreased vision after management of injuries in children.