Traumatic open globe injury in young pediatric patients: Characterization of a novel prognostic score

Sarah P. Read, Kara M Cavuoto

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background Open globe injury is a common cause of monocular blindness in children. Current formulas to predict outcomes of open globe injury often rely heavily on visual acuity and presence of an afferent pupillary defect, examination elements that are difficult to assess in young children. We aimed to analyze the features of open globe injuries in children aged 0-6 years to facilitate development of a novel algorithm for predicting visual outcomes in this age group. Methods The medical records of patients 0-6 years of age presenting at a single institution with open globe injury from 2000 to 2013 were retrospectively reviewed. Epidemiology, physical examination, and intervention data were used to develop a prognostic algorithm. Results A total of 28 patients were included. Mean age at presentation was 4.2 years (range, 1.9-6.7). Glass was the most common mechanism of injury. Associated findings included uveal prolapse (93%), choroidal detachment (39%), hyphema (32%), and retinal detachment (11%). In addition to primary repair, 43% patients required a lensectomy, and 7% underwent surgery to repair retinal detachment. Complicating cataract (P <0.005) and a wound >6 mm (P <0.05) were associated with a final visual acuity worse than 20/40. A novel algorithm for predicting visual outcome was devised with a sensitivity of 81% and a specificity of 92%. Conclusions Patients 0-6 years of age with open globe injuries present unique risk factors for poor outcome. The trauma score generated by our algorithm is not reliant on presenting visual acuity and may be useful in predicting prognosis in very young children.

Original languageEnglish (US)
Pages (from-to)141-144
Number of pages4
JournalJournal of AAPOS
Volume20
Issue number2
DOIs
StatePublished - Apr 1 2016

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Pediatrics
Wounds and Injuries
Visual Acuity
Retinal Detachment
Pupil Disorders
Hyphema
Prolapse
Blindness
Cataract
Physical Examination
Medical Records
Glass
Epidemiology
Age Groups

ASJC Scopus subject areas

  • Ophthalmology
  • Pediatrics, Perinatology, and Child Health

Cite this

Traumatic open globe injury in young pediatric patients : Characterization of a novel prognostic score. / Read, Sarah P.; Cavuoto, Kara M.

In: Journal of AAPOS, Vol. 20, No. 2, 01.04.2016, p. 141-144.

Research output: Contribution to journalArticle

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abstract = "Background Open globe injury is a common cause of monocular blindness in children. Current formulas to predict outcomes of open globe injury often rely heavily on visual acuity and presence of an afferent pupillary defect, examination elements that are difficult to assess in young children. We aimed to analyze the features of open globe injuries in children aged 0-6 years to facilitate development of a novel algorithm for predicting visual outcomes in this age group. Methods The medical records of patients 0-6 years of age presenting at a single institution with open globe injury from 2000 to 2013 were retrospectively reviewed. Epidemiology, physical examination, and intervention data were used to develop a prognostic algorithm. Results A total of 28 patients were included. Mean age at presentation was 4.2 years (range, 1.9-6.7). Glass was the most common mechanism of injury. Associated findings included uveal prolapse (93{\%}), choroidal detachment (39{\%}), hyphema (32{\%}), and retinal detachment (11{\%}). In addition to primary repair, 43{\%} patients required a lensectomy, and 7{\%} underwent surgery to repair retinal detachment. Complicating cataract (P <0.005) and a wound >6 mm (P <0.05) were associated with a final visual acuity worse than 20/40. A novel algorithm for predicting visual outcome was devised with a sensitivity of 81{\%} and a specificity of 92{\%}. Conclusions Patients 0-6 years of age with open globe injuries present unique risk factors for poor outcome. The trauma score generated by our algorithm is not reliant on presenting visual acuity and may be useful in predicting prognosis in very young children.",
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