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      Epidemiology of Pediatric Eye Injury in Split-Dalmatia County

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          Abstract

          Aims: The aim of this study was to assess the etiological factors and circumstances associated with the occurrence of eye injuries in children in Split-Dalmatia County, and to assess the visual outcomes of such injuries. Methods: All 106 cases of pediatric eye trauma presenting to the Clinical Hospital Split, during a 4-year period, were identified by a medical record search. Results: The annual calculated incidence of serious eye injuries in pediatric patients of Split-Dalmatia County that required hospitalization was 22.5 per 100,000 in the underage population. The most common causes of ocular injury were blunt objects and missiles, which mostly caused contusions and lamellar lacerations, and sharp objects, which mostly caused penetrating eye injury. In 99 (90.83%) eyes, the injuries were mechanical. Open globe injuries were significantly severer than closed globe injuries. Final visual acuity was better than upon admission in 78.10% of cases. The annual incidence of pediatric monocular blindness in Split-Dalmatia County was 0.63 per 100,000 in the underage population. Conclusions: Eye trauma in children occurs most frequently outdoors and generally results from the use of blunt objects. Prevention of ocular injury requires greater education of both children and their parents and adult supervision of children, especially while at play.

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          Most cited references 6

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          The Ocular Trauma Score (OTS).

          Only based on a standardized terminology of ocular trauma terms, and using a very large number of injuries treated by a wide variety of ophthalmologists, could a reliable method be developed so that the functional outcome of a serious eye injury can be predicted with reasonable certainty. The authors used the databases of the United States and Hungarian Eye Injury Registries and, with a grant from the National Center for Injury Prevention at the Centers for Disease Control and Prevention, designed such a system.
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            The aetiology of perforating ocular injuries in children.

            To assess the aetiological factors associated with the occurrence of perforating ocular injuries in children in an urban setting and to assess the visual outcomes of such injuries. All cases of perforating ocular injury presenting to a single paediatric hospital (age less than 16 years) over a 17 year period were identified by a medical record search. All new cases of perforating ocular injury identified were included. All information was obtained retrospectively from the medical records. There were 72 cases identified. The commonest causes of perforating ocular injury were sharp tools (knives/scissors) poked by the child into his/her own eye (17%), or objects thrown at the child (17%). Injuries were most likely to have occurred at home (58%). The age range for injuries was 8 months to 14 years 8 months. Perforating ocular injury was most frequent in the 3-6 year group (32%) followed by the 6-9 year group (25%). Males were more frequently involved than females (48-24). There was no correlation between the laterality of the eye, the time of day of the occurrence, or the day of the week of the occurrence. The final acuity achieved was better or equal to 6/12 in 36% and less than 6/60 in 31%. Injuries occurred more frequently on weekends than on weekdays. There were six enucleations (8%). Follow up was for an average period of 25 months. Penetrating ocular injury occurs most frequently in the home setting and mostly as the result of the use of sharp tools or by thrown objects. Prevention of penetrating ocular injury requires greater education of children and their carers especially on the potential dangers within the home.
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              Eye injuries: a prospective survey of 5671 cases.

               C MacEwen (1989)
              5671 patients with injuries presenting to a busy eye casualty department were examined prospectively to determine the incidence, aetiology, and severity of the injury. Of these cases 69.9% occurred at work, 18.3% during leisure and domestic activities (excluding recognised sport), 2.3% during sport, and 1.9% were due to assaults; contact lens injury occurred in a further 2.3%, and the cause was unknown in 5.3%. One hundred and two (1.8%) patients required admission to hospital, and of their injuries 13.7% occurred at work, 22.6% during leisure and domestic activities, 42.2% at sport, 18.6% during assault, and 2.9% from an unknown cause. Children under 10 years of age accounted for 4% of the total patients presenting, but for more than 18% of those admitted and 26% of ocular penetrations. 98.3% of all injuries involved periorbital or superficial ocular structures only. The remainder involved intraocular structures. The majority of serious injuries were contusional. There was only one case of intraocular foreign body. This indicates that, while most injuries still occur in the workplace, sport and leisure activities account for the majority of serious injuries. While most injuries do not threaten sight, they do so disproportionately in children.
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                Author and article information

                Journal
                ORE
                Ophthalmic Res
                10.1159/issn.0030-3747
                Ophthalmic Research
                S. Karger AG
                0030-3747
                1423-0259
                2009
                November 2009
                07 August 2009
                : 42
                : 4
                : 199-204
                Affiliations
                Department of Ophthalmology, University Hospital Split, Split, Croatia
                Article
                232403 Ophthalmic Res 2009;42:199–204
                10.1159/000232403
                19672128
                © 2009 S. Karger AG, Basel

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                Page count
                Figures: 4, Tables: 5, References: 19, Pages: 6
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