Paediatric open globe injuries. Visual outcome and risk factors for endophthalmitis.
OBJECTIVE
To study the incidence of open globe injuries and the outcome in children, and to study the risk factors for post-traumatic endophthalmitis.


METHODS
Paediatric patient population. Retrospective analysis of 72 consecutive cases of open globe injury over 3 years (January 1998 to December 2000).


RESULTS
The cause of trauma was sports related (n = 18), home-made bow and arrow (n = 16), household kitchen injuries (n = 10), cracker injuries (n = 7) and other miscellaneous outdoor activities (n = 16). In 5 children the cause could not be ascertained. Visual acuity of > or = 3/60 in the injured eye at the last follow-up examination was recorded in 37 of 70 patients (52.86%) whose visual acuity could be tested. The final visual acuity was significantly poorer in eyes where primary repair was delayed beyond 24 hours of injury (P < 0.05). Post- traumatic endophthalmitis developed in 39 of 72 (54.16%) eyes. Bow and arrow and household injuries (P < 0.5) and eyes in which primary repair was delayed beyond 24 hours of injury (P < 0.01) had a higher risk of endophthalmitis in univariate analysis. In multivariate analysis delayed repair was the only significant risk factor for the occurrence of endophthalmitis (P = 0.014).


CONCLUSIONS
Delayed repair, bow and arrow injuries and household injuries were associated with significantly higher risk of endophthalmitis. The incidence of endophthalmitis can be reduced by early referral of trauma cases and parental supervision.
Narang
Subina
S
Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Gupta
Vishali
V
Simalandhi
Prabhat
P
Gupta
Amod
A
Raj
Srishti
S
Dogra
Mangat R
MR
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D009877:Endophthalmitis / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D015807:Eye Injuries, Penetrating / Q000150:complications / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014792:Visual Acuity