Penetrating eye injuries in South African children: aetiology and visual outcome.
OBJECTIVE
To assess the aetiology, prognosis, and visual outcome of penetrating eye injuries in South African children.


METHODS
In all, 100 consecutive patients, aged 16 years and under, with penetrating ocular injuries undergoing surgery between January 2001 and November 2002 were prospectively evaluated.


RESULTS
Most children (66%) were injured during play. In all, 55% of penetrating eye injuries occurred at home, and all injuries to children under the age of 6 years occurred there. Most injuries occurred in the absence of a caregiver (85%). Sticks, wire, and glass caused half of all injuries (48%). The most common mechanism of injury was impact with a sharp object (46%). Only 25% of injured presented to the hospital within 24 h of injury; the more severe the sustained injury and the younger the patient, the earlier was attendance at the clinic. Most patients (71%) regained best-corrected visual acuity (Snellen equivalent) of 20/200 or better, and 51% regained 20/40 or better. Patient age and delay of presentation were not of prognostic value. Indicators of poor visual outcome were identified as wound size greater than 11 mm in length, mixed corneoscleral type wounding, and involvement of the lens and posterior segment in the injury.


CONCLUSIONS
Penetrating eye injuries in African children, reviewed here, generally occur when children are at play in a domestic setting. Effective prevention should stress parental awareness, careful supervision, greater home safety, safe toys, and avoidance of hazardous games.
Department of Ophthalmology, Medical University of Southern Africa, PO Box 66, Medunsa 0204, South Africa. mgrieshaber@uhbs.ch
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Grieshaber
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Stegmann
D000293:Adolescent; D000353:Africa, Southern / Q000453:epidemiology; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D015807:Eye Injuries, Penetrating / Q000453:epidemiology* / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D017678:Sex Distribution; D015599:Trauma Severity Indices; D014792:Visual Acuity