Comparison of the clinical presentation and visual outcome in open globe injuries in adults and children over 30 months.
OBJECTIVE
To compare the clinical presentation and final visual outcome of open globe injuries in children and adults in a referral hospital over a 30-month period.


METHODS
This is an institutional-based prospective study of open globe injuries cases presenting in the emergency department between July 2003 and December 2005. Patients were divided in 2 groups: group 1, children (2-15 years), and group 2, adults (>15 years). All the patients were admitted and emergency surgical interventions were undertaken. The clinical features at presentation and the final visual acuity are compared. Chi-square and Fisher exact tests were used for statistical analysis.


RESULTS
Ninety and 84 patients were included in group 1 and group 2, respectively. The most common places of injuries were home or while playing outdoor games in group 1 (67%) and workplace in group 2 (53.5%). The presenting features were significantly more grave in group 2. These included poor presenting visual acuity (p=0.012), vitreous prolapse (p=0.002), presence of relative afferent pupillary defect (p=0.001), and incidence of endophthalmitis (p=0.004). Time interval between injury and surgical intervention (p=0.018) was better in group 2. Other features, such as presence of hyphema, uveal tissue prolapse, cataract, intraocular foreign body, and length or location of laceration were similar in both groups. The final visual outcome was similar in the groups (p = 0.21), with approximately half of the patients achieving vision of 20/60 or better in each group.


CONCLUSIONS
The majority of injuries in children and adults occurred in their homes or workplaces, respectively. Although the clinical presentations of open globe injuries were significantly more grave in adults than in children, the final visual outcomes were similar.
Gupta
Arvind
A
Department of Ophthalmology, JIPMER (Jawaharlal Institute of Postgraduate Medical Education and Research), Pondicherry - India. arvind_ophtahl@yahoo.co.in
Srinivasan
Renuka
R
Babu
K Ramesh
KR
Setia
Sajita
S
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015807:Eye Injuries, Penetrating / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D014792:Visual Acuity / Q000502:physiology*; D055815:Young Adult