Corneal abrasions in young infants.
OBJECTIVE
We sought to determine the prevalence of corneal abrasions and possible associations with fingernail length, demographic information, sleeping, and crying among young infants.


METHODS
Parents of 1- to 12-week-old infants without symptoms who were presenting for well-child visits completed a brief questionnaire on age, gender, race, fingernail-trimming practices, and sleeping and crying in the preceding 24-hour period. Fingernail length was measured, and eyes were examined through staining with fluorescein and illumination/magnification with a Bluminator (Eidolon Optical, Natick, MA). Patients with corneal abrasions were given orally administered acetaminophen and erythromycin ointment. Masked interrater reliability for abrasions was measured. Logistic regression analyses determined the association of corneal abrasions with potential covariates.


RESULTS
Ninety-six subjects were enrolled, including 47 girls (49%), with a mean age of 32.2 days (SD: 21.7 days). Forty-seven infants (49%) had abrasions. Demographic variables and mean crying times (114.8 +/- 124.9 vs 86.5 +/- 111.7 minutes; P < .24) were not significantly different for infants with and without abrasions. Infants with abrasions slept more (15.9 +/- 3.3 vs 14.5 +/- 3.6 hours; P = .054). Associations of fingernail-trimming method and fingernail length with corneal abrasions were not statistically significant. Masked interrater reliability was high, with agreement between the primary investigator and the associate investigator for 20 (91%) of 22 eyes and agreement between the primary investigator and a pediatric ophthalmologist for 9 (90%) of 10 eyes.


CONCLUSIONS
Corneal abrasions are extremely common among 1- to 12-week-old infants and have unclear clinical significance. Primary care physicians should be careful about attributing unexplained persistent crying to corneal abrasions, potentially missing a more-serious problem.
Department of Pediatrics, Naval Medical Center Portsmouth, 620 John Paul Jones Circle, Portsmouth, VA 23708, USA. timothy.shope@med.navy.mil
Timothy R
TR
Shope
Thomas S
TS
Rieg
Nazima N
NN
Kathiria
D065306:Corneal Injuries; D003448:Crying; D005131:Eye Injuries / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009262:Nails; D015995:Prevalence