title: Post-traumatic endophthalmitis in 143 eyes of children and adolescents from India.
abstract: OBJECTIVE
  The purpose of this study was to describe clinical features, risk factors, causative organisms, treatment options, and outcomes of post-traumatic endophthalmitis in children and adolescents.
  
  
  METHODS
  Retrospective interventional case series. Case records of 143 consecutive eyes presenting with post-traumatic endophthalmitis between 1997 and 2007 were reviewed. Univariate and multivariate analysis were done to analyze factors associated with adverse outcomes.
  
  
  RESULTS
  Mean age at presentation was 9.2 years (median 8 years, range: 2 months to 18 years). Broomstick and hypodermic needle were most common causes for injuries. Common presenting features were cataract (n=51), hypopyon (n=45) and retinal detachment (n=29). Corneal abscess (n=21; OR: 5, CI: 1.4-18.7) and retinal detachment (n=29, OR: 5, CI: 1.6-11.3) were independent risk factors for poor outcome (P=0.04 and 0.012, respectively). Gram-positive bacteria were isolated in 54% (n=31) of culture-positive cases. Forty-nine (34%) patients had ambulatory vision at final visit. Patients who received treatment within 24 h were 3.6 and 9 times more likely to have better anatomical outcome than those treated at 2-7 days, or >7 days, respectively (P=0.0001). Patients undergoing early vitrectomy were 27 times more likely to have better outcome (P=0.0001).
  
  
  CONCLUSIONS
  Post-traumatic endophthalmitis in children is more common in boys <10 years of age and most often caused by injury with organic matter. Corneal abscess and retinal detachment are associated with poor outcome. E. fecalis is the most common causative organism. Early vitrectomy results in better outcomes.
authors: Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralya, Chennai, India.
authors: E
authors: E
authors: Rishi
authors: Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralya, Chennai, India.
authors: P
authors: P
authors: Rishi
authors: Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralya, Chennai, India.
authors: V V
authors: VV
authors: Koundanya
authors: Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralya, Chennai, India.
authors: C
authors: C
authors: Sahu
authors: Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralya, Chennai, India.
authors: R
authors: R
authors: Roy
authors: Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralya, Chennai, India.
authors: P S
authors: PS
authors: Bhende
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001082:Aqueous Humor / Q000382:microbiology; D001419:Bacteria / Q000302:isolation & purification; D001431:Bacteriological Techniques; D002648:Child; D002675:Child, Preschool; D009877:Endophthalmitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D015807:Eye Injuries, Penetrating / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D008297:Male; D013508:Ophthalmologic Surgical Procedures; D012189:Retrospective Studies; D012307:Risk Factors; D014822:Vitreous Body / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents