title: Pediatric Eye Trauma in the Republic of Tajikistan: More Than Meets the Eye.
abstract: Pediatric eye injury (PEI) is the leading cause of preventable monocular vision loss in children, with an estimated prevalence of 5.7 million cases. Epidemiological information on PEI is rare, skewed towards high-income countries, and commonly overlooked by non-governmental ophthalmological organizations. This study aims to quantitatively and qualitatively determine incidence of PEI in the Republic of Tajikistan.
  
  
  
  Data were collected from all pediatric eye injury records (N = 454) admitted to three pediatric ophthalmology hospitals in two regions of Tajikistan between 2010 and 2012.
  
  
  
  A review of the records revealed a cumulative annual incidence of 12.8 PEI cases/100,000, with marked inter- and intra-regional differences. Mean age was 7.0 years (95% confidence interval, CI, 6.7-7.4), and male to female ratio was 2.5:1. PEI occurred predominantly outdoors (63%), in rural settings (76%) during unsupervised play, and typically resulted from the eye being hit (53%) by a pointed object (51%), resulting in an open-globe injury (56%). Median time-to-presentation was 24 hours (range 9.6 hours-10 days) and median duration of hospitalization was 15 days (range 2-29 days). Of the 454 cases, 111 (25%) resulted in a blind eye, 62 (14%) in severe visual impairment, and 45 (10%) in moderate visual impairment.
  
  
  
  PEI is a major cause of pediatric monocular visual impairment in Tajikistan, with a high rural incidence of severe blinding injuries. Potential risks and outcomes relate to Tajikistan's cultural, historical, and physical settings. We anticipate that the information provided by this study will facilitate development of culturally derived strategies to reduce PEI in Tajikistan.
authors.affiliation: a Avicenna Tajik State Medical University , Dushanbe , Republic of Tajikistan.
authors.forename: Khakima
authors.initials: K
authors.lastname: Karim-Zade
authors.affiliation: b Department of Ophthalmology , London School of Hygiene & Tropical Medicine and Moorfields Eye Hospital , London , UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Leak
authors.affiliation: c Department of Surgery , Avicenna Tajik State Medical University , Dushanbe , Republic of Tajikistan.
authors.forename: Bakhtovar
authors.initials: B
authors.lastname: Karim-Zade
mesh_terms: D001766:Blindness / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005131:Eye Injuries / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D010988:Play and Playthings / Q000293:injuries; D012424:Rural Population / Q000706:statistics & numerical data; D017678:Sex Distribution; D013620:Tajikistan / Q000453:epidemiology; D014786:Vision Disorders / Q000453:epidemiology / Q000209:etiology; D014792:Visual Acuity
keywords: Culture; Tajikistan; pediatric eye trauma; prevention; visual impairment