Epidemiological Profile And Prognostic Assessment Of Pedriatic Open Globe Injuries In Tertiary Hospital Of Vijayapura

Abstract

BACKGROUND: Open globe injuries in the pediatric age group commonly cause acquired blindness, 90% of them are preventable. Most ocular injuries in children are due to playing with sharp objects like wooden sticks, pens, stones, etc., without knowing the nature of dangerous things, especially in rural areas. Parents should be educated enough to prevent the trauma from happening. Open globe injuries can make the children blind and affect social lives and academic performance. Treatment modalities depend upon the injuries and age group in which they occur. Visual outcomes depend upon several factors, including etiology, severity, and duration of injury. Here, an attempt has been made to study the epidemiological profile and assess the prognosis of pediatric open globe injuries in Northern Karnataka. AIM AND OBJECTIVES: To evaluate the epidemiology and demographic profile and to understand the most common causative factors associated with open globe injuries in the pediatric age group attending the tertiary hospital of Vijayapura and assess the prognosis and predict the final visual outcome using the Pediatric Ocular Trauma Score. MATERIALS AND METHODS: A prospective interventional study was conducted on pediatric open globe injury patients in the outpatient, inpatient and casualty of Shri B M Patil Medical College Hospital and Research Centre, B.L.D.E. (D.U.) from September 2022 to February 2023 (18 months). After obtaining informed consent from the parents/guardians, a detailed ocular examination was done to assess both anterior and posterior segments. Investigations like B Scan, OCT, CT and M.R.I. were done wherever necessary. After examination, raw points are calculated to get the Pediatric ocular trauma score, and are converted into a percentage chance of the final visual outcome at 6 months. RESULTS: A total of 45 eyes of 45 patients were included in the study. The mean age group of patients was 10.13 years, ranging from 4-15 years. Among 45 patients, 36 were boys and 9 were girls (5:1). There was no significant difference between the two eyes. Wooden stick injury was the most common cause (46.66%), followed by stones (15.55%). Most of the open globe injuries happened at home (75.6%) and a few at school and farm. Zone I was the most common location (66.7%) of injury. Most patients had a visual acuity of Hand movements (33.33%), followed by Counting fingers (26.66%). 71.1 % of cases had one or more than one complication at presentation, in which hyphema was the most common (35.55%). Most patients fall in the category of POTS 2 (55.6%). CONCLUSION: Pediatric open globe injury is a significant cause of hospitalization, especially in rural children. Boys far outnumbered girls because of their habit of playing with sharp objects. Studying the epidemiological profile of pediatric open globe injuries gave us a clue about the areas to be focused in prevention. Prognostic assessment using the Pediatric Ocular Trauma Score predicted the final visual outcome and helped educate the parents accordingly.