Ocular Injury Type Affects Risk of Follow-Up Complications

Ocular injury type and even the time of day eye injuries occurs have associations with the likelihood a pediatric patient will experience complications upon follow-up, according to a study published in Pediatrics International. The research identifies daytime emergency department (ED) visit, impact with a sharp object, animal-related injury, visual impairment, decreased visual acuity, and open globe injury as factors associated with greater risk of complications on follow-up.

Ocular injury is a leading cause of blindness in children but there is little data about the relationship between ocular injury type and subsequent ophthalmological complications. The study therefore sought to characterize the factors that increase risk of ophthalmological complications after ocular injury in children.

The researchers retrospectively evaluated data from 469 patients at a single center in Japan over the course of 11 years. The median age of the patients was 7.3 years (interquartile range, 3.1-11.5 years). The main ocular injury types included impact to the eye (34.3%), objects thrown or fired at the patient (21.1%), falls (17.1%), and injuries from animals (1.5%). Approximately 7 (1.5%; cat scratch. [4/7], dog bite/scratch, [3/7]). 

Upon follow-up, ophthalmological complications included oculomotor disturbance, diplopia, retinal detachment, cataract, ptosis, and visual impairment or loss. 

Bivariate analysis revealed that several factors increased the risk of ophthalmological complications. Daytime arrival to the ED increased the likelihood of complications (OR, 10.1; 95% CI, 12.1-84.7). Greater complications were also seen among some ocular injury types, including  impact with a sharp object (OR, 6.9; 95% CI, 1.5-31.7), animal-related injury (OR, 12.7; 95% CI, 1.3-122.0), and open globe injury (OR, 76.8; 95% CI, 42.9-1380.0). Those who presented with visual impairment (OR, 6.5; 95% CI, 1.4-29.8) or decreased visual acuity (OR, 7.3; 95% CI, 1.4-39.6) also experienced elevated rates of complications.

“The present study demonstrated a complication rate of only 1.5%, which reflected the low rate of open globe injuries,” according to the study authors. They caution that “education about preventing eye injuries during interactions with family pets and information about appropriate adult supervision in such situations are critical to prevent animal-related pediatric ocular injuries”.

This single-center study may be limited by selection bias and small sample size of ophthalmological complications.