Epidemiology, aetiology and outcomes of paediatric ocular trauma: a population-level study in Northern Ireland.

BACKGROUND AND

OBJECTIVES

Ocular trauma is a major cause of blindness. The objectives of this study were to report epidemiology, aetiology, visual outcomes, and interactions with ophthalmology services of paediatric ocular trauma patients.

METHODS

A retrospective review of consecutive paediatric ocular trauma presentations between 01 January 2017 and 31 December 2019, within the Belfast Trust. Patients were younger than 16 years old at presentation.

RESULTS

In total, 535 paediatric ocular trauma patients are reported. Epidemiology-Median age was 8.18 years old, with 63.8% of patients being male. Incidence was 0.45 cases per 1000 children aged 0-15, per year. Areas were ranked according to deprivation measures, incidence ranged from 0.43 in the 2nd quintile to 0.64 in the quintile with lowest deprivation measures. Aetiology-Blunt (n = 277, 52%), chemical (n = 96, 18%), sharp (n = 87, 16%), and laser injuries (n = 27, 5%) were the most common mechanisms. There were 2 open globe injuries reported (1.7 per 1,000,000 children aged 0-15, per year). Visual outcomes-Visual acuity at presentation was available for 408 eyes (72%), with 174 (43%) achieving 6/6 or better and 338 (83%) 6/12 or better. 6 eyes (3%) presented with vision worse than 6/60; three improved to better than 6/12 at follow-up, and two remained worse than 6/60. Ophthalmology services-16 patients (3.0%) were admitted.

CONCLUSIONS

Paediatric ocular trauma occurs most commonly in males, in the home setting, with a blunt injury mechanism. Chemical and laser eye mechanisms contribute a significant proportion of presentations.