[Penetrating ocular injuries in children: Clinical profile and psychosocial impact in southern Tunisia].

INTRODUCTION

Penetrating ocular injuries in children are a public health issue due to their frequency, severity, and psychosocial impact. This study describes the clinical and psychosocial profile of such injuries in children from southern Tunisia and identifies poor prognostic factors.

PATIENTS AND

METHODS

We conducted a retrospective study of 86 children hospitalized for penetrating ocular injuries at Habib Bourguiba University Hospital in Sfax from January 2015 to December 2021. Demographic, clinical, and treatment data were collected, as well as impact on quality of life as measured using two validated psychometric scales.

RESULTS

The mean age of the patients was 7.21 years, with a male-to-female ratio of 2.44. All injuries were unilateral, with 57% affecting the right eye, and most occurred during the summer and on weekends. Corneal injuries were observed in 91.9% of cases, with a mean wound size of 6.24mm. Iris herniation and traumatic cataract were the most common associated lesions. All patients underwent emergency surgery, with a mean delay of 15hours after the injury. At follow-up, 40.7% of patients had developed severe amblyopia, defined as a final visual acuity (FVA) ≤1/10 - the threshold used to define a poor functional prognosis. Poor prognostic factors included low initial visual acuity (IVA≤1/10), visual axis involvement, wound size>5mm, hyphema, aphakia, traumatic cataract, posterior segment involvement, and additional surgeries. The psychosocial impact, especially emotional distress, was significant, exceeding physical impacts. 14.5% of patients suffered from severe post-traumatic stress disorder, requiring specialized psychiatric care.

CONCLUSION

A multidisciplinary approach is essential for these children, but prevention remains the key strategy to reduce such injuries and their long-term consequences.