Epidemiological, clinical and therapeutic features of pediatric ocular injuries in an eye emergency unit in Île-de-France

Ocular and orbital trauma is a leading cause of acquired monocular blindnessin childhood. These injuries differ from those in adults in some aspects of the management andprognosis, notably the risk of amblyopia. The goal of this study was to analyze the epidemio-logical, clinical and therapeutic features of ocular trauma in children who consulted in an eyeemergency department in Île-de-France.Patients and methods.-This was a descriptive, prospective and longitudinal study. Over aperiod of 6 months, we included children aged 15 years old or less, who consulted during callsfor ocular trauma. Each child received an ophthalmologic examination as complete as his or hercondition and cooperation permitted. Mechanical injuries of the eyeball and chemical ocularburns were distributed respectively according to the Birmingham Eye Trauma Terminology andDua's classification. The visual prognosis was defined as the best corrected visual acuity of theaffected eye, measured at the conclusion of treatment.Results.-Among 586 children who consulted during the study period, 265 suffered from oculartrauma (45.22%). The male:female ratio was 1.6:1. The main places of occurrence of the inju-ries were home (64.15%) and school (18.11%). Injuries from finger nail scratch were the mostfrequent (12.45%). One hundred and fifty-seven patients consulted within 6 hours (59.19%). Thecornea was the predominant site of the injury (44.40%). Mechanical injuries of the eyeballaccounted for 75% of cases. The incidence of ocular chemical burns was 6.41%. Eyelid and orbi-tal injuries were observed in 22.26% and 2.26% of cases respectively. Surgical treatment wasrequired in 6.79% of cases. The incidence of hospitalization was 3.02% with a mean length ofstay of 3 days. Four children developed sequelae, including 2 corneal scars and 2 cataracts. Nocase of blindness was recorded.Discussion.-The high frequency of traumatic ocular and orbital pathology in our study maybe due to its sudden and accidental onset, leading parents to seek emergency care. Most inju-ries occurred at home and at school, which reflects the presence in these places of potentialhazards, often unrealized or neglected. The low frequency of open-globe injury may be related to the ubiquitous recruitment. Indeed, in studies including only severe trauma, this rate mayreach 73.4%. This clinical presentation is associated with a poor prognosis because of the riskof infection and sequelae causing decreased visual acuity and amblyopia. Few children werehospitalized. This could be explained by the predominance of mild to moderate trauma.Conclusion.-Ocular trauma accounts for nearly half of pediatric conditions encountered inthe eye emergency unit. Adequate emergency care improves the visual prognosis.