Comparison of Clinical Appearance of Pediatric Ocular Injury, According to Grade Level

Hyoung Sub Shim; Su Jeong Song; Chul Young Choi; Joon Mo Kim; Hae Ran Chang

doi:10.3341/jkos.2008.49.1.148

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Shim, Song, Choi, Kim, and Chang: Comparison of Clinical Appearance of Pediatric Ocular Injury, According to Grade Level

Original Article

J Korean Ophthalmol Soc 2008;49(1):148-157.

Published online: 3 August 2008

DOI: https://doi.org/10.3341/jkos.2008.49.1.148

Comparison of Clinical Appearance of Pediatric Ocular Injury, According to Grade Level

Hyoung Sub Shim, M.D., Su Jeong Song, M.D., Chul Young Choi, M.D., Joon Mo Kim, M.D., Hae Ran Chang, M.D.

Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

Address reprint requests to Hae Ran Chang M.D. Department of Ophthalmology, Kangbuk Samsung Hopsital Sungkyunkwan University School of Medicine #108 Pyung-dong, Jongro-gu, Seoul 110-746, Korea Tel: 82-2-2001-2250, Fax: 82-2-2001-2262, E-mail: Hrch0523@hanmail.net

Received 29 May 2007 Accepted 21 September 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the causes and clinical manifestations of pediatric ocular injuries according to grade level.

Methods

We retrospectively reviewed the medical records of 78 children, 15 years and younger, who had been hospitalized for pediatric ocular injuries, classified them into three groups according to grade level, and compared their clinical manifestations.

Results

Eighteen (23.1%) were preschoolers, 39 (50.0%) were elementary school students, and 21 (26.9%) were middle and high school students. The most common causes of injury included toys and household goods at home in the preschool group, toys and sporting activity at home and school in the elementary school group, and sporting activity at school in the middle and high school group. The incidence of ocular injury was higher in the ‘without supervision group’ (57.7%); however, in the preschool group, it was higher (72.2%) even in the ’supervision group’ (P<0.05). In the preschool group, the incidence of perforating ocular injury (P<0.05) and the rate of surgical treatment (P<0.05) were higher than those of other groups.

Conclusions

The causes and clinical manifestations of pediatric ocular injury were different according to school degree. The incidence of pediatric ocular injuries can be decreased more efficiently by recognizing these differences.

Keywords: Grade level, Pediatric ocular injury

References

1. Serrano JC, Chalela P, Arias JD. Epidemiology of childhood ocular trauma in a northeastern Colombian region. Arch Ophthalmol. 2003; 121:1439–45.

2. Han KH, Lee JS, Yoon DK. A statistical observation on the eye injuries in childhood. J Korean Ophthalmol Soc. 1973; 14:363–7.

3. Choi JS, Kim SS, Yi KP. A clinical study of pediatric ocular injuries through emergency room. J Korean Ophthalmol Soc. 1990; 31:69–79.

4. Kim CR, Lee CS, Kim JB, Park YG. Clinical evaluation of the pediatric ocular trauma. J Korean Ophthalmol Soc. 2000; 41:993–9.

5. Oh TS, Ahn Y. Clinical picture of the pediatric ocular trauma. J Korean Ophthalmol Soc. 2001; 42:119–26.

6. Shin WK, Lee SK, Kim BC. Clinical analysis of children's perforating eye injuries in middle western coast of Korea. J Korean Ophthalmol Soc. 1995; 36:91–6.

7. Kim JH, Yu YS. Clinical course and predictive factors of final visual acuity in children with penetrating ocular trauma. J Korean Ophthalmol Soc. 2003; 44:699–705.

8. Kwon JY, Cho HI. Perforating eye injuries in children. J Korean Ophthalmol Soc. 1984; 25:701–06.

9. Kim CH, Jeong JH. A clinicostatical analysis of ocular injuries of inpatients. J Korean Ophthalmol Soc. 1983; 24:517–22.

10. Jung JH, Jung TM, Pak HJ, et al. A statistical observation of the ocular injuries (I). J Korean Ophthalmol Soc. 1972; 13:51–5.

11. Kim YT. Statistical study on industrial eye injuries. J Korean Ophthalmol Soc. 1974; 15:346–53.

12. Brophy M, Sinclair SA, Hostetler SG, Xiang H. Pediatric eye injury-related hospitalizations in the United States. Pediatrics. 2006; 117:1263–71.

13. Han YS, Shin KH. A statistical observation of the ocular injuries. J Korean Ophthalmol Soc. 2005; 46:117–24.

14. Ahn SK, Yang HN, Koo BS. A statistical analysis of ocular Injuries of Inpatients. J Korean Ophthalmol Soc. 1990; 31:359–66.

15. Yoo SH, Rooy KH, Cho HW. A clinical study of ocular injuries. J Korean Ophthalmol Soc. 1982; 23:1021–7.

16. Hwang TJ, Shim WS. A clinical studies of ocular injuries. J Korean Ophthalmol Soc. 1979; 20:175–85.

17. Oum BS, Lee JS, Han YS. Clinical features of ocular trauma in emergency department. Korean J Ophthalmol. 2004; 18:70–8.

18. Nelson LB, Wilson TW, Jeffers JB. Eye injuries in childhood: demography, etiology, and prevention. Pediatrics. 1994; 84:438–41.

19. Cascairo MA, Mazow ML, Prager TC. Pediatric ocular trauma: a retrospective survey. J Pediatr Ophthalmol Strabismus. 1994; 31:312–7.

Figure 1.

Supervision in pediatric ocular injury.

^* Group I=preschool group.

^† Group II=elementary school group.

^‡ Group III=middle and high school group.

^§ P<0.05 vs Group II and Group III (Fisher’s exact test).

Figure 2.

Type of treatment in pediatric ocular injury.

^* Group I=preschool group.

^† Group II=elementary school group.

^‡ Group III=middle and high school group.

^§ P<0.05 vs Group II and Group III (Fisher’s exact test).

Table 1.

Distribution of sex in pediatric ocular injury

Sex	No. of patients (%)
Sex	Group I^*	Group II^†	Group III^‡	Total
Male	13 (72.2)	32 (82.1)	20 (95.2)	65 (83.3)
Female	5 (27.8)	7 (17.9)	1 (4.8)	13 (16.7)
Total	18 (100.0)	39 (100.0)	21 (100.0)	78 (100.0)

^* Group I=preschool group.

^† Group II=elementary school group.

^‡ Group III=middle and high school group.

Table 2.

Ocular di stribution in pediatric ocular injury

Side	No. of patients (%)
Side	Group I^*	Group II^†	Group III^‡	Total
Right	9 (50.0)	23 (59.0)	9 (42.9)	41 (52.6)
Left	9 (50.0)	16 (41.0)	12 (57.1)	37 (47.4)
Total	18 (100.0)	39 (100.0)	21 (100.0)	78 (100.0)

^* Group I=preschool group.

^† Group II=elementary school group.

^‡ Group III=middle and high school group.

Table 3.

Distribution of season in pediatric ocular injury

Season	No. of patients (%)
Season	Group I^*	Group II^†	Group III^‡	Total
Spring	7 (38.9)	16 (41.0)	8 (38.1)	31 (39.7)
Summer	6 (33.3)	3 (7.7)	4 (19.0)	13 (16.7)
Fall	5 (27.8)	13 (33.3)	8 (38.1)	26 (33.3)
Winter		7 (17.9)	1 (4.8)	8 (10.3)
Total	18 (100.0)	39 (100.0)	21 (100.0)	78 (100.0)

^* Group I=preschool group.

^† Group II=elementary school group.

^‡ Group III=middle and high school group.

Table 4.

Distribution of month in pediatric ocular injury

Month	No. of patients (%)
Month	Group I^*	Group II^†	Group III^‡	Total
January		1 (2.6)		1 (1.3)
February		4 (10.3)	1 (4.8)	5 (6.4)
March	3 (16.7)	7 (17.9)	4 (19.0)	14 (17.9)
April	3 (16.7)	2 (5.1)	1 (4.8)	6 (7.7)
May	1 (5.6)	7 (17.9)	3 (14.3)	11 (14.1)
June	3 (16.7)	2 (5.1)	1 (4.8)	6 (7.7)
July		1 (2.6)	2 (4.8)	3 (3.8)
August	3 (16.7)		1 (4.8)	4 (5.1)
September	2 (11.1)	7 (17.9)	1 (4.8)	10 (12.8)
October	2 (11.1)	3 (7.7)	3 (14.3)	8 (10.3)
November	1 (5.6)	3 (7.7)	4 (19.0)	8 (10.3)
December		2 (5.1)		2 (2.6)
Total	18 (100.0)	39 (100.0)	21 (100.0)	78 (100.0)

^* Group I=preschool group.

^† Group II=elementary school group.

^‡ Group III=middle and high school group.

Table 5.

Cause of injury in pediatric ocular injury (detail)

Cause	No. of patients (%)
Cause	Group I^*	Group II^†	Group III^‡	Total
Traffic accident	1 (5.6)	2 (5.1)		3 (3.8)
Railing			3 (14.3)	2 (2.6)
Branch/Wood stick	1 (5.6)	1 (2.6)	3 (14.3)	6 (7.7)
Razor blade	1 (5.6)	1 (2.6)		2 (2.6)
BB pellet	2 (11.1)	14 (35.9)	1 (4.8)	17 (21.8)
Shuttlecock		1 (2.6)	2 (9.5)	3 (3.8)
Metal piece	2 (11.1)			1 (2.6)
Fist/finger		1 (2.6)	4 (19.0)	5 (6.4)
Ground	1 (5.6)	3 (7.7)		4 (5.1)
Ball		2 (5.1)	5 (23.8)	7 (9.0)
Leg/Foot		3 (7.7)	1 (4.8)	4 (5.1)
PET bottle		2 (5.1)		2 (2.6)
Others (< 1 case)	10 (55.6)	9 (23.1)	2 (9.5)	21 (26.9)
Total	18 (100.0)	39 (100.0)	21 (100.0)	78 (100.0)

^* Group I=preschool group.

^† Group II=elementary school group.

^‡ Group III=middle and high school group.

Table 6.

Cause of injury in pediatric ocular injury (grouping)

Cause	No. of patients (%)
Cause	Group I^*	Group II^†	Group III^‡	Total
Toys	7 (38.9)	15 (38.5)	1 (4.8)	23 (29.5)
Fall down	2 (11.1)	3 (7.7)	1 (4.8)	6 (7.7)
Sports goods	1 (5.6)	7 (17.9)	13 (61.9)	21 (26.9)
Household goods	5 (27.8)	4 (10.3)	1 (4.8)	10 (12.8)
School things	1 (5.6)	4 (10.3)	2 (9.5)	7 (9.0)
Assault/Physical touch		3 (7.7)	3 (14.3)	6 (7.7)
Traffic accidents	1 (5.6)	2 (5.1)		3 (3.8)
Others	1 (5.6)	1 (2.6)		2 (2.6)
Total	18 (100.0)	39 (100.0)	21 (100.0)	78 (100.0)

^* Group I=preschool group.

^† Group II=elementary school group.

^‡ Group III=middle and high school group.

Table 7.

Place of injury in pediatric ocular injury

Place	No. of patients (%)
Place	Group I^*	Group II^†	Group III^‡	Total
House	11 (61.1)	13 (33.3)	3 (14.3)	27 (34.6)
School/Child care	1 (5.6)	12 (30.8)	12 (57.1)	25 (32.1)
Street/Road	4 (22.2)	8 (20.5)	4 (19.0)	16 (20.5)
Mountain	1 (5.6)		1 (4.8)	2 (2.6)
Traffic accidents	1 (5.6)	3 (7.7)		4 (5.1)
Others		3 (7.7)	1 (4.8)	4 (5.1)
Total	18 (100.0)	39 (100.0)	21 (100.0)	78 (100.0)

^* Group I=preschool group.

^† Group II=elementary school group.

^‡ Group III=middle and high school group.

Table 8.

Type of injury in pediatric ocular injury

Type	No. of cases (%)
Type	Group I^*	Group II^†	Group III^‡	Total
Extraocular	7 (23.3)	8 (11.6)	2 (5.9)	17 (12.8)
Anterior-perforating	9 (30.0)^§	2 (2.9)	2 (5.9)	13 (9.8)
Anterior-nonperforating	12 (40.0)	47 (68.1)	19 (55.9)	78 (58.6)
Posterior	2 (6.7)	3 (4.3)	1 (2.9)	6 (4.5)
Orbital fracture		9 (13.0)	10 (29.4)	19 (14.3)
Total	30 (100.0)	69 (100.0)	34 (100.0)	133 (100.0)

^* Group I=preschool group.

^† Group II=elementary school group.

^‡ Group III=middle and high school group.

^§ P<0.05 vs Group II and Group III (Fisher’s exact test).

Table 9.

Type of operation in pediatric ocular injury

Operation	No. of operaations (%)
Operation	Group I^*	Group II^†	Group III^‡	Total
Primary repair of corneoscleral laceration	5 (25.0)	2 (10.0)	1 (7.7)	8 (15.1
Orbital fracture repair		9 (45.0)	10 (76.9)	19 (35.
Primary repair of conjunctiva laceration	4 (20.0)	2 (10.0)		6 (11.3
Primary repair of lid laceration	5 (25.0)	5 (25.0)		10 (18.9
ECCE c PCL implantation^§, lensectomy	1 (5.0)		1 (7.7)	2 (3.8)
Others	5 (25.0)	2 (10.0)	1 (7.7)	8 (15.1
Total	20 (100.0)	20 (100.0)	13 (100.0)	53 (100

^* Group I=preschool group.

^† Group II=elementary school group.

^‡ Group III=middle and high school group.

^§ ECCE c PCL implantation=extracapsular cataract extraction with posterior chamber lens implantation.

Table 10.

Visual acuity of the first and final visit in pediatric ocular injury

Visual acuity	No. of patients on the first visit (%)				No. of patients on the final visit (%)
Visual acuity	Group I^*	Group II^†	Group III^‡	Total	Group I^*	Group II^†	Group III^‡	Total
≤0.1	3 (16.7)	6 (15.4)	4 (19.0)	13 (16.7)	1 (5.6)			1 (1.3)
0.2-0.4	2 (11.1)	2 (5.1)		4 (5.1)	1 (5.6)			1 (1.3)
0.5-0.8	3 (16.7)	11 (28.2)	1 (4.8)	15 (19.2)	1 (5.6)	1 (2.6)		2 ((2.6)
≥0.9	4 (22.2)	20 (51.3)	16 (76.2)	40 (51.3)	10 (55.6)	37 (94.9)	21 (100.0)	68 (87.2)
Unknown	6 (33.3)			6 (7.7)	5 (27.8)	1 (2.6)	0 (0.0)	6 (7.7)
Total	18 (100.0)	39 (100.0)	21 (100.0)	78 (100.0)	18 (100.0)	39 (100.0)	21 (100.0)	78 (100.0)

^* Group I=preschool group.

^† Group II=elementary school group.

^‡ Group III=middle and high school group.

Table 11.

Complication in pediatric ocular injury

Complication	No. of cases (%)
Complication	Group I^*	Group II^†	Group III^‡	Total
Vitreous opacity	1 (14.3)	1 (14.3)	1 (14.3)	3 (14.3)
Corneal opacity	5 (71.4)	3 (42.9)	1 (14.3)	9 (42.9)
Aniridia	1 (14.3)			1 (4.8)
Diplopia		2 (28.6)	5 (71.4)	7 (33.3)
Traumatic cataract		1 (14.3)		1 (4.8)
Total	7 (100.0)	7 (100.0)	7 (100.0)	21 (100.0)

^* Group I=preschool group.

^† Group II=elementary school group.

^‡ Group III=middle and high school group.

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