Ocular Trauma in Childhood at the University Hospital Ostrava in the Years 2007-2011

Objective: to investigate and analyze the group of child patients with ocular trauma in the Ostrava region in the Czech Republic.
Methods: A retrospective observational case series. We reviewed and analyzed clinical records of all the paediatric patients with ocular trauma treated at the University Hospital Ostrava in the years 2007 – 2011. Age, sex, mechanism of injury, type of ocular trauma, the consequences of injury and period of the year when the accident occurred were evaluated. BETT classification used in this study was modified and extended by chemical and thermal injuries and orbital trauma. Ocular burns, including thermal and chemical burns, were graded using the classification for ocular surface burns by Dua.
Results: 448 children (309 boys, 139 girls), aged from 3 months to 17 years (median 10 years) were included in this study. The most common ocular injury was closed globe injury (253 patients, 56,5 %), the next common were orbital injuries (149 patients, 33,3 %), burns injuries (39 patients, 8,7 %), the least frequent were open globe injuries (7 patients, 1,6 %). The most common mechanism of ocular trauma was hit by object (34,6 %), followed by trauma caused by blows and falls (15,2 %) and hit by another person (10,3 %). The 50,9 % of injuries occurred in days of school attendance. 10,3 % of injuries occured directly at the school or preschool facilities. 6,5 % of the injuries were polytraumas, which required interdisciplinary cooperation.
Conclusion: This study demonstrated that the incidence of eye injuries is greater in boys, mainly adolescents. Closed globe injuries are the predominant type of ocular trauma in childhood. The mechanism of ocular trauma is variable. Nonetheless there is a relation between the mechanism and the age of the child. Further research in terms of how the preventive measures would affect the incidence and severity of ocular trauma in children would be beneficial. The modified BETT classification of ocular trauma, including chemical and thermal injuries and orbital trauma may better adress current requirements.