Correctly understanding the complexity of diagnosis and treatment of children's open ocular trauma to improve its diagnosis and treatment effect_Chinese Journal of Ocular Fundus Diseases

Authors：

 Lu Hai , Liu Jinghua

Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China;

Corresponding author：

Lu Hai, Email: trdr_luhai@163.com

Keywords：

Child; Eye injuries; Editorial

DOI：

10.3760/cma.j.cn511434-20210512-00250

Video：

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Open ocular trauma in children is one of the main causes of non-congenital monocular blindness in children. Children’s psychological and daily activities are different from those of adults; the eye tissue structure is not maturely enough, and the characteristics of high response to injury and incompatibility with various diagnostic and treatment methods determine the factors that cause injuries and injuries in children with open ocular trauma. The environment, diagnosis and treatment, and prognosis of children are more complicated than adults. For the emergency of first and second stage on diagnosis and treatment of children with open ocular trauma, it should follow the principles of adult open ocular trauma management, combined with the children's characteristics, clarifying the anatomical location of the ocular trauma before surgery, and closing the wound during the first-stage operation. At the same time, the disturbance of intraocular tissue should be minimized, the timing of the second stage operation and the individualization of the operation design, and the medication and care after the operation should also be combined with the characteristics of children. Prevention of ocular trauma in children is the focus of attention. In the new information era, clinical research and public information platforms should be fully utilized to advance the epidemiological study of children's ocular trauma and guide the construction of the prevention and treatment system for children's ocular trauma more scientifically.

Citation： Lu Hai, Liu Jinghua. Correctly understanding the complexity of diagnosis and treatment of children's open ocular trauma to improve its diagnosis and treatment effect. Chinese Journal of Ocular Fundus Diseases, 2021, 37(5): 333-337. doi: 10.3760/cma.j.cn511434-20210512-00250 Copy

1.	Alfaro DV, Chaudhry NA, Walonker AF, et al. Penetrating eye injuries in young children[J]. Retina, 1994, 14(3): 201-205. DOI: 10.1097/00006982-199414030-00003.
2.	Malagola R, Arrico L, Migliorini R, et al. Ocular traumatology in children. A retrospective study[J]. G Chir, 2012, 33(11-12): 423-428.
3.	Madhusudhan AP, Evelyn-Tai LM, Zamri N, et al. Open globe injury in hospital universiti sains malaysia: a 10-year review[J]. Int J Ophthalmol, 2014, 18, 7(3): 486-490. DOI: 10.3980/j.issn.2222-3959.2014.03.18.
4.	Narang S, Gupta V, Simalandhi P, et al. Paediatric open globe injuries. Visual outcome and risk factors for endophthalmitis[J]. Indian J Ophthalmol, 2004, 52(1): 29-34.
5.	Tok O, Tok L, Ozkaya D, et al. Epidemiological characteristics and visual outcome after open globe injuries in children[J]. J AAPOS, 2011, 15(6): 556-561. DOI: 10.1016/j.jaapos.2011.06.012.
6.	Knox FA, Chan WC, Jackson AJ, et al. A british ophthalmological surveillance unit study on serious ocular injuries from fireworks in the UK[J]. Eye (Lond), 2008, 22(7): 944-947. DOI: 10.1038/sj.eye.6702778.
7.	Choovuthayakorn J, Patikulsila P, Patikulsila D, et al. Characteristics and outcomes of pediatric open globe injury[J]. Int Ophthalmol, 2014, 34(4): 839-844. DOI: 10.1007/s10792-013-9890-8.
8.	Liu X, Liu Z, Liu Y, et al. Determination of visual prognosis in children with open globe injuries[J]. Eye (Lond), 2014, 28(7): 852-826. DOI: 10.1038/eye.2014.108.
9.	Gupta A, Rahman I, Leatherbarrow B. Open globe injuries in children: factors predictive of a poor final visual acuity[J]. Eye (Lond), 2009, 23(3): 621-625. DOI: 10.1038/eye.2008.32.
10.	Dulal S, Ale JB, Sapkota YD. Profile of pediatric ocular trauma in mid western hilly region of Nepal[J]. Nepal J Ophthalmol, 2012, 4(1): 134-137. DOI: 10.3126/nepjoph.v4i1.5865.
11.	Kadappu S, Silveira S, Martin F. Aetiology and outcome of open and closed globe eye injuries in children[J]. Clin Exp Ophthalmol, 2013, 41(5): 427-434. DOI: 10.1111/ceo.12034.
12.	Kanoff JM, Turalba AV, Andreoli MT, et al. Characteristics and outcomes of work-related open globe injuries[J]. Am J Ophthalmol, 2010, 150(2): 265-269. DOI: 10.1016/j.ajo.2010.02.015.
13.	Kelly SP, Reeves GM. Penetrating eye injuries from writing instruments[J]. Clin Ophthalmol, 2012, 6: 41-44. DOI: 10.2147/OPTH.S28342.
14.	El-Sebaity DM, Soliman W, Soliman AM, et al. Pediatric eye injuries in upper Egypt[J]. Clin Ophthalmol, 2011, 5: 1417-1423. DOI: 10.2147/OPTH.S24679.
15.	Chaudhary R, Upendran M, Campion N, et al. The role of computerised tomography in predicting visual outcome in ocular trauma patients[J]. Eye (Lond), 2015, 29(7): 867-871. DOI: 10.1038/eye.2015.39.
16.	Shazlee MK, Ali M, SaadAhmed M, et al. Diagnostic accuracy of ultrasound B scan using 10 MHz linear probe in ocular trauma; results from a high burden country[J]. Pak J Med Sci, 2016, 32(2): 385-388. DOI: 10.12669/pjms.322.9241.
17.	McWhae JA, Crichton AC, Rinke M. Ultrasound biomicroscopy for the assessment of zonules after ocular trauma[J]. Ophthalmology, 2003, 110(7): 1340-1343. DOI: 10.1016/S0161-6420(03)00464-0.
18.	Tabatabaei SA, Soleimani M, Etesali H, et al. Accuracy of swept-source optical coherence tomography and ultrasound biomicroscopy for evaluation of posterior lens capsule in traumatic cataract[J]. Am J Ophthalmol, 2020, 216: 55-58. DOI: 10.1016/j.ajo.2020.03.030.
19.	Li X, Zarbin MA, Bhagat N. Pediatric open globe injury: a review of the literature[J]. J Emerg Trauma Shock, 2015, 8(4): 216-223. DOI: 10.4103/0974-2700.166663.
20.	Bullock JD, Warwar RE. A system for classifying mechanical injuries of the eye (globe)[J]. Am J Ophthalmol, 1998, 125(4): 565-566. DOI: 10.1016/s0002-9394(99)80206-2.
21.	Shah MA, Shah SM, Applewar A, et al. Ocular trauma score: a useful predictor of visual outcome at six weeks in patients with traumatic cataract[J]. Ophthalmology, 2012, 119(7): 1336-1341. DOI: 10.1016/j.ophtha.2012.01.020.
22.	Unver YB, Acar N, Kapran Z, et al. Visual predictive value of the ocular trauma score in children[J]. Br J Ophthalmol, 2008, 92(8): 1122-1124. DOI: 10.1136/bjo.2007.131227.
23.	Acar DE, Burcu A, Ornek F. A new ocular trauma score in pediatric penetrating eye injuries[J]. Eye (Lond), 2011, 25(3): 370-374. DOI: 10.1038/eye.2010.211.
24.	Xue C, Yang LC, Kong YC. Application of pediatric ocular trauma score in pediatric open globe injuries[J]. Int J Ophthalmol, 2020, 18, 13(7): 1097-1101. DOI: 10.18240/ijo.2020.07.13.
25.	Andreoli CM, Andreoli MT, Kloek CE, et al. Low rate of endophthalmitis in a large series of open globe injuries[J]. Am J Ophthalmol, 2009, 147(4): 601-608. DOI: 10.1016/j.ajo.2008.10.023.
26.	Lee CH, Lee L, Kao LY, et al. Prognostic indicators of open globe injuries in children[J]. Am J Emerg Med, 2009, 27(5): 530-535. DOI: 10.1016/j.ajem.2008.04.004.
27.	陆骏麒. 开放性眼外伤患者玻璃体手术的时机选择[J]. 国际眼科杂志, 2016, 16(9): 1765-1767. DOI: 10.3980/j.issn.1672-5123.2016.9.46.Lu JQ. Opportunity of vitreous surgery in patients with open ocular trauma[J]. Int Eye Sci, 2016, 16(9): 1765-1767. DOI: 10.3980/j.issn.1672-5123.2016.9.46.
28.	Shah MA, Shah SM, Applewar A, et al. Ocular trauma score as a predictor of final visual outcomes in traumatic cataract cases in pediatric patients[J]. J Cataract Refract Surg, 2012, 38(6): 959-965. DOI: 10.1016/j.jcrs.2011.12.032.
29.	Kuhn F, Morris R, Witherspoon CD, et al. Epidemiology of blinding trauma in the United States Eye Injury Registry[J]. Ophthalmic Epidemiol, 2006, 13(3): 209-216. DOI: 10.1080/09286580600665886.
30.	丁法德, 张金嵩, 贾春琪, 等. 儿童眼外伤及其致盲特点[J]. 中华眼科杂志, 2002, 38(1): 49-50. DOI: 10.3760/j:issn:0412-4081.2002.01.016.Ding FD, Zhang JC, Jia CQ, et al. Ocular trauma and its blindness in children[J]. Chin J Ophthamol, 2002, 38(1): 49-50. DOI: 10.3760/j:issn:0412-4081.2002.01.016.
31.	杨晓慧, 曹木荣, 吴怡丹. 儿童眼外伤1126例临床分析[J]. 眼外伤职业眼病杂志, 2000, 22(4): 433-434. DOI: 10.3760/cma.j.issn.2095-1477.2000.04.040.Yang XH, Cao MR, Wu YD. Clinical analysis of 1126 cases of ocular trauma in children[J]. Chinese Journal of Ocular Trauma & Occupational Eye Disease, 2000, 22(4): 433-434. DOI: 10.3760/cma.j.issn.2095-1477.2000.04.040.
32.	李华, 宋胜仿, 张永烨, 等. 儿童眼外伤127例临床分析[J]. 国际眼科杂志, 2009, 9(11): 2209-2210. DOI: 10.3969/j.issn.1672-5123.2009.11.059.Li H. Song SF, Zhang YY, et al Clinical analysis of 127 cases of pediatric ocular trauma[J]. Int J Ophthalmol, 2009, 9(11): 2209-2210. DOI: 10.3969/j.issn.1672-5123.2009.11.059.
33.	罗蓉. 儿童眼外伤168例分析报告[J]. 眼外伤职业眼病杂志, 2005, 27(10): 780-781. DOI: 10.3760/cma.j.issn.2095-1477.2005.10.026.Luo R. Analysis report of 168 cases of children's ocular trauma[J]. Chinese Journal of Ocular Trauma & Occupational Eye Disease, 2005, 27(10): 780-781. DOI: 10.3760/cma.j.issn.2095-1477.2005.10.026.

1. Alfaro DV, Chaudhry NA, Walonker AF, et al. Penetrating eye injuries in young children[J]. Retina, 1994, 14(3): 201-205. DOI: 10.1097/00006982-199414030-00003.
2. Malagola R, Arrico L, Migliorini R, et al. Ocular traumatology in children. A retrospective study[J]. G Chir, 2012, 33(11-12): 423-428.
3. Madhusudhan AP, Evelyn-Tai LM, Zamri N, et al. Open globe injury in hospital universiti sains malaysia: a 10-year review[J]. Int J Ophthalmol, 2014, 18, 7(3): 486-490. DOI: 10.3980/j.issn.2222-3959.2014.03.18.
4. Narang S, Gupta V, Simalandhi P, et al. Paediatric open globe injuries. Visual outcome and risk factors for endophthalmitis[J]. Indian J Ophthalmol, 2004, 52(1): 29-34.
5. Tok O, Tok L, Ozkaya D, et al. Epidemiological characteristics and visual outcome after open globe injuries in children[J]. J AAPOS, 2011, 15(6): 556-561. DOI: 10.1016/j.jaapos.2011.06.012.
6. Knox FA, Chan WC, Jackson AJ, et al. A british ophthalmological surveillance unit study on serious ocular injuries from fireworks in the UK[J]. Eye (Lond), 2008, 22(7): 944-947. DOI: 10.1038/sj.eye.6702778.
7. Choovuthayakorn J, Patikulsila P, Patikulsila D, et al. Characteristics and outcomes of pediatric open globe injury[J]. Int Ophthalmol, 2014, 34(4): 839-844. DOI: 10.1007/s10792-013-9890-8.
8. Liu X, Liu Z, Liu Y, et al. Determination of visual prognosis in children with open globe injuries[J]. Eye (Lond), 2014, 28(7): 852-826. DOI: 10.1038/eye.2014.108.
9. Gupta A, Rahman I, Leatherbarrow B. Open globe injuries in children: factors predictive of a poor final visual acuity[J]. Eye (Lond), 2009, 23(3): 621-625. DOI: 10.1038/eye.2008.32.
10. Dulal S, Ale JB, Sapkota YD. Profile of pediatric ocular trauma in mid western hilly region of Nepal[J]. Nepal J Ophthalmol, 2012, 4(1): 134-137. DOI: 10.3126/nepjoph.v4i1.5865.
11. Kadappu S, Silveira S, Martin F. Aetiology and outcome of open and closed globe eye injuries in children[J]. Clin Exp Ophthalmol, 2013, 41(5): 427-434. DOI: 10.1111/ceo.12034.
12. Kanoff JM, Turalba AV, Andreoli MT, et al. Characteristics and outcomes of work-related open globe injuries[J]. Am J Ophthalmol, 2010, 150(2): 265-269. DOI: 10.1016/j.ajo.2010.02.015.
13. Kelly SP, Reeves GM. Penetrating eye injuries from writing instruments[J]. Clin Ophthalmol, 2012, 6: 41-44. DOI: 10.2147/OPTH.S28342.
14. El-Sebaity DM, Soliman W, Soliman AM, et al. Pediatric eye injuries in upper Egypt[J]. Clin Ophthalmol, 2011, 5: 1417-1423. DOI: 10.2147/OPTH.S24679.
15. Chaudhary R, Upendran M, Campion N, et al. The role of computerised tomography in predicting visual outcome in ocular trauma patients[J]. Eye (Lond), 2015, 29(7): 867-871. DOI: 10.1038/eye.2015.39.
16. Shazlee MK, Ali M, SaadAhmed M, et al. Diagnostic accuracy of ultrasound B scan using 10 MHz linear probe in ocular trauma; results from a high burden country[J]. Pak J Med Sci, 2016, 32(2): 385-388. DOI: 10.12669/pjms.322.9241.
17. McWhae JA, Crichton AC, Rinke M. Ultrasound biomicroscopy for the assessment of zonules after ocular trauma[J]. Ophthalmology, 2003, 110(7): 1340-1343. DOI: 10.1016/S0161-6420(03)00464-0.
18. Tabatabaei SA, Soleimani M, Etesali H, et al. Accuracy of swept-source optical coherence tomography and ultrasound biomicroscopy for evaluation of posterior lens capsule in traumatic cataract[J]. Am J Ophthalmol, 2020, 216: 55-58. DOI: 10.1016/j.ajo.2020.03.030.
19. Li X, Zarbin MA, Bhagat N. Pediatric open globe injury: a review of the literature[J]. J Emerg Trauma Shock, 2015, 8(4): 216-223. DOI: 10.4103/0974-2700.166663.
20. Bullock JD, Warwar RE. A system for classifying mechanical injuries of the eye (globe)[J]. Am J Ophthalmol, 1998, 125(4): 565-566. DOI: 10.1016/s0002-9394(99)80206-2.
21. Shah MA, Shah SM, Applewar A, et al. Ocular trauma score: a useful predictor of visual outcome at six weeks in patients with traumatic cataract[J]. Ophthalmology, 2012, 119(7): 1336-1341. DOI: 10.1016/j.ophtha.2012.01.020.
22. Unver YB, Acar N, Kapran Z, et al. Visual predictive value of the ocular trauma score in children[J]. Br J Ophthalmol, 2008, 92(8): 1122-1124. DOI: 10.1136/bjo.2007.131227.
23. Acar DE, Burcu A, Ornek F. A new ocular trauma score in pediatric penetrating eye injuries[J]. Eye (Lond), 2011, 25(3): 370-374. DOI: 10.1038/eye.2010.211.
24. Xue C, Yang LC, Kong YC. Application of pediatric ocular trauma score in pediatric open globe injuries[J]. Int J Ophthalmol, 2020, 18, 13(7): 1097-1101. DOI: 10.18240/ijo.2020.07.13.
25. Andreoli CM, Andreoli MT, Kloek CE, et al. Low rate of endophthalmitis in a large series of open globe injuries[J]. Am J Ophthalmol, 2009, 147(4): 601-608. DOI: 10.1016/j.ajo.2008.10.023.
26. Lee CH, Lee L, Kao LY, et al. Prognostic indicators of open globe injuries in children[J]. Am J Emerg Med, 2009, 27(5): 530-535. DOI: 10.1016/j.ajem.2008.04.004.
27. 陆骏麒. 开放性眼外伤患者玻璃体手术的时机选择[J]. 国际眼科杂志, 2016, 16(9): 1765-1767. DOI: 10.3980/j.issn.1672-5123.2016.9.46.Lu JQ. Opportunity of vitreous surgery in patients with open ocular trauma[J]. Int Eye Sci, 2016, 16(9): 1765-1767. DOI: 10.3980/j.issn.1672-5123.2016.9.46.
28. Shah MA, Shah SM, Applewar A, et al. Ocular trauma score as a predictor of final visual outcomes in traumatic cataract cases in pediatric patients[J]. J Cataract Refract Surg, 2012, 38(6): 959-965. DOI: 10.1016/j.jcrs.2011.12.032.
29. Kuhn F, Morris R, Witherspoon CD, et al. Epidemiology of blinding trauma in the United States Eye Injury Registry[J]. Ophthalmic Epidemiol, 2006, 13(3): 209-216. DOI: 10.1080/09286580600665886.
30. 丁法德, 张金嵩, 贾春琪, 等. 儿童眼外伤及其致盲特点[J]. 中华眼科杂志, 2002, 38(1): 49-50. DOI: 10.3760/j:issn:0412-4081.2002.01.016.Ding FD, Zhang JC, Jia CQ, et al. Ocular trauma and its blindness in children[J]. Chin J Ophthamol, 2002, 38(1): 49-50. DOI: 10.3760/j:issn:0412-4081.2002.01.016.
31. 杨晓慧, 曹木荣, 吴怡丹. 儿童眼外伤1126例临床分析[J]. 眼外伤职业眼病杂志, 2000, 22(4): 433-434. DOI: 10.3760/cma.j.issn.2095-1477.2000.04.040.Yang XH, Cao MR, Wu YD. Clinical analysis of 1126 cases of ocular trauma in children[J]. Chinese Journal of Ocular Trauma & Occupational Eye Disease, 2000, 22(4): 433-434. DOI: 10.3760/cma.j.issn.2095-1477.2000.04.040.
32. 李华, 宋胜仿, 张永烨, 等. 儿童眼外伤127例临床分析[J]. 国际眼科杂志, 2009, 9(11): 2209-2210. DOI: 10.3969/j.issn.1672-5123.2009.11.059.Li H. Song SF, Zhang YY, et al Clinical analysis of 127 cases of pediatric ocular trauma[J]. Int J Ophthalmol, 2009, 9(11): 2209-2210. DOI: 10.3969/j.issn.1672-5123.2009.11.059.
33. 罗蓉. 儿童眼外伤168例分析报告[J]. 眼外伤职业眼病杂志, 2005, 27(10): 780-781. DOI: 10.3760/cma.j.issn.2095-1477.2005.10.026.Luo R. Analysis report of 168 cases of children's ocular trauma[J]. Chinese Journal of Ocular Trauma & Occupational Eye Disease, 2005, 27(10): 780-781. DOI: 10.3760/cma.j.issn.2095-1477.2005.10.026.

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Correctly understanding the complexity of diagnosis and treatment of children's open ocular trauma to improve its diagnosis and treatment effect

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