Characteristics, Etiological Factors, and Visual Outcomes of Pediatric Open Globe Injuries in Central Saudi Arabia: A 22-Year Retrospective Study

Abstract

Purpose

To discuss the characteristics, etiological factors, and visual outcomes of open globe injuries (OGIs) in children at a tertiary eye hospital in Riyadh, Central Saudi Arabia.

Methods

This was a hospital-based cohort study conducted in 2021. Children aged ≤16 years with OGI based on the Birmingham Eye Trauma Terminology classification were included. The age, gender, type, cause of OGI, and vision were recorded, as well as uncorrected and best corrected visual acuity (UCVA and BCVA, respectively). There was a change in the UCVA and BCVA one year after management. BCVA following management was linked to a variety of factors.

Results

There were 664 eyes with OGI. [median age 5.1, 461 (69.6%) boys]. UCVA at presentation was <20/400 in 525 (79%) of eyes with OGI. Injuries were mainly due to metallic objects in 195 (29.4%), glass in 102 (15.4%), and fireworks in 62 (9.4%). The Change in visual impairment grade in UCVA and BCVA after management compared to the initial presentation was significant (p < 0.001). Improvement of two lines of BCVA was noted in 345 (52%), no change in (<± 2 lines) 299 (45%) and deteriorated in 10 (1.5%).

Conclusion

OGI was identified as a leading cause of unilateral blindness. Children with OGIs who receive standard treatment have better outcomes. Many children could not achieve normal, functional vision despite the intervention of skilled care providers.

Keywords:

• child
• injuries
• ocular
• pediatrics
• trauma

Abbreviations

OGI, Open Global Injury; UCVA, Uncorrected Visual Acuity; BCVA, Best Corrected Visual Acuity; NLP, No Light Perception; SPSS, Statistical Package for Social Sciences; SVI, Severe Visual Impairment; RTA, Road Traffic Accident.

Ethical Statement

This study was authorized by the King Khaled Eye Specialist Hospital’s local ethical board and followed the Helsinki Declaration’s tenets. All participants’ parents/guardians have provided written informed consent for their children to participate in this study.

Acknowledgments

The abstract of this paper was presented at the ARVO 2023 Annual Meeting as a poster presentation with interim findings. The poster’s abstract was published in “Poster Abstracts” in Investigative Ophthalmology & Visual Science June 2023, Vol.64.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis, and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This manuscript received no funding.