331 - Risk factors of pediatric ocular trauma related to ophthalmological complications in a Japanese pediatric emergency department

Saturday, April 29, 2023

3:30 PM – 6:00 PM ET

Poster Number: 331
Publication Number: 331.208

Takaaki Mori, KK Women's and Children's Hospital, Singapore, N/A, Singapore; Masakazu Kinoshita, Tokyo Metropolitan Children’s Medical Center, Fuchu, Tokyo, Japan; Takateru Ihara, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan

Presenting Author(s)

Takaaki Mori, MD

Resident physician
KK Women's and Children's Hospital
Singapore, Singapore

Background:

Ocular injury is a major complaint in the pediatric emergency department, which is the leading cause of monocular blindness in the pediatric population. A previous cohort study demonstrated that ocular injuries caused by a gun, piercing instrument, violence, or chemical/thermal objects carried a high risk of vision loss. However, in Japan, data on the characteristics of pediatric ocular trauma, its management in the pediatric emergency department, and types of injuries most likely to lead to ophthalmological complications are lacking.

Objective:

To investigate the risk factors of high-risk, pediatric, ocular injuries related to urgent ophthalmological complications.

Design/Methods:

The present retrospective observational study was conducted in a pediatric emergency department in Japan from March 2010 to March 2021. Patients younger than 16 years who presented to our emergency department (ED) with eye complaints and received the diagnosis of ocular trauma were enrolled. ED visits for follow-up examinations for the same complaint were excluded. The patients’ sex, age, arrival time, mechanism of injury, signs and symptoms, examinations, diagnosis, history of urgent ophthalmological consultation, outcomes, and ophthalmological complications were investigated. The primary endpoints were the odds ratio (OR) and 95% confidence interval (CI) of the incidence of ophthalmologic complications.

Results:

In total, 469 patients were analyzed. The median age was 7.3 years (interquartile range (IQR): 3.1-11.5 years), and males comprised 67.8% (318/469) of the cohort. The most common diagnosis was contusion at 79.3%, followed by lamellar laceration, and superficial foreign body at 11.7% and 0.9%, respectively. Seven patients (3.4%) had ophthalmological complications during follow-up. Bivariate analysis demonstrated that impact with a sharp object, animal-related injury, visual impairment, decreased visual acuity, and open globe injury were factors significantly associated with ophthalmological complications.

Conclusion(s):

Impact with a sharp object, animal-related injury, visual impairment, decreased visual acuity, and open globe injury were independent factors of ophthalmological complications. Therefore, pediatric emergency physicians need to be aware of these factors to optimize patient management.