Pattern of pediatric ocular trauma in a Eastern Uttar Pradesh

Introduction: Eye injuries are important leading cause of acquired unilateral blindness in paediatric age group. The burden and pattern of ocular trauma in Northern India are poorly known. The aim of this study was to assess the epidemiological characteristics, profile of trauma, clinical presentation and visual outcome in study subjects. Materials and Methods: Present hospital based, observational study was conducted over a period of three years at the Sir Sunderlal Hospital, Institute of Medical Science, Banaras Hindu University, Uttar Pradesh, India. This study includes patients who are ≤ 15 years of age fulfilling the various inclusion and exclusion criteria. All the patients underwent for detailed workup according to the protocol. The follow-up period was about 6 months. Data regarding demographic profile, injury profile, clinical presentation, treatment outcomes and prognostic factors were analysed. Results: Out of 402 total cases of ocular trauma meeting inclusion and exclusion criteria, 122 children ≤ 15 years of age were found as subjects for this study for which there were 77 (63.1%) boys and 45 (36.9%) girls. The ocular trauma was more prevalent (43.4%) in the age group of 11-15 years followed by 6-10 years of age group (36.9%). 84.4% of them were Hinduand 14.8% were Muslim. Majority (48.4%) of them belonged to rural background. The highest proportion of injuries occurred at home (48.4%) followed by school premises and playground (19.7% each). Maximum injury occurred during summer season (42.6%). Commonest non-occupational injury was sports related (58.2%) followed by domestic accidents (27%). Most common source of mechanical injury was vegetative materials / wooden objects (31.1%) followed by stone/brick (15.6%) and metallic objects (13.1%). Commonest non mechanical injury was cracker burn (10.66%). Only left eye was affected in 52.5%, right eye 40.2% while 7.4% had bilateral injury. 79.5% had isolated ocular injury rest had poly-trauma whereas out these, 49 (40.2%) & 42 (34.4%) were blunt object and sharp object. Of 131 injured eye 70 (53.4%) eyes had open globe injury. Most of the open globe injuries were in Zone-I (27.87%). 16 (13.1%) presented to hospital > 24 hours after injury. 54.10% were managed surgically and rest 41.80% were managed by conservative treatment. 65.6% children reported clinical improvement and 4.9% deteriorated while 24.6% were dropout cases. Conclusions: Children are more susceptible to ocular trauma. Male gender, teen age and rural background were determinants, associated with paediatric ocular trauma. Lack of regular follow-up indicates that need of awareness to be created among the parents, care takers and teachers. A safe environment should be maintained for children.