• Trends in Traumatic Pediatric Acute Ocular Injury

    By Lynda Seminara
    Selected By: Neil M. Bressler, MD, and Deputy Editors

    Journal Highlights

    JAMA Ophthalmology, August 2018

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    Understanding national trends in pe­diatric eye injury may guide efforts to prevent ocular trauma.

    Focusing on mechanisms of injury and their association with demographic factors and the risk of vision loss, Matsa et al. reviewed prevalence data and noted trends for a 9-year span. During that period, the rate of pediatric ocular injuries associated with visits to the emergency department (ED) de­creased substantially and was consistent among demographic characteristics, patterns of injury, and vision-loss risk categories.

    For their research, the authors used a stratified U.S. sample of data from ED visits for acute traumatic ocular injury, occurring from 2006 through 2014. The study cohort consisted of 376,040 patients from birth to 17 years of age. Collected data included demographic and clinical characteristics. Temporal trends were explored and compared, including the incidence of ocular injury, risk of vision loss, and mechanism of injury.

    Diagnoses were assigned to 1 of 3 risk categories for vision loss, depend­ing on the injury location: high risk (pathognomonic), variable risk (need for injury monitoring), or low risk (vision sparing was anticipated). Data analysis was completed in 2018.

    Between 2006 and 2014, the propor­tion of pediatric acute ocular injuries presenting to EDs declined by 26.1% and was similar across demographic variables, injury patterns, categories of vision-loss risk, and most mechanisms of injury.

    Among injuries with a high risk of vision loss, the greatest declines were observed for motor vehicle trau­ma (−79.8%) and gunshot wounds (−68.5%). Injured children were more often male (63%) and in the youngest age group (birth to 4 years: 35.3%). In­juries commonly resulted from a strike to the eye (22.5%) and affected the adnexa (43.7%). Most injuries (84.2%) were low risk for vision loss; only 1.3% were high risk. Types of injury that in­creased during the study span involved sports (+12.8%) or household/domes­tic activities (+20.7%).

    The authors suggest further inves­tigation to pinpoint the initiatives that may be contributing to the observed decline in pediatric ocular injury and to identify interventions to reduce the most common injuries and those with high risk of visual impairment.

    The original article can be found here.